Psychedelics and psychosis: A systematic review of recent-era studies (1984-2025).
José Augusto Silva Reis, Lara Zancaner Ueta, José Carlos Bouso et al.
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In 30 seconds
This systematic review examined evidence from 1984–2025 on classical psychedelic use and psychotic symptoms, drawing on 52 papers, including population studies, clinical trials, emergency and toxicology data, and case reports. Population-based studies showed no consistent association between lifetime psychedelic use and psychosis. In controlled clinical settings, reported risk was minimal, with one case of transient delusions across the trials reviewed. Case reports indicated that psychiatric history and unsupervised use may be relevant risk factors, although causality is difficult to establish.
Key findings
- The review included 52 papers, among them 34 case reports.
- Population-based data showed no consistent correlation between lifetime psychedelic use and psychosis.
- Controlled trials documented one case of transient delusions across all trials.
- Among case reports, 58% of individuals had a personal or family psychiatric history.
Why it matters
The findings distinguish evidence from screened, supervised clinical settings from reports arising in emergency care and naturalistic use. They suggest that psychosis risk may vary with context and individual psychiatric history, while also underscoring that rare cases can occur in people without known risk factors. This context is important when evaluating safety as psychedelic-assisted therapies are studied in broader populations.
What to keep in mind
The review combines heterogeneous evidence, including case reports and observational data, and the authors note that causality is difficult to establish.