{"id":"doi:10.1038/s41380-024-02800-5","kind":"review","title":"Reconsidering evidence for psychedelic-induced psychosis: an overview of reviews, a systematic review, and meta-analysis of human studies","authors":["Michel Sabé","Adi Sulstarova","Alban Glangetas","Marco De Pieri","Luc Mallet","Logos Curtis","Hélène Richard-Lepouriel","Louise E. Penzenstadler","Federico Seragnoli","Gabriel Thorens","DANIELE FABIO ZULLINO","Katrin H. Preller","Kerem Böge","Stefan Leucht","Christoph Ulrich Correll","Marco Solmi","Stefan Kaiser","Matthias Kirschner"],"author_count":18,"year":2024,"published":"2024-11-26","venue":"Molecular Psychiatry","cited_by":53,"doi":"10.1038/s41380-024-02800-5","arxiv_id":null,"nct_id":null,"source_url":"https://doi.org/10.1038/s41380-024-02800-5","archive_url":"https://space-kitty.com/papers/doi:10.1038/s41380-024-02800-5","updated":null,"pmid":"39592825","pmcid":null,"openalex_id":"W4404731501","pdf_url":"https://www.nature.com/articles/s41380-024-02800-5.pdf","abstract":"BACKGROUND: Persons with schizophrenia are excluded from psychedelic-assisted therapy due to concerns about the risk of triggering or worsening psychosis. However, there is limited meta-analytic data on the risk of psychedelic-induced psychosis in individuals with pre-existing psychotic disorders. METHODS: We conducted a systematic review, meta-analysis, and overview of reviews to assess the incidence of psychedelic-induced psychosis and symptom exacerbation in schizophrenia. Our pre-registered protocol (CRD42023399591) covered: LSD, psilocybin, mescaline, DMT, and MDMA, using data from Embase, PubMed, PsyARTICLES, PsyINFO, and trial registries up to November 2023. A random-effects model was used to calculate psychosis incidence, with standardized assessments of study quality. RESULTS: From 131 publications, we analyzed 14 systematic reviews, 20 reviews, 35 randomized-controlled trials (RCTs), 10 case-control studies, 30 uncontrolled trials (UCTs), and 22 cohort studies, most of which were low quality. Meta-analysis of nine studies showed an incidence of psychedelic-induced psychosis at 0.002% in population studies, 0.2% in UCTs, and 0.6% in RCTs. In UCTs including individuals with schizophrenia, 3.8% developed long-lasting psychotic symptoms. Of those with psychedelic-induced psychosis, 13.1% later developed schizophrenia. Sensitivity analyses confirmed the results. CONCLUSION: In summary, the reviewed evidence suggests that schizophrenia might not be a definite exclusion criterion for clinical trials exploring safety and efficacy of psychedelics for treatment-resistant depression and negative symptoms. However, given the low quality and limited number of studies, more high-quality research is needed, and a conservative approach is recommended until further data is available.","abstract_license":"CC-BY (publisher license, via OpenAlex)","license":"cc-by","is_open_access":true,"retracted":false,"peer_reviewed":null,"categories":["Psychedelics and Drug Studies"],"details":null,"provenance":"openalex","attribution":"Abstract of \"Reconsidering evidence for psychedelic-induced psychosis: an overview of reviews, a systematic review, and meta-analysis of human studies\" by Michel Sabé, Adi Sulstarova, Alban Glangetas et al., https://doi.org/10.1038/s41380-024-02800-5, used under its Creative Commons Attribution license (CC-BY); markup removed, otherwise unmodified.","topics":[{"slug":"psychiatric-therapeutics","name":"Novel Psychiatric Therapeutics","domain_slug":"neuroscience"}],"cited_in_dossiers":[]}