Therapeutic effect of psilocybin in addiction: A systematic review
BackgroundPsychedelic-assisted therapy [e.g., with lysergic acid diethylamide (LSD)] has shown promising results as treatment for substance use disorders (SUDs). Previous systematic reviews assessing the efficacy of psilocybin in SUDs only included clinical trials conducted in the last 25 years, but...
| Main Authors: | , , , , , , , , , , |
|---|---|
| Format: | Article |
| Language: | English |
| Published: |
Frontiers Media S.A.
2023-02-01
|
| Series: | Frontiers in Psychiatry |
| Subjects: | |
| Online Access: | https://www.frontiersin.org/articles/10.3389/fpsyt.2023.1134454/full |
| _version_ | 1811168346215809024 |
|---|---|
| author | Pim B. van der Meer Pim B. van der Meer Juan J. Fuentes Juan J. Fuentes Juan J. Fuentes Ad A. Kaptein Jan W. Schoones Marleen M. de Waal Marleen M. de Waal Marleen M. de Waal Anneke E. Goudriaan Anneke E. Goudriaan Anneke E. Goudriaan Kees Kramers Arnt Schellekens Arnt Schellekens Metten Somers Matthijs G. Bossong Albert Batalla |
| author_facet | Pim B. van der Meer Pim B. van der Meer Juan J. Fuentes Juan J. Fuentes Juan J. Fuentes Ad A. Kaptein Jan W. Schoones Marleen M. de Waal Marleen M. de Waal Marleen M. de Waal Anneke E. Goudriaan Anneke E. Goudriaan Anneke E. Goudriaan Kees Kramers Arnt Schellekens Arnt Schellekens Metten Somers Matthijs G. Bossong Albert Batalla |
| author_sort | Pim B. van der Meer |
| collection | DOAJ |
| description | BackgroundPsychedelic-assisted therapy [e.g., with lysergic acid diethylamide (LSD)] has shown promising results as treatment for substance use disorders (SUDs). Previous systematic reviews assessing the efficacy of psilocybin in SUDs only included clinical trials conducted in the last 25 years, but they may have missed clinical trials assessing the efficacy of psilocybin that were conducted before the 1980s, given much research has been done with psychedelics in the mid-20th century. In this systematic review, we specifically assessed the efficacy of psilocybin in patients with a SUD or non-substance-related disorder with no publication date restrictions in our search strategy.MethodsA systematic literature search was performed according to Preferred Reporting Items for Systematic reviews and Meta-Analysis (PRISMA) guidelines from the earliest published manuscript up to September 2, 2022, in seven electronic databases, including clinical trials in patients with a SUD or non-substance-related disorder evaluating the efficacy of psilocybin.ResultsA total of four studies (six articles, of which two articles were long-term follow-up results from the same trial) were included in this systematic review. Psilocybin-assisted therapy was administered to n = 151 patients in a dose ranging from 6 to 40 mg. Three studies focused on alcohol use disorder, and one study on tobacco use disorder. In a pilot study (n = 10), the percentage of heavy drinking days decreased significantly between baseline and weeks 5–12 (mean difference of 26.0, 95% CI = 8.7–43.2, p = 0.008). In another single-arm study (n = 31), 32% (10/31) became completely abstinent from alcohol (mean duration of follow-up 6 years). In a double-blind, placebo-controlled randomized controlled trial (RCT, n = 95), the percentage of heavy drinking days during the 32-week double-blind period was significantly lower for psilocybin compared to placebo (mean difference of 13.9, 95% CI = 3.0–24.7, p = 0.01). In a pilot study (n = 15), the 7-day point prevalence of smoking abstinence at 26 weeks was 80% (12/15), and at 52 weeks 67% (10/15).ConclusionOnly one RCT and three small clinical trials were identified assessing the efficacy of psilocybin combined with some form of psychotherapy in patients with alcohol and tobacco use disorder. All four clinical trials indicated a beneficial effect of psilocybin-assisted therapy on SUD symptoms. Larger RCTs in patients with SUDs need to evaluate whether psilocybin-assisted therapy is effective in patients with SUD. |
| first_indexed | 2024-04-10T16:25:51Z |
| format | Article |
