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Record W4411679609 · doi:10.1016/j.ajp.2025.104604

Treatment approaches and efficacy in psychedelic-induced psychosis: A systematic review

2025· review· en· W4411679609 on OpenAlexaff
Adi Sulstarova, Luise Scheuerlein, Silvia Monari, Federico Seragnoli, Gabriel Thorens, Katrin H. Preller, Kerem Böge, Othman Sentissi, Stefan Kaiser, Marco Solmi, Matthias Kirschner, Michel Sabé

Bibliographic record

VenueAsian Journal of Psychiatry · 2025
Typereview
Languageen
FieldPsychology
TopicPsychedelics and Drug Studies
Canadian institutionsOttawa HospitalUniversity of Ottawa
Fundersnot available
KeywordsPsychosisElectroconvulsive therapyPsychiatryObservational studyPopulationSchizophrenia (object-oriented programming)Bipolar disorderPsychologyMedicineSystematic reviewClinical psychologyMEDLINELithium (medication)Internal medicine

Abstract

fetched live from OpenAlex

Psychedelics are increasingly used in the general population, yet they are associated with increased risk of psychosis in a minority of users that can experience psychedelic-induced psychosis (<1 % in controlled trial settings). In contrast, the evidence regarding the treatment of psychedelics-induced psychosis remains to date scarce. We conducted a PRISMA 2020-compliant systematic review (CRD42023399591), searching electronic databases (inception-August 2024) for interventional, observational studies, case series, or case reports on the treatment of psychedelic-induced psychosis. Frequencies of population, treatment, and outcome characteristics were analyzed. We included 14 case series, 20 case reports, and one prospective study, reporting on 93 cases of psychedelic-induced psychosis, between 1955 and 2024. The primary substances implicated were LSD (47.3 %) and MDMA (38.7 %), and the average patient age of 23.7 ± 6.3 years, with a predominance of male subjects (88 %). Psychosis lasted an average of 1.8 weeks. We identified two main treatment categories: first-generation antipsychotics (n = 37) and second-generation antipsychotics (n = 57). Electroconvulsive therapy was used in a minor subset of cases (n = 9). The response rate for first-generation antipsychotics (27 %) was significantly lower than that for second-generation agents (91.3 %) and electroconvulsive therapy (91 %). Follow-up data indicated 34 % of patients later developed schizophrenia spectrum disorders, and 20.4 % were diagnosed with bipolar disorder. However, the lack of comprehensive follow-up limits the interpretation of findings In conclusion, the evidence supporting treatment options remains limited, primarily based on case reports. Our findings suggest that second-generation antipsychotics seem to be more beneficial in managing psychedelic-induced psychosis, warranting further investigation into optimized treatment protocols.

Fetched live from OpenAlex and de-inverted. Abstracts are not stored in this database: the inverted indexes are 8.6 GB of the frame’s 9.3 GB of text, and the host has 13 GB free.

How this classification was reachedexpand

Full frame distilled prediction

Teacher imitation

Not calibrated prevalence, not ground truth. Human validation pending. Learned from the 10,348 direct Codex labels and 10,348 direct Gemma labels. Candidate is the union of thresholded teacher heads; consensus is their intersection. These outputs are machine_predicted_unvalidated and are not human labels or direct frontier model labels.

metaresearch head score (Codex)0.001
metaresearch head score (Gemma)0.000
Version: codex-gemma-dda1882f352aValidation status: machine_predicted_unvalidated
Candidate categoriesMeta-epidemiology (narrow)
Consensus categoriesnone
DomainCandidate signal: none · Consensus signal: none
Study designCandidate signal: Systematic review · Consensus signal: Systematic review
GenreCandidate signal: Review · Consensus signal: Review
Teacher disagreement score0.320
Threshold uncertainty score1.000

Codex and Gemma teacher scores by category

CategoryCodexGemma
Metaresearch0.0010.000
Meta-epidemiology (narrow)0.0010.001
Meta-epidemiology (broad)0.0070.002
Bibliometrics0.0010.001
Science and technology studies0.0000.000
Scholarly communication0.0000.000
Open science0.0010.000
Research integrity0.0010.001
Insufficient payload (model declined to judge)0.0000.000

Machine scores (provisional)

The two teacher heads of the student model, read on this work. A score orders the frame for review; it never asserts a category, and the validation status ships verbatim with every row.

Baseline scores from an immature model (maturity gate not passed, 7 training rounds). Scores rank; they never assert a category.

Opus teacher head0.094
GPT teacher head0.397
Teacher spread0.304 · how far apart the two teachers sit on this one work
Validation statusscore_only:v0-immature-baseline · verbatim from the scoring run: score_only means the number may rank works, and no category label ships from it

Classification

machine, unvalidated

Machine predicted; a candidate call from one teacher head, not a consensus.

Study designSystematic review
Domainnot available
GenreReview

How this classification was reached, model by model and score by score, is at the end of the page under "How this classification was reached".

Quick stats

Citations4
Published2025
Admission routes1
Has abstractyes

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