Eating disorders (EDs) have complex presentations with high rates of comorbidities and low recovery rates. Current treatment options often lack sufficiency in improving ED symptoms. Psychedelic-assisted therapies represent a novel treatment approach for the treatment of EDs, with research documenting preliminary positive evidence. However, psychedelics have their own challenges and risks which need to be considered within an ED population to inform study design and future clinical application. The primary aim of this meta-synthesis was to integrate existing qualitative data on the experience of using psychedelics in ED treatment from the perspectives of both individuals with EDs and providers (e.g. clinicians, ceremony leaders), using meta-ethnography to generate new interpretative insights. The methods followed the seven steps of a meta ethnographic approach. An electronic search of three databases (PubMed, Medline, and PsycINFO) was conducted. Papers were included if they were qualitative studies exploring the use of typical or atypical psychedelics, from the perspective of either a provider or individual experiencing an ED. A total of eight studies were included. From the data we identified five meta-themes that together depict how psychedelic experiences may act as catalysts for transformation. Our interpretive narrative posits that core transformative processes (Mind-Body-Spirit, Emotional Processing), unfold within specific contextual conditions (Navigating Challenges and Risks, Enabling Safe and Supportive Experiences), and lead to meaningful outcomes (Therapeutic Improvements). Meta- and sub-themes reflect ED-specific elements, highlighting that psychedelics may improve emotion processing and enhance perception of and connection with the body and the self, which is pertinent to ED recovery. Themes also indicate the increased risk for adverse side effects with low weight and other physical vulnerabilities associated with EDs. The themes and interpretive narratives identified in this meta-synthesis suggest that to achieve therapeutic outcomes, ED-specific contextual conditions are required to facilitate internal processes during psychedelic therapy for EDs. This includes minimising the uncertainty that typifies EDs through exploration of expectations and autonomy in selection of setting elements (e.g. lighting, music, eye-mask) or collaboratively agreeing strategies for if anxiety spikes. Further, facilitators should require dual competency in psychedelic treatment and ED psychopathology and treatment.

Classical serotonergic psychedelics, such as psilocybin, show emerging evidence of therapeutic potential across a range of mental health disorders, including depression, anxiety, and substance use disorders, with indications of transdiagnostic efficacy. While early-phase studies yielded encouraging results, recent larger-scale Phase 3 trials, such as those evaluating psilocybin for treatment-resistant depression (TRD), have shown more modest effects, and further findings from ongoing trials are awaited. Despite the absence of regulatory approvals from the United States (U.S.) Food and Drug Administration (FDA) and European Medicines Agency (EMA), a small but growing number of countries have permitted psychedelic therapies within regulated clinical settings. Across these divergent international approaches, the long-term trajectory and real-world impact of these therapies within public health systems remain uncertain. In anticipation of potential future approval, Ireland has an opportunity to draw on international experience and proactively plan for the integration of psychedelic therapies. Building on emerging evidence, international frameworks, and Ireland-specific policy and health system features, this paper examines the challenges of integrating psychedelic therapies into the Irish public healthcare system. These challenges span regulatory approval, Health Technology Assessment (HTA), service implementation, workforce capacity, and the evaluation of long-term patient outcomes. The aim is to inform policymakers, practitioners, and researchers about key system-level considerations.

Background The use of psychedelics for clinical purposes and psychological healing is well-documented across many settings, often addressing trauma or mood disorders. Two gaps remain underexplored: (1) the use of psychedelics for psychological healing by gender-diverse individuals, and (2) the personal therapeutic use of psychedelics in non-clinical settings and how this shows up in psychotherapy as understood by clinicians. We address these gaps by examining how gender-exploring folks report personal therapeutic psychedelic use for psychological healing to clinicians during psychotherapy, as relayed by “key informants” (mental health professionals). Objective We investigate how accounts of personal therapeutic psychedelic use surface in therapy and shape clients’ processes of gender identity exploration and psychological healing, according to their therapists. Materials and Methods Drawing on semi-structured interviews with five mental health professionals, an inductive thematic analysis was conducted, identifying four themes. Results Themes were (1) Processing Gender-Based Rejection, (2) Engaging with Gender Role Models, (3) Seeking Exploration and Authenticity, and (4) Striving for Healing through Psychedelics, with subthemes (4a) Navigating Breakthrough Moments and (4b) Accepting Oneself & Reclaiming Power. Conclusions Findings highlight ways psychedelics may facilitate gender exploration and psychological healing, underscoring the need for more inclusive approaches in psychedelic research and therapy.

