The Impact of Psilocybin on Patients Experiencing Psychiatric Symptoms: A Systematic Review of Randomized Clinical Trials

Waguih William IsHak; Paloma Garcia; Rachel Pearl; Jonathan Dang; Catherine William; Jayant Totlani; Itai Danovitch

The Impact of Psilocybin on Patients Experiencing Psychiatric Symptoms: A Systematic Review of Randomized Clinical Trials

Innov Clin Neurosci. 2023 Spring;20(4-6):39-48.

Authors

Waguih William IsHak^{1

2}, Paloma Garcia³, Rachel Pearl¹, Jonathan Dang¹, Catherine William¹, Jayant Totlani⁴, Itai Danovitch¹

Affiliations

¹ Drs. IsHak, Pearl, Dang, and Danovitch and Ms. William are with Cedars-Sinai Medical Center in Los Angeles, California.
² Dr. IsHak is also with David Geffen School of Medicine at the University of California, Los Angeles in Los Angeles, California.
³ Ms. Garcia is with Brown University.
⁴ Mr. Totlani is with Western University of Health Sciences in Pomona, California.

PMID: 37387703
PMCID: PMC10306375

Abstract

Objective: This systematic review aims to evaluate the impact of psilocybin on patients experiencing psychiatric symptoms, with a focus on health-related quality of life (HRQoL) and safety.

Method of research: Following the Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) guidelines, we searched the PubMed database and identified studies published from January 2011 to December 2021 pertaining to the impact of psilocybin on psychiatric symptoms. Two authors independently conducted a focused analysis and reached a final consensus on five studies meeting the specific selection criteria. Study bias was addressed using the Cochrane risk of bias tool.

Results: The impact of psilocybin on psychiatric symptoms was examined in five randomized controlled trials (RCTs). Four studies administered 1 to 2 doses of psilocybin, with doses ranging from 14mg/70kg to 30mg/70kg, and one study administered a fixed dose of 25mg to all participants. Administration of psilocybin resulted in significant and sustained reduction in symptoms of anxiety and depression, enhanced sense of wellbeing, life satisfaction, and positive mood immediately after psilocybin administration and up to six months after conclusion of treatment. All studies included some form of psychotherapy, and none reported serious adverse effects.

Conclusion: RCTs show the efficacy of psilocybin in the treatment of anxiety and depression symptoms, as well as improvement in HRQoL, and no serious side effects. However, additional research is necessary to characterize predictors of treatment response, patient screening requirements, effectiveness in broader clinical populations, and guidelines for psilocybin-assisted psychotherapy.

Keywords: Psilocybin; anxiety; depression; health-related quality of life; psychedelics; psychiatric symptoms.

Publication types

Review