Insights on Psychedelics: A Systematic Review of Therapeutic Effects.
Neuroscience and biobehavioral reviews – March 22, 2025
Source: PubMed
Summary
Psychedelics often lead to profound insights that can significantly enhance mental health. A review of 98 studies reveals that these insights, typically stronger with higher doses, correlate with improved well-being in 86% of cases. This suggests that fostering such experiences could be key to effective therapeutic practices.
Abstract
Insight - a sudden change in understanding or perspective that feels true or reliable - is a common occurrence during psychedelic experiences, and often considered by clinicians and patients to be central to their therapeutic value. However, their occurrence and role has not been systematically assessed. We reviewed all peer-reviewed studies that published data on insight catalysed by a classic psychedelic at psychoactive levels, to elucidate several aspects of psychedelic-catalysed insight, including its prevalence, relationship to dose, time-course, and relationship to therapeutic outcomes. Risk of bias was assessed regarding selection, reliability, causality, and transparency. PROSPERO registration: CRD42023405854 FINDINGS: The final database and key bibliography searches were completed on July 13, 2024. We screened 741 abstracts and included 98 studies (40 survey, 58 interventional). Insight was positively correlated with psychedelic dose, and was significantly higher following psychedelics in 43 of 46 (93%) studies that presented a comparison to a placebo condition. Crucially, 25 of 29 studies (86%) found that insight was associated with therapeutic improvement, and this relationship was often stronger than mystical-type experience, which has received more research attention. This review indicates that psychedelic-catalysed insight is associated with therapeutic improvement, suggesting its importance for clinical practice and for understanding the mechanisms of psychedelic therapy. Heterogeneous study designs and operationalisations of insight precluded a meta-analytic summary. Publication bias and selective reporting is possible, given insight was typically not a primary outcome of the included studies. This study was not supported by any external funding.