Review

. 2025 Sep 7:15:20451253251372449.

doi: 10.1177/20451253251372449. eCollection 2025.

Effect of psilocybin therapy on suicidal ideation, attempts, and deaths in people with psychiatric diagnoses: a systematic review and meta-analysis

Stanley Wong¹, Gray Meckling², Nicholas Fabiano², Sanghun Lee³, Brett D M Jones^{3

4}, Risa Shorr⁵, Aroldo Dargel^{2

6

7}, Alan K Davis^{8

9

10}, Jess G Fiedorowicz^{2

6

7

11}, Marco Solmi^{2

6

7

11

12}, Joshua D Rosenblat^{3

13}, Benoit H Mulsant^{3

4}, Daniel M Blumberger^{3

4

14}, Muhammad Ishrat Husain^{3

4}

Affiliations

¹ Department of Psychiatry, University of Toronto, 250 College Street, Toronto, ON M5T 1R8, Canada.
² Department of Psychiatry, University of Ottawa, Ottawa, ON, Canada.
³ Department of Psychiatry, University of Toronto, Toronto, ON, Canada.
⁴ Campbell Family Mental Health Research Institute, Centre for Addiction and Mental Health, Toronto, ON, Canada.
⁵ Library Services, The Ottawa Hospital, Ottawa, ON, Canada.
⁶ Department of Mental Health, The Ottawa Hospital, Ottawa, ON, Canada.
⁷ Ottawa Hospital Research Institute (OHRI), Ottawa, ON, Canada.
⁸ Center for Psychedelic Drug Research and Education, College of Social Work, The Ohio State University, Columbus, OH, USA.
⁹ Center for Psychedelic and Consciousness Research, School of Medicine, Johns Hopkins University, Baltimore, MD, USA.
¹⁰ Department of Internal Medicine, Ohio State University, Columbus, OH, USA.
¹¹ School of Epidemiology and Public Health, Faculty of Medicine, University of Ottawa, Ottawa, ON, Canada.
¹² Department of Child and Adolescent Psychiatry, Charité Universitätsmedizin, Berlin, Germany.
¹³ Mood Disorder Pharmacology Unit, University Health Network, Toronto, ON, Canada.
¹⁴ Temerty Centre for Therapeutic Brain Intervention, CAMH, Toronto, ON, Canada.

PMID: 40933784
PMCID: PMC12417673
DOI: 10.1177/20451253251372449

Review

Effect of psilocybin therapy on suicidal ideation, attempts, and deaths in people with psychiatric diagnoses: a systematic review and meta-analysis

Stanley Wong et al. Ther Adv Psychopharmacol. 2025.

. 2025 Sep 7:15:20451253251372449.

doi: 10.1177/20451253251372449. eCollection 2025.

Authors

Affiliations

¹ Department of Psychiatry, University of Toronto, 250 College Street, Toronto, ON M5T 1R8, Canada.
² Department of Psychiatry, University of Ottawa, Ottawa, ON, Canada.
³ Department of Psychiatry, University of Toronto, Toronto, ON, Canada.
⁴ Campbell Family Mental Health Research Institute, Centre for Addiction and Mental Health, Toronto, ON, Canada.
⁵ Library Services, The Ottawa Hospital, Ottawa, ON, Canada.
⁶ Department of Mental Health, The Ottawa Hospital, Ottawa, ON, Canada.
⁷ Ottawa Hospital Research Institute (OHRI), Ottawa, ON, Canada.
⁸ Center for Psychedelic Drug Research and Education, College of Social Work, The Ohio State University, Columbus, OH, USA.
⁹ Center for Psychedelic and Consciousness Research, School of Medicine, Johns Hopkins University, Baltimore, MD, USA.
¹⁰ Department of Internal Medicine, Ohio State University, Columbus, OH, USA.
¹¹ School of Epidemiology and Public Health, Faculty of Medicine, University of Ottawa, Ottawa, ON, Canada.
¹² Department of Child and Adolescent Psychiatry, Charité Universitätsmedizin, Berlin, Germany.
¹³ Mood Disorder Pharmacology Unit, University Health Network, Toronto, ON, Canada.
¹⁴ Temerty Centre for Therapeutic Brain Intervention, CAMH, Toronto, ON, Canada.

