On the Relationship between Classic Psychedelics and Suicidality: A Systematic Review
This review (2021; 64 studies) investigated the literature and found no clear relationship (finding correlation both ways, and non-significant results) between non-clinical use of psychedelics and suicidality. There is preliminary evidence for acute and sustained decreases in suicidality after psychedelic therapy.
Authors
- Richard Zeifman
- Cory Ross Weissman
Published
Abstract
Use of classic psychedelics (e.g., psilocybin, ayahuasca, and lysergic acid diethylamide) is increasing, and psychedelic therapy is receiving growing attention as a novel mental health intervention. Suicidality remains a potential safety concern associated with classic psychedelics and is, concurrently, a mental health concern that psychedelic therapy may show promise in targeting. Accordingly, further understanding of the relationship between classic psychedelics and suicidality is needed. Therefore, we conducted a systematic review of the relationship between classic psychedelics (both non-clinical psychedelic use and psychedelic therapy) and suicidality. We identified a total of 64 articles, including 41 articles on the association between non-clinical classic psychedelic use and suicidality and 23 articles on the effects of psychedelic therapy on suicidality. Findings on the association between lifetime classic psychedelic use and suicidality were mixed, with studies finding positive, negative, and no significant association. A small number of reports of suicide and decreased suicidality following non-clinical classic psychedelic use were identified. Several cases of suicide in early psychedelic therapy were identified; however, it was unclear whether this was due to psychedelic therapy itself. In recent psychedelic therapy clinical trials, we found no reports of increased suicidality and preliminary evidence for acute and sustained decreases in suicidality following treatment. We identify some remaining questions and provide suggestions for future research on the association between classic psychedelics and suicidality.
Research Summary of 'On the Relationship between Classic Psychedelics and Suicidality: A Systematic Review'
Introduction
Earlier research on classic psychedelics (for example psilocybin, ayahuasca, and LSD) presents a mixed picture regarding their relationship with suicidality. Some epidemiological and case-based reports have suggested increased suicidal ideation or behaviour following use, while other studies — including more recent cohort work and clinical investigations of psychedelic therapy — have suggested potential protective or therapeutic effects. Heterogeneity in samples (adolescents versus nationally representative adults), varying control for confounders (such as other substance use and psychiatric history), and differences in context (recreational, ceremonial, or clinical) have contributed to these conflicting findings. To address this uncertainty, Zeifman and colleagues conducted a systematic review to synthesise available evidence on the association between classic psychedelics and suicidality. The review considered both non-clinical (recreational or ceremonial) psychedelic use and psychedelic therapy in clinical settings, with the aim of clarifying whether classic psychedelics are linked to increased suicide risk, decreased suicidality, or show no clear association, and to highlight gaps for future research. The authors frame the work as timely given rising lifetime use of psychedelics and ongoing interest in psychedelic therapy as a novel psychiatric intervention.
