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Expert Rev Clin Pharmacol. 2018 Sep;11(9):889-902. doi: 10.1080/17512433.2018.1511424. Epub 2018 Aug 23.

Efficacy, tolerability, and safety of serotonergic psychedelics for the management of mood, anxiety, and substance-use disorders: a systematic review of systematic reviews.

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a ICEERS Foundation (International Center for Ethnobotanical Education, Research and Services) , Barcelona , Spain.
b Department of Neurosciences and Behavior, Ribeirão Preto Medical School , University of São Paulo , Ribeirão Preto , Brazil.
c Translational Medicine , National Institute of Science and Technology , Ribeirão Preto , Brazil.
d Departamento de Psicología Biológica y de la Salud. Facultad de Psicología , Universidad Autónoma de Madrid , Madrid , Spain.


Mood, anxiety, and substance-use disorders are among the most prevalent psychiatric disorders in the population. Although several pharmacological treatments are available, they are not effective for a significant proportion of patients and are associated with several adverse reactions. Therefore, new treatments should be explored. Recent studies suggest that serotonergic hallucinogens/psychedelics including ayahuasca, psilocybin, and lysergic acid diethylamide (LSD) have anxiolytic, antidepressive, and antiaddictive effects. Areas Covered: A systematic review of systematic reviews assessing the efficacy, safety, and tolerability of serotonergic hallucinogens/psychedelic was performed using the PubMed data base until 11 April 2018. Systematic reviews with or without meta-analysis were analyzed, but only reviews that described at least one randomized controlled trial (RCT) were included. Expert Commentary: Psilocybin and LSD reduced anxiety and depression in cancer patients and symptoms of alcohol and tobacco dependence, and ayahuasca reduced depression symptoms in treatment-resistant depression. Although the results are promising, several studies were open label, and only few were RCTs, and most had small sample sizes and a short duration. Single or few doses of these drugs seem to be well tolerated, but long-term studies are lacking. New RCTs with bigger samples and longer duration are needed to replicate these findings.


5-HT2A receptor; anxiety disorders; ayahuasca; dimethyltryptamine; lysergic acid diethylamide; mood disorders; psilocybin; substance-use disorders

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