PMID: 40933784
PMCID: PMC12417673
DOI: 10.1177/20451253251372449

Abstract

Background: Suicidal ideation, attempts, and deaths present a major and tragic public health concern. Recent trials of psilocybin therapy (PT) have shown promise in treating treatment-resistant depression and have found a reduction in suicidal ideation. Given the growth of PT research, there is a need to further understand its effect on suicidal ideation, attempts, and deaths.

Objective: To assess and synthesize evidence on the effects of PT on suicidal ideation, attempts, and deaths in psychiatric patients.

Design: PRISMA-compliant systematic review and meta-analysis.

Data source: MEDLINE, EMBASE, Cochrane, and PsychINFO.

Method: Databases were searched for randomized controlled trials of PT in adults with psychiatric diagnoses that reported suicide outcomes (ideation, attempts, and deaths). Abstract and full-text screening were conducted, and suicide outcomes were extracted. Meta-analysis was performed with a random effects model to assess changes in suicide outcomes compared to control through the standardized mean difference (SMD). Assessment of heterogeneity, risk of bias, and subgroup analysis was completed.

Results: Nine studies were included (N = 593; 335 psilocybin & 258 control). Two studies were excluded from meta-analysis because suicide-related outcomes data were not available. Participants with PT experienced a small and significant decrease in suicidal ideation compared to control (k = 7, SMD = -0.24, 95% CI -0.42 to -0.06, p = 0.008, I ² = 0%). There was no publication bias found. Subgroup analysis found no significant differences between groups. No study reported suicide attempts or suicide deaths. Two studies had a high risk of bias.

Conclusion: Psilocybin therapy may reduce suicidal ideation in adults with psychiatric diagnoses. Current studies are limited by small sample size, lack of follow-up data, and assessment of blinding.

Trial registration: CRD42023445706.

Keywords: psilocybin; psychedelics; suicidal ideation; suicide; suicide attempts.

Plain language summary

The effects of psilocybin on suicidal ideation, attempts, and deaths 1. This systematic review and meta-analysis evaluated the effects of psilocybin therapy (PT) suicidal ideations, attempts, and deaths in people living with a psychiatric disorder. 2. Nine studies involved 593 adults, comparing those who received PT (335 people) to those who did not and were in a control group (258 people). 3. PT led to a small but significant reduction in suicidal ideation. There were no instances of suicide attempts or completed suicides reported. However, most studies did not report on suicide attempts or completed suicides. 4. Current studies had limitations, such as low number of participants, lack of long-term follow-up, and issues with how the participants were blinded in a study. 5. PT may help reduce suicidal ideation in people with a psychiatric disorder, but more higher quality research is needed to confirm these findings.

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Figures

**Figure 1.**
PRISMA diagram of screening of studies for extraction. PRISMA, Preferred reporting items for systematic reviews and meta-analyses.

**Figure 2.**
Forest plot of the effect of psilocybin therapy on suicidal ideation compared to control.

**Figure 3.**
Risk of bias assessment of RCT studies. RCT, randomized controlled trial.

See this image and copyright information in PMC

References

1. Naghavi M. Global, regional, and national burden of suicide mortality 1990 to 2016: systematic analysis for the Global Burden of Disease Study 2016. BMJ 2019; 364: l94. - PMC - PubMed
1. Hubers AAM, Moaddine S, Peersmann SHM, et al. Suicidal ideation and subsequent completed suicide in both psychiatric and non-psychiatric populations: a meta-analysis. Epidemiol Psychiatr Sci 2018; 27(2): 186–198. - PMC - PubMed
1. Suicide Data | Statistics | Suicide | CDC, https://www.cdc.gov/suicide/suicide-data-statistics.html (2023, accessed 28 June 2023).
1. Shepard DS, Gurewich D, Lwin AK, et al. Suicide and suicidal attempts in the United States: costs and policy implications. Suicide Life Threat Behav 2016; 46(3): 352–362. - PMC - PubMed
1. Bruce ML, Ten Have TR, Reynolds CF, III, et al. Reducing suicidal ideation and depressive symptoms in depressed older primary care patients: a randomized controlled trial. JAMA 2004; 291(9): 1081–1091. - PubMed

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Effect of psilocybin therapy on suicidal ideation, attempts, and deaths in people with psychiatric diagnoses: a systematic review and meta-analysis

Affiliations

Effect of psilocybin therapy on suicidal ideation, attempts, and deaths in people with psychiatric diagnoses: a systematic review and meta-analysis

Authors

Affiliations

Abstract

Plain language summary

Figures

References

Publication types

LinkOut - more resources

Full Text Sources