Psychedelic therapy for depressive symptoms: A systematic review and meta-analysis
Cleare, A. J., Ko, K., Kopra, E., Rucker, J.
This meta-analysis (s=6) explored the therapeutic effects of psilocybin, LSD and ayahuasca on depressive symptoms in the clinical setting. When administered with psychological support, all psychedelics led to significant reductions in depressive symptoms at all measured timepoints (1-day, 1-week, 3-5 weeks, and 6-8 weeks). Some limitations include the small sample sizes used in most individual studies and the use of a cross-over design for long-term follow-up, which made it difficult to include those results in the meta-analysis.
Abstract
Background: Psychedelic therapy shows promise for Major Depressive Disorder, especially when treatment-resistant, as well as life-threatening illness distress. The objective of this systematic review, inclusive of meta-analysis, is to examine recent clinical research on the therapeutic effects of classic psychedelics on depressive symptoms.Methods: Fourteen psychedelic therapy studies, utilising psilocybin, ayahuasca, or LSD, were systematically reviewed. For the meta-analysis, standardised mean differences were calculated for six randomised controlled trials.Results: The systematic review indicated significant short- and long-term reduction of depressive symptoms in all conditions studied after administration of psilocybin, ayahuasca, or LSD, with psychological support. In the meta-analysis, symptom reduction was significantly indicated in three time points out of four, including 1-day, 1-week, and 3-5 weeks, supporting the results of the systematic review, with the exception of the 6-8 weeks follow-up point which was less conclusive.Limitations: The absence of required data for 2 studies necessitated the less precise use of graphical extraction and imputation. The small sample size in all but one study negatively affected the statistical power. None of the studies had long-term follow-up without also utilising the cross-over method, which did not allow for long-term results to be included in the meta-review.Conclusions: This review indicates an association between psychedelic therapy and a significant reduction of depressive symptoms at several time points. However, the small number of studies, and low sample sizes, calls for careful interpretation of results. This suggests the need for more randomised clinical trials of psychedelic therapy, with larger and more diverse samples.