Background: Institutional review boards (IRBs) are gatekeepers of psychedelic research, deciding whether and under what conditions it may proceed. Yet IRB understanding, attitudes, perspectives, and concerns regarding psychedelics and psychedelic research have not previously been studied. These factors are important to assessing whether US IRBs are likely to be over- or underprotective of psychedelic research participants and to helping psychedelic investigators address key IRB concerns. Methods: A total of 529 current IRB chairs were invited to participate in an electronic survey conducted in October–November 2024. The sample included chairs at US organizations affiliated with psychedelic studies registered on ClinicalTrials.gov, the top 100 NIH-funded organizations, and organizations in states with more and less favorable psychedelic policies; IRB chairs affiliated with the Department of Veterans Affairs and two commercial IRBs were also included. Survey domains included psychedelic experience, understanding and attitudes about psychedelics, confidence reviewing psychedelic protocols, concern about aspects of psychedelic administration research compared to other research, views on risks associated with psychedelic administration research, perspectives on participant protections, and resource needs. Results: Overall, 212 IRB chairs completed at least 80% of the survey (42.7% response rate), a third of whom (34.9%) reported professional experience with psychedelics. Participants often reported lacking knowledge about psychedelic risks/benefits (35–51%) and selected neutral responses to questions examining their attitudes about psychedelics (35–47%). Most (61–78%) reported similar confidence reviewing psychedelic and nonpsychedelic protocols. Many IRB chairs (33–53%) reported heightened concern about psychedelic administration research, including legal, employment, and other social risks, expectations of benefit leading to bias, participant safety, consent challenges, and inclusion of vulnerable populations; about half (47.2%) reported heightened institutional risk compared to other research. Most agreed with requiring extensive monitoring of psychedelic administration sessions (82.9%) but expressed wide-ranging views on other protections. Conclusions: Rather than reflecting a broadly conservative approach to psychedelic research, IRB chairs often expressed a neutral attitude toward psychedelics alongside some uncertainty, while noting concerns that align with unsettled issues in the field. Gaps in IRB knowledge regarding psychedelic risks/benefits can be addressed in research protocols, while the field must continue to work toward consensus on best practices for participant protection.

Renewal of research into psychedelics indicates their ability to provide relief from challenging conditions like trauma, treatment resistant depression, addictions, and end-of-life distress. Psychedelics appear to promote neuroplasticity, stimulate creativity, dampen fear responses, circumvent psychological defenses, soften rigid beliefs, and foster profound feelings of unity. The non-verbal, non-linear, and experiential nature of art therapy makes it well matched for psychedelic assisted therapy (PAT), providing a way to externalize and engage with the ineffable qualities of Non-Ordinary States of Consciousness (NOSC). This article presents a psychedelic art therapy approach that weaves art therapy principles and interventions into the preparation, dosing, and integration phases of PAT. Recommendations for research are presented, along with training competencies and ethical considerations unique to this work.

ABSTRACT This article presents the results of a Cognitive Linguistic analysis of metaphors used in a series of interviews by a single healthy volunteer following four moderate-to-high dosing sessions with psilocybin. The interviews were conducted by members of a human psychedelic research lab in a deep-sampling fMRI and EEG brain imaging study, allowing the participant to recount experiences under the effects of the compound. The goal of this case analysis is to make theoretically informed inferences about the participant’s cognitive-phenomenal processes during the interviews and the psychedelic experiences. To this end, we use Conceptual Metaphor Theory to explain how the participant consistently uses metaphors that frame abstract introspective events in terms of more concrete, visible and interpersonal events. This instantiates a cognitive frame that is known as the Observer’s Model. The metaphor themes we identify also imply a recurring sense of cognitive defusion and heightened metacognitive awareness during the psilocybin sessions. Moreover, we find that literal descriptions of hallucinatory visual experiences correlate semantically with metaphorical expressions, suggesting that metaphorical thinking plays a role in motivating those experiences. We link these linguistic-analytical results to neuroscientific findings about psychedelics and explore psychological and therapeutic implications.

