Therapeutic effect of psilocybin in addiction : A systematic review
van der Meer, Pim B. (Department of Psychiatry. University Medical Center Utrecht)
Fuentes, Juan J. (Universitat Autònoma de Barcelona. Departament de Psiquiatria i de Medicina Legal)
Kaptein, Ad A. (Department of Medical Psychology, Leiden University Medical Center)
Schoones, Jan W. (Leiden University Medical Center)
de Waal, Marleen M. (Amsterdam UMC. University Medical Center)
Goudriaan, Anneke E. (Amsterdam UMC. University Medical Center)
Kramers, Kees (Department of Pharmacology-Toxicology, Radboud University Medical Center)
Schellekens, Arnt (Department of Psychiatry, Radboud University Medical Center)
Somers, Metten (Department of Psychiatry. University Medical Center Utrecht)
Bossong, Matthijs G. (Department of Psychiatry. University Medical Center Utrecht)
Batalla, Albert (Department of Psychiatry, University Medical Center Utrecht)

Date:	2023
Abstract:	Psychedelic-assisted therapy [e. g. , with lysergic acid diethylamide (LSD)] has shown promising results as treatment for substance use disorders (SUDs). Previous systematic reviews assessing the efficacy of psilocybin in SUDs only included clinical trials conducted in the last 25 years, but they may have missed clinical trials assessing the efficacy of psilocybin that were conducted before the 1980s, given much research has been done with psychedelics in the mid-20th century. In this systematic review, we specifically assessed the efficacy of psilocybin in patients with a SUD or non-substance-related disorder with no publication date restrictions in our search strategy. A systematic literature search was performed according to Preferred Reporting Items for Systematic reviews and Meta-Analysis (PRISMA) guidelines from the earliest published manuscript up to September 2, 2022, in seven electronic databases, including clinical trials in patients with a SUD or non-substance-related disorder evaluating the efficacy of psilocybin. A total of four studies (six articles, of which two articles were long-term follow-up results from the same trial) were included in this systematic review. Psilocybin-assisted therapy was administered to n = 151 patients in a dose ranging from 6 to 40 mg. Three studies focused on alcohol use disorder, and one study on tobacco use disorder. In a pilot study (n = 10), the percentage of heavy drinking days decreased significantly between baseline and weeks 5-12 (mean difference of 26. 0, 95% CI = 8. 7-43. 2, p = 0. 008). In another single-arm study (n = 31), 32% (10/31) became completely abstinent from alcohol (mean duration of follow-up 6 years). In a double-blind, placebo-controlled randomized controlled trial (RCT, n = 95), the percentage of heavy drinking days during the 32-week double-blind period was significantly lower for psilocybin compared to placebo (mean difference of 13. 9, 95% CI = 3. 0-24. 7, p = 0. 01). In a pilot study (n = 15), the 7-day point prevalence of smoking abstinence at 26 weeks was 80% (12/15), and at 52 weeks 67% (10/15). Only one RCT and three small clinical trials were identified assessing the efficacy of psilocybin combined with some form of psychotherapy in patients with alcohol and tobacco use disorder. All four clinical trials indicated a beneficial effect of psilocybin-assisted therapy on SUD symptoms. Larger RCTs in patients with SUDs need to evaluate whether psilocybin-assisted therapy is effective in patients with SUD.
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Language:	Anglès
Document:	Article ; recerca ; Versió publicada
Subject:	Psilocybin ; Hallucinogens ; Substance-related disorders ; Substance abuse ; Drug addiction ; Psychotherapy
Published in:	Frontiers in psychiatry, Vol. 14 (february 2023) , ISSN 1664-0640

DOI: 10.3389/fpsyt.2023.1134454
PMID: 36846225

10 p, 1.9 MB

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