| id | doaj.art-74c791288fde47c0b7651a989884b45c |
| institution | Directory Open Access Journal |
| issn | 1664-0640 |
| language | English |
| last_indexed | 2024-04-10T16:25:51Z |
| publishDate | 2023-02-01 |
| publisher | Frontiers Media S.A. |
| record_format | Article |
| series | Frontiers in Psychiatry |
| spelling | doaj.art-74c791288fde47c0b7651a989884b45c2023-02-09T06:36:28ZengFrontiers Media S.A.Frontiers in Psychiatry1664-06402023-02-011410.3389/fpsyt.2023.11344541134454Therapeutic effect of psilocybin in addiction: A systematic reviewPim B. van der Meer0Pim B. van der Meer1Juan J. Fuentes2Juan J. Fuentes3Juan J. Fuentes4Ad A. Kaptein5Jan W. Schoones6Marleen M. de Waal7Marleen M. de Waal8Marleen M. de Waal9Anneke E. Goudriaan10Anneke E. Goudriaan11Anneke E. Goudriaan12Kees Kramers13Arnt Schellekens14Arnt Schellekens15Metten Somers16Matthijs G. Bossong17Albert Batalla18Department of Neurology, Leiden University Medical Center, Leiden, NetherlandsDepartment of Psychiatry, University Medical Center Utrecht Brain Center, University Medical Center Utrecht, Utrecht, NetherlandsAddiction Program, Institute of Neuropsychiatry and Addictions (INAD), Hospital del Mar, Barcelona, SpainAddiction Research Group, IMIM Hospital del Mar Medical Research Institute, Barcelona, SpainDepartment of Psychiatry and Legal Medicine, Universitat Autònoma de Barcelona, Cerdanyola del Vallés, SpainDepartment of Medical Psychology, Leiden University Medical Center, Leiden, NetherlandsDirectorate of Research Policy, Leiden University Medical Center, Leiden, NetherlandsDepartment of Research and Jellinek, Arkin Mental Health Care, Amsterdam, NetherlandsDepartment of Psychiatry, Amsterdam University Medical Center, Amsterdam, Netherlands0Amsterdam Institute for Addiction Research, Amsterdam University Medical Center, Amsterdam, NetherlandsDepartment of Research and Jellinek, Arkin Mental Health Care, Amsterdam, NetherlandsDepartment of Psychiatry, Amsterdam University Medical Center, Amsterdam, Netherlands0Amsterdam Institute for Addiction Research, Amsterdam University Medical Center, Amsterdam, Netherlands1Department of Pharmacology-Toxicology, Radboud University Medical Center, Nijmegen, Netherlands2Nijmegen Institute for Science Practitioners in Addiction (NISPA), Nijmegen, Netherlands3Department of Psychiatry, Radboud University Medical Center, Nijmegen, NetherlandsDepartment of Psychiatry, University Medical Center Utrecht Brain Center, University Medical Center Utrecht, Utrecht, NetherlandsDepartment of Psychiatry, University Medical Center Utrecht Brain Center, University Medical Center Utrecht, Utrecht, NetherlandsDepartment of Psychiatry, University Medical Center Utrecht Brain Center, University Medical Center Utrecht, Utrecht, NetherlandsBackgroundPsychedelic-assisted therapy [e.g., with lysergic acid diethylamide (LSD)] has shown promising results as treatment for substance use disorders (SUDs). Previous systematic reviews assessing the efficacy of psilocybin in SUDs only included clinical trials conducted in the last 25 years, but they may have missed clinical trials assessing the efficacy of psilocybin that were conducted before the 1980s, given much research has been done with psychedelics in the mid-20th century. In this systematic review, we specifically assessed the efficacy of psilocybin in patients with a SUD or non-substance-related disorder with no publication date restrictions in our search strategy.MethodsA systematic literature search was performed according to Preferred Reporting Items for Systematic reviews and Meta-Analysis (PRISMA) guidelines from the earliest published manuscript up to September 2, 2022, in seven electronic databases, including clinical trials in patients with a SUD or non-substance-related disorder evaluating the efficacy of psilocybin.ResultsA total of four studies (six articles, of which two articles were long-term follow-up results from the same trial) were included in this systematic review. Psilocybin-assisted therapy was administered to n = 151 patients in a dose ranging from 6 to 40 