Efficacy and safety of psilocybin-assisted therapy for alcohol use disorder: A systematic review and meta-analysis.

In 30 seconds

This systematic review and meta-analysis assessed the efficacy and safety of psilocybin-assisted therapy (PAT) for alcohol use disorder. Six clinical trials involving 202 participants were included, three of them randomised controlled trials. Compared with controls, PAT showed short-term advantages in drinks per day, percent drinking days, and percent heavy drinking days; at mid- to long-term follow-up, only percent drinking days remained significantly better. Psilocybin-treated participants also had higher odds of maintaining abstinence (OR = 2.78; p = 0.029). Adverse events were predominantly mild and transient, although the authors describe the overall evidence as mixed and preliminary.

Key findings

• Compared with controls, short-term effects favoured psilocybin for drinks per day (SMD = 0.48; p = 0.004), percent drinking days (SMD = 0.50; p = 0.009), and percent heavy drinking days (SMD = 0.39; p = 0.020).
• At mid- to long-term follow-up, percent drinking days was the only drinking measure that remained significantly superior to control (SMD = 0.41; p = 0.032).
• Psilocybin-treated participants had higher odds of maintaining abstinence than controls (OR = 2.78; p = 0.029).
• Adverse events were predominantly mild and transient.

Why it matters

Alcohol use disorder can require interventions that reduce consumption and support abstinence. This synthesis identifies preliminary comparative evidence that PAT may improve several drinking outcomes, with some benefit persisting at follow-up and mostly mild, transient adverse events. The findings are relevant to ongoing evaluation of treatment options, but the limited and mixed evidence does not establish definitive efficacy or safety.

What to keep in mind

The evidence base comprised only six trials (N = 202), including three randomised controlled trials; the authors characterize the evidence as mixed and preliminary.