ABSTRACT Between 1967 and 1975, psychiatrist Dr Howard Whitaker directed a program for the legal use of LSD and psilocybin in Victoria, Australia. His controversial practices were marred by misconduct, unscientific methods and evidence of malpractice. This study explores Whitaker’s LSD-assisted therapy in the 1970s through interviews with former staff of Mayday Hills Psychiatric Hospital in Beechworth, Victoria. These staff members share their experiences working with Whitaker and implementing groundbreaking techniques. The interview data, collected in a broader social history project about Mayday Hills, sheds light on Whitaker’s unconventional and unethical approaches and reminds us that the 1970s was a time of reform in Victorian mental institutions. The current research in psychedelic drug therapies shows remarkable similarities to Whitaker’s early positive findings from over 50 years ago.

Conventional psychological and pharmacological substance abuse treatments are limited to moderate effect sizes and fail to magnify outcomes when combined. Analog psychedelic agents N, N-dimethyltryptamine (DMT) and 5-methoxy-N, N-dimethyltryptamine (5-MeO-DMT) show therapeutic potential for treatment-resistant psychiatric disorders including substance addictions. This systematic review and meta-analysis synthesized DMT intervention studies (1960-2024) across PubMed, PsycINFO, Web of Science, and EBSCO databases, calculating pooled effects for substance use reduction. Subgroup sensitivity analyses examined the impacts of psychotherapy, population type, and treatment design on outcomes. DMT yielded a large overall effect size for substance abuse reduction (g = 0.94, 95% CI: 0.56-1.31, p < 0.0001), with superior efficacy for drug use (g = 1.35, 95% CI: 0.63-2.07, p < 0.0001) compared to alcohol use (g = 0.65, 95% CI: 0.31-0.99, p < 0.0001). Studies incorporating psychotherapy showed significantly greater effects (g = 1.38, 95% CI: 1.06-1.71, p < 0.0001) than those without (g = 0.60, 95% CI: 0.09-1.12, p < 0.0001), with significant subgroup difference (p = 0.0121). High risk of bias and high heterogeneity were observed (I2 = 96.9%), with effects varying by substance type and treatment context. No publication bias was detected. When combined, available studies demonstrate DMT's potentially substantial post-treatment efficacy for substance misuse, particularly with psychotherapy. Effect magnitudes vary by abused substances. Included studies had substantial methodological limitations and high risk of bias. Reported effects should therefore be interpreted as preliminary rather than indicative of established efficacy. Furthermore, the use of exploratory subgroup analyses in this review can only conclude that DMT efficacy for treating alcohol and substance abuse disorders is highly heterogeneous, depending on study and treatment design. If sustained positive results are clearly demonstrated in future research, it might position DMT-assisted psychotherapy as an effective, economical alternative to conventional treatments.

Interest in classical psychedelics as potential treatments for ADHD has grown alongside broader psychiatric psychedelic research, but ADHD-specific evidence remains limited. This systematic review examined prospective and experimental studies on whether classical psychedelics, including microdosing-like use and retreat-based exposure, are associated with changes in adult ADHD symptoms and related functioning. A PRISMA-guided systematic review was conducted using a PECO/PICO framework focused on adults (≥18 years) with diagnosed ADHD and/or elevated ADHD symptomatology who were exposed to a classical psychedelic and assessed prospectively with quantitative ADHD outcomes. Major databases were searched, with reference screening and targeted checks for recent or registered trials. Risk of bias was assessed using RoB 2 for the RCT and ROBINS-I for non-randomized studies. Because of heterogeneity and the small number of studies, findings were synthesized narratively. Five studies met the inclusion criteria. Five prospective/experimental studies were included: three naturalistic online microdosing cohorts, one randomized double-blind placebo-controlled phase 2A trial of low-dose LSD, and one pre-post ayahuasca retreat pilot. In uncontrolled naturalistic microdosing studies, participants reported short-term reductions in ADHD symptom ratings together with improvements in well-being and affect-related functioning; however, these studies were highly vulnerable to self-selection, expectancy, attrition, and non-standardized exposure. In contrast, the only randomized placebo-controlled ADHD trial found improvement in both LSD and placebo groups, with no statistically significant advantage for LSD on clinician-rated or self-reported ADHD outcomes. Objective cognitive findings were limited and inconsistent, and safety data outside the supervised trial context were sparse. Naturalistic studies provide, at most, low-certainty signals of perceived short-term improvement, but the strongest controlled evidence does not demonstrate drug-specific efficacy of repeated low-dose LSD for core ADHD symptoms. Current evidence therefore does not allow separation of pharmacological effects from expectancy, setting, self-monitoring, and broader experiential/contextual influences, and is insufficient to support psychedelics as an evidence-based treatment for ADHD.

