Introduction

The paper "Adverse events in clinical treatments with serotonergic psychedelics and MDMA: A mixed-methods systematic review" by Joost J Breeksema, Bouwe W Kuin, Jeanine Kamphuis, Wim van den Brink, Eric Vermetten, and Robert A Schoevers (2022) explores the full range of adverse events (AEs) associated with the clinical use of serotonergic psychedelics and MDMA. This systematic review includes 44 articles from studies conducted since 2000, covering treatments with MDMA, psilocybin, lysergic acid diethylamide, and ayahuasca in 598 patients.

Key Findings

AEs were often not systematically assessed across the studies, suggesting that they may be underreported due to limitations in study design and sample selection.- Commonly reported acute AEs were nausea, headaches, and anxiety, regardless of the specific compound or diagnosis.- Late AEs included headaches (for psilocybin and MDMA), fatigue, low mood, and anxiety (particularly for MDMA).- There was one serious AE during MDMA administration involving an increase in premature ventricular contractions requiring brief hospitalization; however, no other AEs required medical intervention.- Interestingly, qualitative studies highlighted that psychologically challenging experiences, often considered AEs, could also have therapeutic benefits.- A significant portion of participants had prior experience with psychedelic drugs before participating in these studies, except for those involving ayahuasca.

Implications

This review underlines the necessity for a more systematic and detailed reporting of AEs in the context of psychedelic treatments to better understand their risks and benefits. While treatments with serotonergic psychedelics and MDMA appear to be overall well-tolerated, the potential for underreporting of AEs and the occurrence of challenging psychological experiences necessitate careful consideration in harm reduction strategies. These findings are crucial for organizations dedicated to psychedelic harm reduction, as they underscore the importance of informed consent, preparation, and support for individuals considering these treatments. Moreover, they highlight the need for continued research into both the therapeutic potentials and risks of psychedelics and MDMA to ensure their safe and effective use in clinical settings (Breeksema et al., 2022).