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Meta-Analysis
. 2024 Jun 26;14(1):14782.
doi: 10.1038/s41598-024-65391-9.

Cognitive functioning associated with acute and subacute effects of classic psychedelics and MDMA - a systematic review and meta-analysis

Lukas A Basedow #  1 , Tomislav Majić #  2   3 , Nicklas Jakob Hafiz  4 , Engi A E Algharably  5 , Reinhold Kreutz  5 , Thomas G Riemer  2   5
Affiliations
Meta-Analysis

Cognitive functioning associated with acute and subacute effects of classic psychedelics and MDMA - a systematic review and meta-analysis

Lukas A Basedow et al. Sci Rep. .

Abstract

Classic psychedelics and MDMA have a colorful history of recreational use, and both have recently been re-evaluated as tools for the treatment of psychiatric disorders. Several studies have been carried out to assess potential long-term effects of a regular use on cognition, delivering distinct results for psychedelics and MDMA. However, to date knowledge is scarce on cognitive performance during acute effects of those substances. In this systematic review and meta-analysis, we investigate how cognitive functioning is affected by psychedelics and MDMA during the acute drug effects and the sub-acute ("afterglow") window. Our quantitative analyses suggest that acute cognitive performance is differentially affected by psychedelics when compared to MDMA: psychedelics impair attention and executive function, whereas MDMA primarily affects memory, leaving executive functions and attention unaffected. Our qualitative analyses reveal that executive functioning and creativity may be increased during a window of at least 24 h after the acute effects of psychedelics have subsided, whereas no such results have been observed for MDMA. Our findings may contribute to inform recommendations on harm reduction for recreational settings and to help fostering differential approaches for the use of psychedelics and MDMA within a therapeutic framework.

Keywords: Acute; Afterglow; Cognition; MDMA; Psychedelic; Subacute.

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Conflict of interest statement

The authors declare no competing interests.

Figures

Figure 1
Figure 1
PRISMA flowchart.
Figure 2
Figure 2
Forest plot of psychedelic and MDMA studies involving memory tasks. MDMA, 3,4-methylenedioxymethamphetamine; RIP, rapid information processing; PR, prose recall; SeSe, serial sevens; VVLT, visual verbal learning task; PMT, prospective memory task; SMT, Sternberg memory task; AVPLT, abstract visual pattern learning task; DRM, Deese/Roediger-McDermott word list; SpMT, spatial memory task; SCT, star counting task; WLT, word learning task; CRMT, continuous recognition memory task; NWM, numeric working span; GMLT, Groton maze learning task; SpWM, spatial working memory task; DS, digit span; BT, block tapping.
Figure 3
Figure 3
Forest plot of psychedelic and MDMA studies involving executive functioning tasks. MDMA, 3,4-methylenedioxymethamphetamine; SST, stop-signal task; DT, discounting task; GnG, go/no-go task; TMT-B, trail-making task trial B; MFF, matching familiar figures; CR, cue-reversal task; TOL, Tower of London; DSST, digit-symbol substitution; WCST, Wisconsin card sorting task; CGT, Cambridge gambling task.
Figure 4
Figure 4
Forest plot of psychedelic and MDMA studies involving attention tasks. MDMA, 3,4-methylenedioxymethamphetamine; DAT, divided attention task; PVT, psychomotor vigilance task; CTT, critical tracking task; OMEDA, object movement under divided attention; MCT, Macworth clock task; RT, simple reaction time; DV, digit vigilance; CRT, choice reaction time; TMT-A, trail-making task trial A; OT, object tracking; COVAT, covert orienting of attention test; FAIR, Frankfurt attention inventory.
Figure 5
Figure 5
Plot of microdosing studies involving creativity tasks. LSD, lysergic acid diethylamide; RAT, remote association task; AUT, alternative uses task; WK, Wallach-Kogan Test; PCT, picture concept task.
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