The Role of Music in Psychedelic-Assisted Therapy: A Comparative Analysis of Neuroscientific Research, Indigenous Entheogenic Ritual, and Contemporary Care Models

Studies dating back to the 1950s and more recent participant reports indicate that music is a central component of both traditional entheogenic ceremonies and contemporary psychedelic‑assisted therapies (PAT). Earlier research and clinical practice suggest music helps create a safe, supportive environment, facilitates emotional processing and self‑reflection, influences meaning‑making, and can shape sustained behavioural change after treatment. Despite a broad literature across neuroscience, psychology, anthropology and music therapy about music's general therapeutic roles, the authors note a relative paucity of focused scientific work that describes how music specifically contributes to clinical outcomes in PAT and how indigenous musical practices might inform contemporary care models. Argot and colleagues set out to evaluate interdisciplinary evidence on music in the context of psychedelic use: neuroscientific and psychological studies of music perception and brain effects, empirical findings on music paired with psychedelics in research settings, and anthropological accounts of music’s role in indigenous entheogenic ritual. The review aims to identify convergences and gaps between traditional practices and contemporary protocols, to highlight candidate principles for music curation in PAT, and to flag ethical considerations around translating indigenous music into clinical contexts.

Overview of psychedelic treatments and outcome signals: The review summarises evidence that psychedelics (plant‑derived and synthetic) have been studied for a range of mental health conditions including depression, PTSD, anxiety, obsessive‑compulsive disorder, substance misuse, and cancer‑related distress. Mechanistically, many classical psychedelics act via serotonin (5‑HT) receptors, with growing literature on downstream effects including dopaminergic and glutamatergic pathways and markers of neuroplasticity. Clinical signals cited in the paper include examples such as MDMA‑assisted psychotherapy for PTSD showing larger effects than psychotherapy alone and SSRIs (reported as two times and four times more effective respectively in the extracted text), and psilocybin demonstrating efficacy in treatment‑resistant depression in early studies. Neurobiological and psychological effects of music: Neuroscience studies reported in the review indicate that music activates auditory, motor and prefrontal cortices and engages limbic structures (amygdala, hippocampus, orbitofrontal cortex) implicated in emotion and reward. Functional imaging links personally meaningful music to increased connectivity between auditory regions and reward networks (nucleus accumbens, ventral tegmental area) and implicates serotoninergic signalling in modulating music perception, memory and emotional salience. Behavioural and clinical summaries include a paediatric systematic review of 29 studies (5,468 participants total; 2,693 intervention, 2,775 control) showing improvements in executive functions with music training, and a systematic review of 25 studies in neurological patients reporting mood and behavioural benefits. A cited meta‑analysis of 39 randomised music‑therapy trials found recreative music therapy and guided imagery with music superior for reducing depression relative to other music methods; music listening also reduced depressive symptoms in adults with effect sizes that depend on genre alignment with listener preferences. Music in PAT protocols and phenomenology: The authors synthesise evidence that music is a persistent element of PAT protocols, typically delivered as curated playlists during sessions while patients lie down and undergo guided psychotherapy. Studies since the 1970s and recent research associate music with enhanced emotion processing, meaning‑making, mental imagery and tolerability; music may act simultaneously as an anchor (grounding) and a propeller (driving affective exploration). Music can facilitate mystical‑type experiences, which predict longer‑term therapeutic benefit. A psilocybin study is highlighted in which participants’ appraisal of music as “welcome” or “unwelcome” predicted reductions in depressive symptoms the week after treatment, whereas drug intensity did not predict this outcome in the same way. Indigenous musical practices and characteristics: Ethnographic material reviewed shows diverse traditional repertoires that play defined roles in entheogenic ritual. Peruvian Icaros are described as monophonic, repetitive melodies with accompanying rattling and vibrational sounds; they are used in ayahuasca ceremonies to create a sense of safety, attune to subconscious material, and guide the trance, with rhythmic elements that parallel theta‑range neural oscillations. Accounts from Colombia, the Brazilian Amazon (Suyá), and Wixárika peyote chants illustrate music’s use to evoke shared visionary content, anchor participants to a sense of place, and structure sacred journeys. Traditional music is framed as ritual technology with healers seen as crucial performers. Translation to contemporary practice and ethical issues: The review documents contemporary adaptations of traditional repertoires (for example, instrument changes and interethnic musical exchanges) and suggests possible ways to incorporate indigenous principles into PAT—such as creating new compositions inspired by, but not replicating, ceremonial music and ensuring attribution and permission. The authors flag risks of extractive practices and cultural appropriation, and they emphasise the need for consultation, community partnership and culturally accurate translation when engaging with indigenous knowledge. Gaps and future research directions: Key gaps identified include a lack of standardised, evidence‑based music protocols tailored to different medicines and indications, scarce empirical work on music used in post‑session integration, limited research comparing music types across psychedelic compounds, and concerns over homogeneous trial populations lacking diversity. The review also notes that much current guidance about pairing music genres with substances (for example, ambient music with psilocybin, rhythmic/upbeat music with MDMA) is anecdotal rather than empirically validated.

Argot and colleagues interpret the assembled literature to conclude that music is a fundamental, polyvalent component of both traditional entheogenic ritual and contemporary PAT. Neuroscientific, psychological and anthropological lines of evidence are presented as mutually reinforcing: music engages brain networks that support emotion, reward and meaning, and traditional practices show how curated soundscapes are used deliberately to shape communal and individual healing journeys. The authors argue that, given these convergences, music should be treated as an imperative part of PAT design rather than an ancillary element. They caution, however, that important uncertainties remain. The review highlights the need for more rigorous, large‑scale and diverse research to define optimal musical features, to test specific music therapy modalities in PAT settings, and to evaluate music as a tool for integration and long‑term outcome maintenance. Ethical limitations are emphasised: historical extractivism and power imbalances require researchers and clinicians to avoid cultural appropriation, to seek permission and partnership when borrowing from indigenous repertoires, and to develop culturally respectful hybrid protocols when appropriate. For practice and future research, the authors propose directions including development of personalised music curation that attends to a medicine’s phenomenology and a participant’s preferences, use of technology and real‑world data to categorise musical features (tones, resonance, frequencies) by indication and compound, and deliberate efforts to increase participant diversity. They conclude by urging clinicians, researchers and advocates to investigate music’s role in PAT more systematically and ethically, and to recognise musical interventions as central to the psychedelic therapeutic process rather than peripheral.