LSD revisited: Mechanisms of action and therapeutic potential in mental health

Psychedelic-assisted therapy is regaining attention as a promising approach to treating mental health disorders. This research aimed to compare related factors regarding the therapeutic use of psychedelics between medical and nursing students, addressing a notable gap in existing research. A cross-sectional survey was conducted at the University of Las Palmas de Gran Canaria (Spain) during the 2024/2025 academic year, including 325 students—204 from nursing and 121 from medicine—who completed a 7-item Likert-scale questionnaire assessing attitudes, perceived knowledge, and beliefs about the therapeutic potential, risks, and regulation of psychedelics, alongside sociodemographic data. Results revealed a growing interest in the therapeutic potential of psychedelics, although concerns persist. Gender and age were significantly associated with beliefs, with women reporting lower levels of perceived knowledge about psychedelics and older students exhibiting greater openness toward their therapeutic potential. Medical students demonstrated higher levels of perceived knowledge and greater agreement with therapeutic applications compared to nursing students, who more strongly associated psychedelic use with psychiatric risk. Participants with prior psychedelic use were more supportive of legalization and therapeutic use, highlighting the impact of personal experience. Formal education on psychedelics was linked to more favourable attitudes and increased knowledge, suggesting that training may reduce stigma and support evidence-based policy. Overall, students showed a cautiously optimistic view toward psychedelic therapies. These findings underscore the importance of integrating content on emerging treatments into health sciences curricula to foster informed, critical perspectives among future clinicians.

ABSTRACT Mystical dynamics—the notion that mystical oneness may unfold involving ego disintegration, renewal, and luminous light—has been discussed anecdotally by psychedelic researchers and therapists but has not yet been empirically examined in controlled settings. This study investigated the occurrence and dose-dependency of mystical dynamics in healthy participants after administration of psychedelics. A total of 816 mystical-dynamics measurements were collected from 386 participants across 15 studies at two sites: University Hospital Basel (Switzerland) and Johns Hopkins University (USA). Participants received low to high doses of four serotonergic psychedelics: LSD, psilocybin, mescaline, and DMT. Mystical dynamics was assessed using five corresponding constructs from the Psychedelic Experience Scale (PES100): ego disintegration, distress, renewal, luminous light, and mystical (focusing on mystical oneness, the core of mystical experience). We hypothesized strong intercorrelations of mystical oneness with ego disintegration, renewal, and luminous light, and a dose-dependent intensity pattern. Results showed dose-sensitive strong correlations of mystical oneness with luminous light and renewal, and a moderate-to-strong correlation of mystical oneness with ego disintegration. These findings support a broader, dynamic model of mystical experience and offer novel insights relevant to psychedelic-assisted therapy, while acknowledging additional experiential features that may also associate with mystical oneness.

Reports of near-death experiences (NDEs), end-of-life visions (ELVs), and culturally embedded afterlife narratives frequently describe profoundly positive or distressing states. Traditional interpretations treat these phenomena as evidence of external metaphysical realms. The Dying-Moment Dream Hypothesis proposes an alternative, neurobiologically grounded explanation: that culturally conditioned afterlife experiences may constitute a final, endogenous simulation ("dream") generated by the dying brain. This simulation is hypothesized to emerge from a confluence of transiently heightened terminal neural activity, affective-memory integration, temporal processing collapse, and the brain's neurochemical end-of-life cascade. Because subjective time may dilate under hypoxic stress, seconds of neural activity may be computationally experienced as a perceived loss of temporal boundaries. The absence of a subsequent awakening is proposed to render this final simulation the individual's last phenomenologically accessible conscious state. This paper synthesizes evidence from prospective NDE studies, terminal EEG recordings, dream neuroscience, cultural cognition, psychedelic research, and hospice ethnography to present a unified theoretical framework. Limitations, competing models, and explicitly falsifiable predictions are discussed.

