Reconsidering evidence for psychedelic-induced psychosis: an overview of reviews, a systematic review, and meta-analysis of human studies

Article Article scientifique Revue de la littérature Reconsidering evidence for psychedelic-induced psychosis: an overview of reviews, a systematic review, and meta-analysis of human studies eng 2024-11-27 2025-03 author Sabe Michel 0000-0002-8530-5596 Division of Adult Psychiatry, Department of Psychiatry, University Hospitals of Geneva, 2, Chemin du Petit-Bel-Air, CH-1226, Thonex, Switzerland. michel.sabe@hcuge.ch.,Faculty of Medicine, University of Geneva, Geneva, Switzerland. michel.sabe@hcuge.ch. 889218 Département de psychiatrie (PSYAT) author Sulstarova Adi Division of Adult Psychiatry, Department of Psychiatry, University Hospitals of Geneva, 2, Chemin du Petit-Bel-Air, CH-1226, Thonex, Switzerland. 833782 author Glangetas Alban Division of Adult Psychiatry, Department of Psychiatry, University Hospitals of Geneva, 2, Chemin du Petit-Bel-Air, CH-1226, Thonex, Switzerland. 779424 author De Pieri Marco Division of Adult Psychiatry, Department of Psychiatry, University Hospitals of Geneva, 2, Chemin du Petit-Bel-Air, CH-1226, Thonex, Switzerland. 418699 SYNAPSY Centre de recherche translationnelle en neurosciences psychiatriques (CTNP) (SYNAPM) author Mallet Luc Univ Paris-Est Créteil, DMU IMPACT, Département Médical-Universitaire de Psychiatrie et d'Addictologie, Hôpitaux Universitaires Henri Mondor - Albert Chenevier, Assistance Publique-Hôpitaux de Paris, Créteil, France.,Sorbonne Université, Institut du Cerveau-Paris Brain Institute-ICM, Inserm, CNRS, Paris, France.,Department of Mental Health and Psychiatry, Global Health Institute, University of Geneva, Geneva, Switzerland. 830282 Département de psychiatrie (PSYAT) author Curtis Logos Simian 0000-0003-1020-9425 Faculty of Medicine, University of Geneva, Geneva, Switzerland.,Young Adult Psychiatry Unit, Geneva University Hospitals, Geneva, Switzerland. 28777 Département de psychiatrie (PSYAT) author Richard Lepouriel Hélène 0000-0002-0778-3728 Faculty of Medicine, University of Geneva, Geneva, Switzerland.,Mood Disorder Unit, Psychiatric Specialties Service, Geneva University Hospital, Geneva, Switzerland. 797416 Département de psychiatrie (PSYAT) author Penzenstadler Louise Emilie 0000-0003-1379-0243 Faculty of Medicine, University of Geneva, Geneva, Switzerland.,Division of Addiction Psychiatry, Department of Psychiatry, University Hospitals of Geneva, 70, Grand-Pré, CH-1202, Geneva, Switzerland. 821101 Département de psychiatrie (PSYAT) author Seragnoli Federico Division of Addiction Psychiatry, Department of Psychiatry, University Hospitals of Geneva, 70, Grand-Pré, CH-1202, Geneva, Switzerland. 876311 author Thorens Gabriel 0000-0002-3622-9179 Faculty of Medicine, University of Geneva, Geneva, Switzerland.,Division of Addiction Psychiatry, Department of Psychiatry, University Hospitals of Geneva, 70, Grand-Pré, CH-1202, Geneva, Switzerland. 88882 Département de psychiatrie (PSYAT) author Zullino Daniele Fabio Faculty of Medicine, University of Geneva, Geneva, Switzerland.,Division of Addiction Psychiatry, Department of Psychiatry, University Hospitals of Geneva, 70, Grand-Pré, CH-1202, Geneva, Switzerland. 649976 Département de psychiatrie (PSYAT) author Preller Katrin 0000-0003-0413-7672 Department of Adult Psychiatry and Psychotherapy, Psychiatric University Clinic Zurich and University of Zurich, Zurich, Switzerland. author Böge Kerem Department of Psychiatry and Psychotherapy, Campus Benjamin Franklin, Charité-Universitätsmedizin Berlin; and Freie Universität Berlin; and Humboldt-Universität zu Berlin; and Berlin Institute of Health, Berlin, Germany.,German Center of Mental Health (DZPG), Berlin, Germany.,Medical University Brandenburg-Theodor Fontane, Berlin, Germany. author Leucht Stefan Department of Psychiatry and Psychotherapy, School of Medicine, Technical University of Munich, Munich, Germany. author Correll Christoph U 0000-0002-7254-5646 Klinik für Psychiatrie, Psychosomatik und Psychotherapie des Kindes- und Jugendalters, Charité-Universitätsmedizin Berlin, Campus Virchow, Augustenburger Platz 1, 13353, Berlin, Deutschland.,Department of