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Masking Influences : A Systematic Review of Placebo Control and Masking in Psychedelic Studies

Barstowe, Aleksandra LU orcid and Kajonius, Petri J. LU (2024) In Journal of Psychoactive Drugs
Abstract

Psychedelic-assisted therapy is becoming increasingly acknowledged as an effective therapeutic intervention for various psychiatric illnesses. However, the evaluation of masking success is rarely reported in trials. The objective of the present systematic review was to evaluate placebo-control and masking in studies exploring psychedelic-assisted therapy. Nine (k = 9) studies dating between January 2010 and March 2023 were retrieved using six databases, following strict inclusion and exclusion criteria. The results show that almost 78% of the studies had, at best, “poor” masking success. At the same time, 60% of active placebo and 75% of inactive placebo studies showed large effect sizes. In other words, masking influences, including... (More)

Psychedelic-assisted therapy is becoming increasingly acknowledged as an effective therapeutic intervention for various psychiatric illnesses. However, the evaluation of masking success is rarely reported in trials. The objective of the present systematic review was to evaluate placebo-control and masking in studies exploring psychedelic-assisted therapy. Nine (k = 9) studies dating between January 2010 and March 2023 were retrieved using six databases, following strict inclusion and exclusion criteria. The results show that almost 78% of the studies had, at best, “poor” masking success. At the same time, 60% of active placebo and 75% of inactive placebo studies showed large effect sizes. In other words, masking influences, including benign unmasking, cannot be excluded. We therefore conclude that efficacy of psilocybin, Ayahuasca, or LSD is only one of the possible interpretations of large, positive changes in symptomatology for patients suffering from, for example, alcohol use disorder, anxiety with or without life-threatening disease, anxiety and/or depression with life-threatening cancer, treatment-resistant depression or major depressive disorder. We recommend care be taken to increase successful masking procedures and discuss alternative treatment designs to better control for potential masking influences.

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author
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organization
publishing date
type
Contribution to journal
publication status
epub
subject
keywords
masking, Masking influences, placebo control, psychedelics, systematic review
in
Journal of Psychoactive Drugs
publisher
Taylor & Francis
external identifiers
  • scopus:85208480541
  • pmid:39503404
ISSN
0279-1072
DOI
10.1080/02791072.2024.2424272
language
English
LU publication?
yes
id
a1fb85a6-bb50-4978-bffe-28720c6f7ecb
date added to LUP
2025-02-18 09:42:20
date last changed
2025-07-08 21:38:10
@article{a1fb85a6-bb50-4978-bffe-28720c6f7ecb,
  abstract     = {{<p>Psychedelic-assisted therapy is becoming increasingly acknowledged as an effective therapeutic intervention for various psychiatric illnesses. However, the evaluation of masking success is rarely reported in trials. The objective of the present systematic review was to evaluate placebo-control and masking in studies exploring psychedelic-assisted therapy. Nine (k = 9) studies dating between January 2010 and March 2023 were retrieved using six databases, following strict inclusion and exclusion criteria. The results show that almost 78% of the studies had, at best, “poor” masking success. At the same time, 60% of active placebo and 75% of inactive placebo studies showed large effect sizes. In other words, masking influences, including benign unmasking, cannot be excluded. We therefore conclude that efficacy of psilocybin, Ayahuasca, or LSD is only one of the possible interpretations of large, positive changes in symptomatology for patients suffering from, for example, alcohol use disorder, anxiety with or without life-threatening disease, anxiety and/or depression with life-threatening cancer, treatment-resistant depression or major depressive disorder. We recommend care be taken to increase successful masking procedures and discuss alternative treatment designs to better control for potential masking influences.</p>}},
  author       = {{Barstowe, Aleksandra and Kajonius, Petri J.}},
  issn         = {{0279-1072}},
  keywords     = {{masking; Masking influences; placebo control; psychedelics; systematic review}},
  language     = {{eng}},
  publisher    = {{Taylor & Francis}},
  series       = {{Journal of Psychoactive Drugs}},
  title        = {{Masking Influences : A Systematic Review of Placebo Control and Masking in Psychedelic Studies}},
  url          = {{http://dx.doi.org/10.1080/02791072.2024.2424272}},
  doi          = {{10.1080/02791072.2024.2424272}},
  year         = {{2024}},
}