Psychedelic drugs are increasingly under investigation as potential therapeutic agents for mental health conditions and are being increasingly used recreationally. Psychedelic use may result in an episode of intense psychological distress, commonly referred to as a "bad trip." Bad trips represent a potentially volatile, erratic, and dangerous situation, which may, in extreme cases, require presentation to accident and emergency departments and psychiatric hospital admission. Managing such cases requires careful consideration, with priority given to non-pharmacological strategies. When these measures prove insufficient, an alternative approach may be necessary, one that can effectively attenuate or terminate the psychedelic state and restore psychological stability. Despite clinical relevance, there is no systematic evaluation of pharmacological interventions to terminate such experiences. This review identifies and critically appraises candidate medications with potential utility as abortive agents, including serotonin antagonists, drugs for psychosis, and select drugs for anxiety and depression. We review these agents, their mechanisms of action, pharmacokinetics, safety profiles, and applicability in acute care settings. Binding strength at the molecular level, potency to functionally block receptor-mediated effects, and lack of side effects are key considerations. We conclude by proposing a provisional framework for the pharmacologic management of adverse psychedelic experiences and highlight key priorities for future research.

ABSTRACT Psilocybin, N,N-dimethyltryptamine (DMT), lysergic acid diethylamide (LSD), and 3,4-methylenedioxymethamphetamine (MDMA) are psychedelic compounds with therapeutic potential for depression, anxiety, and post-traumatic stress. However, their relevance to endurance athletes, who face particular psychological and physical stressors, remains underexplored. This study combines a conceptual overview with cross-sectional survey data from Brazilian endurance athletes. Twenty-eight participants completed a questionnaire addressing mental health, use of supplements, medications, and psychoactive substances, as well as perceptions and attitudes toward psychedelics and psychedelic therapies. The mean age was 37 ± 10 years. Women more frequently reported pharmacological treatment for depression or anxiety. Overall, 64% reported a lack of mental health support in their athletic environments; 11% had prior psychedelic experience, while 79% expressed openness to psychedelic therapies if legal and supervised. However, 61% were unaware of existing evidence for psychedelics in treating mental health conditions. Their potential anti-inflammatory and analgesic properties were similarly unrecognized and unexpected. Misconceptions were common: 78% believed psychedelics to be addictive. Despite this, attitudes toward their therapeutic potential were generally positive. These findings reveal unmet mental health needs, significant knowledge gaps, and widespread misconceptions among endurance athletes, suggesting the value of targeted, evidence-based education to support informed consideration of psychedelic therapies.

ABSTRACT Psychedelic experiences have been associated with improved quality of life, but many studies rely on samples of enthusiasts, raising concerns about selection bias. This study examined whether self-reported quality-of-life impact differed between a convenience sample of psychedelic enthusiasts and a general population sample recruited through Prolific, and whether sample differences persisted after controlling for mindset, setting, motivation, and personality. A total of N = 1,182 participants (N = 583 enthusiasts; N = 599 general sample) with prior psychedelic experience completed an online survey assessing perceived impact, contextual factors, motivation for use, and Big Five personality. Between-group differences were analyzed using Welch’s t-tests, Pearson´s chi-squared tests and Mann-Whitney-Wilcoxon tests. A Type III ANCOVA was used to assess whether sample differences in quality-of-life impact remained after controlling for relevant covariates. Enthusiasts reported significantly greater quality-of-life impact (d = 0.84), higher openness, extraversion and agreeableness, more favorable mindsets and settings, and a higher frequency of personal growth motives. In the ANCOVA, sample membership was the strongest predictor of quality-of-life impact, followed by setting, motivation, openness, and mindset. These findings provide empirical clarification of how enthusiast-leaning recruitment strategies can shape reported outcomes in psychedelic research. Results underscore the need to consider sampling frames when interpreting reported benefits and to prioritize representative recruitment in future psychedelic research.

Psychedelics in functional disorders: A scoping review.