Psychiatry and Molecular Medicine, Donald and Barbara Zucker School of Medicine at Hofstra/Northwell, Hempstead, USA.,Department of Psychiatry, The Zucker Hillside Hospital and Zucker School of Medicine at Hofstra/Northwell, New York, USA. author Solmi Marco 0000-0003-4877-7233 SIENCES lab, Department of Psychiatry, University of Ottawa, Ottawa, ON, Canada.,Department of Mental Health, The Ottawa Hospital, Ottawa, ON, Canada.,Ottawa Hospital Research Institute (OHRI) Clinical Epidemiology Program University of Ottawa, Ottawa, ON, Canada.,School of Epidemiology and Public Health, Faculty of Medicine, University of Ottawa, Ottawa, ON, Canada.,Department of Child and Adolescent Psychiatry, Charité Universitätsmedizin, Berlin, Germany. author Kaiser Stefan 0000-0002-3013-2034 Division of Adult Psychiatry, Department of Psychiatry, University Hospitals of Geneva, 2, Chemin du Petit-Bel-Air, CH-1226, Thonex, Switzerland.,Faculty of Medicine, University of Geneva, Geneva, Switzerland. 868946 Département de psychiatrie (PSYAT) author Kirschner Matthias 0000-0002-9486-1439 Division of Adult Psychiatry, Department of Psychiatry, University Hospitals of Geneva, 2, Chemin du Petit-Bel-Air, CH-1226, Thonex, Switzerland.,Faculty of Medicine, University of Geneva, Geneva, Switzerland. 403290 Département de psychiatrie (PSYAT) 1223-1255 10.1038/s41380-024-02800-5 39592825 1359-4184 https://www.nature.com/articles/s41380-024-02800-5 Background: Persons with schizophrenia are excluded from psychedelic-assisted therapy due to concerns about the risk of triggering or worsening psychosis. However, there is limited meta-analytic data on the risk of psychedelic-induced psychosis in individuals with pre-existing psychotic disorders. Methods: We conducted a systematic review, meta-analysis, and overview of reviews to assess the incidence of psychedelic-induced psychosis and symptom exacerbation in schizophrenia. Our pre-registered protocol (CRD42023399591) covered: LSD, psilocybin, mescaline, DMT, and MDMA, using data from Embase, PubMed, PsyARTICLES, PsyINFO, and trial registries up to November 2023. A random-effects model was used to calculate psychosis incidence, with standardized assessments of study quality. Results: From 131 publications, we analyzed 14 systematic reviews, 20 reviews, 35 randomized-controlled trials (RCTs), 10 case-control studies, 30 uncontrolled trials (UCTs), and 22 cohort studies, most of which were low quality. Meta-analysis of nine studies showed an incidence of psychedelic-induced psychosis at 0.002% in population studies, 0.2% in UCTs, and 0.6% in RCTs. In UCTs including individuals with schizophrenia, 3.8% developed long-lasting psychotic symptoms. Of those with psychedelic-induced psychosis, 13.1% later developed schizophrenia. Sensitivity analyses confirmed the results. Conclusion: In summary, the reviewed evidence suggests that schizophrenia might not be a definite exclusion criterion for clinical trials exploring safety and efficacy of psychedelics for treatment-resistant depression and negative symptoms. However, given the low quality and limited number of studies, more high-quality research is needed, and a conservative approach is recommended until further data is available. Dewey 616.89 Dewey 613 60 Département de psychiatrie 225 66 Institut de santé globale 22A1 false 1236 Psychopathologie clinique et expérimentale 987 496 Abus de substances 834 1465 Neurosciences transdiagnostiques et multimodales 1075 Molecular psychiatry 30 3 7bbe5f00-df23-45cf-ae34-f7b669474e4a Article (Published version) Public Article_scientifique_from_crossref.pdf 2880226 application/pdf CC BY-4.0 972f00192a482ad2acf0409eba2faa6edc192b5472df1a73f5ea7122303a7f91 dc5e7d6b-ef97-4d31-bab2-1940eae739bb Supplemental data Public 41380_2024_2800_MOESM1_ESM.docx 484303 application/vnd.openxmlformats-officedocument.wordprocessingml.document 06057847bc83fbee4e8db3db983423bce04ac150ef63ac397b028fdf6cbaa0d4 openAccess Faculté de médecine / Section de médecine clinique / Département de psychiatrie Faculté de médecine / Section de médecine clinique / Département de santé et médecine communautaires / Institut de santé globale

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