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Psychedelics and Suicide-Related Outcomes: A Systematic Review

Summary

This comprehensive review examined how psychedelic substances like psilocybin and MDMA affect suicidal thoughts. Overall, psilocybin and MDMA-assisted therapy showed promise in reducing suicidal ideation in controlled clinical settings, with effects appearing within weeks. However, LSD use was associated with increased suicidal thoughts. The researchers conclude that while psychedelics show potential, more research is needed to ensure safety and understand how they work.

Background

Suicide accounts for 1.4% of global deaths, and traditional treatments for suicide risk are slow-acting. Psychedelic therapies may offer rapid reduction in suicide risk through enhanced emotional processing and personal insights.

Objective

This systematic review evaluates the impact of psychedelic therapies on suicide-related outcomes across randomized controlled trials and observational studies to clarify safety and therapeutic mechanisms.

Results

Four RCTs showed significant reductions in suicidal ideation with psilocybin and MDMA-AT (effect sizes d=0.52-1.25). Five additional RCTs reported reductions as safety measures. Among 24 non-randomized studies, psilocybin and MDMA-AT reduced suicidality, but LSD showed increased odds of suicidality (OR 1.15-2.08). DMT and multiple psychedelic studies showed mixed results.

Conclusion

Psychedelic therapies show potential for reducing suicidality in controlled settings, particularly psilocybin and MDMA-assisted therapy, but effects remain inconclusive. Further trials are needed to clarify safety profiles, mechanisms of action, and applicability to high-risk populations.
  • Published in:Journal of Clinical Medicine,
  • Study Type:Systematic Review,
  • Source: PMID: 40094838, DOI: 10.3390/jcm14051416
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