This review provides an overview of Roland R. Griffiths' history of research, and his mentoring and collaborating approach to science that contributed to his impact in behavioral and neuropsychopharmacology and psychedelic medicines development. The approach was to summarize studies in his major domains of research, including preclinical and clinical abuse liability assessment science, alcohol, benzodiazepines, caffeine, tobacco, and psychedelics. All the authors of this review were mentored by and collaborated with Griffiths-some over several decades-and were able to provide personal perspectives and insights into Griffiths' approach to science and scientific collaborations, including insights into how major research initiatives were conceived and evolved with personal anecdotes and quotes. Roland Griffiths is widely described as a "scientist's scientist," driven by his powerful curiosity to explore new frontiers in behavioral biology and neuropharmacology, with a passion to pursue humanity-serving science. His methodical approach to research development and then systematic extension and assessment of the generalizability of findings contributed to the evolution of thinking and scientific methods for abuse liability assessment, policy, and regulation of alcohol and other sedatives, tobacco and nicotine, caffeinated products and other stimulants, and in his last 2 decades, psychedelics. His inclusive and collegial approach to science, mentoring, and collaborating fueled his creativity and productivity and a fountain of innovation and research that will go on in perpetuity. Nowhere is this more evident than at the Johns Hopkins Center for Psychedelic and Consciousness Research established in the last few years of his life, in part because of his remarkable scientific life.

Psychedelic-assisted therapy (PAT) trials have high levels of functional unblinding, which biases results when comparing PAT with blinded interventions. Because PAT is effectively always open label, treatment results should be compared with those of open-label traditional antidepressants (TADs), so potential benefits associated with patients knowing their treatment is equal between the interventions. To investigate the comparative effectiveness of PAT vs open-label traditional antidepressants (TADs; such as selective serotonin and norepinephrine reuptake inhibitors) for the treatment of major depression. PubMed was systematically searched in March 2024 for trials of PAT and open-label TADs for the treatment of major depression without comorbidity in adults without psychosis in the outpatient setting. Extraction was supplemented with data from a review and meta-analysis of antidepressant drugs to assess the open-label vs blinded TAD difference. Depression scores were extracted by 2 independent reviewers; estimates were pooled with both bayesian and frequentist mixed-effects models. Reporting follows the PRISMA guideline. Following predefined hypotheses, the mean within-arm effect from baseline to primary end point (ie, patient improvement between PAT and open-label TAD trials on the 17-item Hamilton Depression Rating Scale) was compared. To assess the potential role of blinding, the within-arm effect of blinded vs open-label trials in both PAT and TADs was also compared. Of the initially retrieved PubMed 619 records, 24 met inclusion criteria. Contrary to the first of 3 hypotheses, PAT (8 trials; 249 patients) was no more effective than open-label TAD treatment (16 open-label TAD trials; 7921 patients), with an estimated difference of 0.3 favoring open-label TADs (95% CI, -1.39 to 1.98; P = .73). Open-label TADs were associated with better outcomes than blinded treatment (144 blinded TAD trials; 31 792 patients), with an estimated difference of 1.3 (95% CI, 0.07-2.51; P = .04;), but the same difference was not observed for PAT (0.67; 95% CI, -3.08 to 1.73; P = .58). In trials of depression, PAT was not more effective than open-label TADs. Blinding made a difference for TADs, but not for PAT, confirming that PAT trials are effectively always open label. These results argue against highly optimistic narratives surrounding PAT and highlight the importance of blinding integrity.

ABSTRACT Sexual and gender minority (SGM) individuals experience disproportionately high rates of depression, anxiety, trauma, and discrimination, yet remain underrepresented in psychedelic research. This prospective, naturalistic study explored the impact of an ayahuasca retreat experience on mental health, quality of life, and spiritual well-being among SGM participants. Participants attended a seven-day ayahuasca retreat and completed assessments across six time points from 2–4 weeks pre-ceremony to 2–3 months post-ceremony. Findings revealed significant reductions in depression and anxiety scores, alongside increases in spiritual well-being and quality of life, particularly within the first month following the retreat. Participants consistently described the experience as highly meaningful and spiritually significant, with many identifying the ceremony as among the most meaningful of their lives. Benefits were further supported by reports of positive behavioral changes, including improved interpersonal relationships and reduced substance use. Adverse effects were minimal and transient. Importantly, this study addresses the historical gap in the literature and highlights the need to reconceptualize psychedelic spaces as inclusive and reparative for queer communities. Given the historical misuse of psychedelics in conversion therapy, these findings mark a critical step in reclaiming psychedelics for SGM healing, empowerment, and identity affirmation.