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Zeifman, R. J., Singhal, N., Breslow, L., & Weissman, C. R. (2021). On the Relationship between Classic Psychedelics and Suicidality: A Systematic Review. ACS Pharmacology & Translational Science, 4(2), 436-451. https://doi.org/10.1021/acsptsci.1c00024
References (44)
Papers cited by this study that are also in Blossom
Nichols, D. E. · Pharmacological Reviews (2016)
Nour, M. R., Carhart-Harris, R. L. · British Journal of Psychiatry (2017)
Carhart-Harris, R. L., Erritzoe, D., Haijen, E. C. H. M. et al. · Psychopharmacology (2017)
Richards, W. A., Garcia-Romeu, A. · International Review of Psychiatry (2018)
Johnson, M. W., Richards, W. A., Griffiths, R. R. · Journal of Psychopharmacology (2008)
Yockey, R. A., King, K. A. · Journal of Psychedelic Studies (2021)
Nutt, D. J., Erritzoe, D., Carhart-Harris, R. L. · Cell (2020)
Hendricks, P. S., Thorne, C. B., Clark, B. et al. · Journal of Psychopharmacology (2015)
Martinotti, G., Santacroce, R., Pettorruso, M. et al. · Brain Sciences (2018)
Argento, E., Strathdee, S. A., Tupper, K. et al. · BMJ Open (2017)
Show all 44 referencesShow fewer
Johansen, P. Ø., Krebs, T. S. · Journal of Psychopharmacology (2015)
Andersen, K. A. A., Carhart-Harris, R. L., Nutt, D. J. et al. · Acta Psychiatrica Scandinavica (2020)
Carhart-Harris, R. L., Bolstridge, &. M., Day, C. M. J. et al. · Psychopharmacology (2017)
Palhano-Fontes, F., Barreto, D., Onias, H. et al. · Psychological Medicine (2018)
Sanches, R. F., Osório, F. L., Dos Santos, R. G. et al. · Journal of Clinical Psychopharmacology (2016)
Griffiths, R. R., Johnson, M. W. · Journal of Psychopharmacology (2016)
Ross, S., Bossis, A. P., Guss, J. et al. · Journal of Psychopharmacology (2016)
Bogenschutz, M. P., Forcehimes, A. A., Pommy, J. A. et al. · Journal of Psychopharmacology (2015)
Krebs, T. S., Johansen, P. Ø. · Journal of Psychopharmacology (2012)
Johnson, M. W., Garcia-Romeu, A., Cosimano, M. P. et al. · Journal of Psychopharmacology (2014)
Johnson, M. W., Garcia-Romeu, A., Griffiths, R. R. · The American Journal of Drug and Alcohol Abuse (2016)
Moreno, F. A., Wiegand, C. B., Taitano, E. K. et al. · Journal of Clinical Psychiatry (2006)
Araújo, D. B., Zeifman, R. J., Palhano-Fontes, F. et al. · Frontiers in Pharmacology (2019)
Zeifman, R. J., Dos Santos, R. G., Sanches, R. F. et al. · Psychopharmacology (2020)
Davis, A. K., Averill, L. A., Sepeda, N. D. et al. · Chronic Stress (2020)
Zeifman, R. J., Wagner, A. C., Watts, R. et al. · Frontiers in Psychiatry (2020)
Hendricks, P. S., Johnson, M. W., Griffiths, R. R. · Journal of Psychopharmacology (2015)
Jiménez-Garrido, D. F., Gómez-Sousa, M., Ona, G. et al. · Scientific Reports (2020)
Carbonaro, T. M., Bradstreet, M. P., Barrett, F. S. et al. · Journal of Psychopharmacology (2016)
Kirchner, K. · Journal of Psychopharmacology (2014)
Anderson, B. T., Danforth, A. L., Daroff, R. et al. · EClinicalMedicine (2020)
Osório, F. L., Sanches, R. F., Macedo, L. et al. · brazilian Journal of Psychiatry (2015)
Cohen, S. · Journal of Nervous and Mental Disease (1980)
Johnson, M. W., Griffiths, R. R., Hendricks, P. S. et al. · Neuropharmacology (2018)
Ballard, E. D., Luckenbaugh, D. A., Walls, T. S. et al. · Journal of Psychiatric Research (2015)
Carhart-Harris, R. L., Roseman, L., Haijen, E. C. H. M. et al. · Journal of Psychopharmacology (2018)
Davis, A. K., Streeter Barrett, F., Griffiths, R. R. et al. · Journal of Psychopharmacology (2021)
Roseman, L., Haijen, E. C. H. M., Idialu-Ikato, K. et al. · Journal of Psychopharmacology (2019)
Carhart-Harris, R. L., Friston, K. J. · Pharmacological Reviews (2019)
Inserra, A., De Gregorio, D., Gobbi, G. · Pharmacological Reviews (2021)
Ly, C., Greb, A. C., Cameron, L. P. et al. · Cell Reports (2018)
Olson, J. A. · Neuroscience Insights (2018)
Carhart-Harris, R. L. · Neuropharmacology (2018)
Vollenweider, F. X., Preller, K. H. · Nature Reviews Neuroscience (2020)
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