mg. Three studies focused on alcohol use disorder, and one study on tobacco use disorder. In a pilot study (n = 10), the percentage of heavy drinking days decreased significantly between baseline and weeks 5–12 (mean difference of 26.0, 95% CI = 8.7–43.2, p = 0.008). In another single-arm study (n = 31), 32% (10/31) became completely abstinent from alcohol (mean duration of follow-up 6 years). In a double-blind, placebo-controlled randomized controlled trial (RCT, n = 95), the percentage of heavy drinking days during the 32-week double-blind period was significantly lower for psilocybin compared to placebo (mean difference of 13.9, 95% CI = 3.0–24.7, p = 0.01). In a pilot study (n = 15), the 7-day point prevalence of smoking abstinence at 26 weeks was 80% (12/15), and at 52 weeks 67% (10/15).ConclusionOnly one RCT and three small clinical trials were identified assessing the efficacy of psilocybin combined with some form of psychotherapy in patients with alcohol and tobacco use disorder. All four clinical trials indicated a beneficial effect of psilocybin-assisted therapy on SUD symptoms. Larger RCTs in patients with SUDs need to evaluate whether psilocybin-assisted therapy is effective in patients with SUD.https://www.frontiersin.org/articles/10.3389/fpsyt.2023.1134454/fullpsilocybinhallucinogenssubstance-related disorderssubstance abusedrug addictionpsychotherapy |
| spellingShingle | Pim B. van der Meer Pim B. van der Meer Juan J. Fuentes Juan J. Fuentes Juan J. Fuentes Ad A. Kaptein Jan W. Schoones Marleen M. de Waal Marleen M. de Waal Marleen M. de Waal Anneke E. Goudriaan Anneke E. Goudriaan Anneke E. Goudriaan Kees Kramers Arnt Schellekens Arnt Schellekens Metten Somers Matthijs G. Bossong Albert Batalla Therapeutic effect of psilocybin in addiction: A systematic review Frontiers in Psychiatry psilocybin hallucinogens substance-related disorders substance abuse drug addiction psychotherapy |
| title | Therapeutic effect of psilocybin in addiction: A systematic review |
| title_full | Therapeutic effect of psilocybin in addiction: A systematic review |
| title_fullStr | Therapeutic effect of psilocybin in addiction: A systematic review |
| title_full_unstemmed | Therapeutic effect of psilocybin in addiction: A systematic review |
| title_short | Therapeutic effect of psilocybin in addiction: A systematic review |
| title_sort | therapeutic effect of psilocybin in addiction a systematic review |
| topic | psilocybin hallucinogens substance-related disorders substance abuse drug addiction psychotherapy |
| url | https://www.frontiersin.org/articles/10.3389/fpsyt.2023.1134454/full |
| work_keys_str_mv | AT pimbvandermeer therapeuticeffectofpsilocybininaddictionasystematicreview AT pimbvandermeer therapeuticeffectofpsilocybininaddictionasystematicreview AT juanjfuentes therapeuticeffectofpsilocybininaddictionasystematicreview AT juanjfuentes therapeuticeffectofpsilocybininaddictionasystematicreview AT juanjfuentes therapeuticeffectofpsilocybininaddictionasystematicreview AT adakaptein therapeuticeffectofpsilocybininaddictionasystematicreview AT janwschoones therapeuticeffectofpsilocybininaddictionasystematicreview AT marleenmdewaal therapeuticeffectofpsilocybininaddictionasystematicreview AT marleenmdewaal therapeuticeffectofpsilocybininaddictionasystematicreview AT marleenmdewaal therapeuticeffectofpsilocybininaddictionasystematicreview AT annekeegoudriaan therapeuticeffectofpsilocybininaddictionasystematicreview AT annekeegoudriaan therapeuticeffectofpsilocybininaddictionasystematicreview AT annekeegoudriaan therapeuticeffectofpsilocybininaddictionasystematicreview AT keeskramers therapeuticeffectofpsilocybininaddictionasystematicreview AT arntschellekens therapeuticeffectofpsilocybininaddictionasystematicreview AT arntschellekens therapeuticeffectofpsilocybininaddictionasystematicreview AT mettensomers therapeuticeffectofpsilocybininaddictionasystematicreview AT matthijsgbossong therapeuticeffectofpsilocybininaddictionasystematicreview AT albertbatalla therapeuticeffectofpsilocybininaddictionasystematicreview |