Review finds little evidence that lesser-known tryptamine psychedelics help alcohol use disorder

The question

Do psychedelic tryptamine drugs other than psilocybin and ibogaine help people with addiction, and are they safe?

What they did

Researchers searched eight research databases up to February 2024 for clinical trials of psychoactive tryptamines, excluding psilocybin and ibogaine, in people with a substance use disorder or gambling disorder. They assessed the quality of each trial using the revised Cochrane risk-of-bias tools. Four trials met the criteria: three randomized controlled trials and one single-arm study, with 176 patients in total.

What they found

All four trials were in people with alcohol use disorder, and the drugs studied were dipropyltryptamine and diethyltryptamine. Rates of abstinence from alcohol ranged from 10% (the follow-up period was not reported) to 38% at 26 weeks of follow-up. The severity of alcohol use did not differ between the tryptamine groups and the comparison groups. Side effects were not well reported in the trials.

The fine print

Only four trials with 176 people in total were available, and none covered gambling disorder or substances other than alcohol. Safety reporting was poor, so harms cannot be judged. Follow-up length was unclear in at least one trial. This summary is based on the abstract alone, which does not give the trials’ dates, doses or individual sample sizes.

What it means

The small amount of published trial evidence on these less-studied tryptamines does not show a clear benefit for alcohol use disorder, and safety data are largely missing.

Evidence grade: Low. A systematic review that found only four trials, small in total and with poorly reported harms, so the pooled evidence base is thin.

This summary is based on the study’s published abstract.