Clinical psychedelic research in adolescents: a scoping review and overview of ethical considerations
Teenagers could benefit from psychedelic therapy, but they’ve been systematically excluded from clinical research.
The potential use of psychedelic-assisted therapy for adolescents with mental illness has sparked both interest and concern. Modern psychedelic research has focused on adults, and adolescents younger than 18 years are typically excluded due to ethical and legal challenges.
To explore whether adolescents have been included in 21st century psychedelic research, the authors conducted a scoping review of the medical literature from January, 2000, to April, 2025. Three trial registrations and one trial plan showed involvement of participants younger than 18 years, but none of these trials were completed and no trial findings have been published.
The proposed studies would investigate 3,4-methylenedioxymethamphetamine (MDMA)-assisted or psilocybin-assisted psychotherapy as an intervention for adolescents with post-traumatic stress disorder, autism with social anxiety, or self-harm. Ethical approval and recruitment details were inconsistently reported.
This scarcity of data highlights a major evidence gap that could hinder informed care. Given that many medications are used off-label in adolescents, the authors argue for cautious, ethically grounded research—starting with older adolescents with the highest foreseeable benefit–risk ratio due to special circumstances—to better understand the potential risks and benefits of psychedelic therapies for this vulnerable population.
Comments -
Psychedelic use in adolescence carries known and unknown risks, including potential developmental risks and higher rates of adverse events than in adults. The risks of psychedelic-assisted therapies should be weighed in the context of existing therapies, standards of care, and the effects of unresolved mental illness in adolescence.
Many adolescents, especially with parental involvement, can provide valid consent or assent. Informed consent should address stigma, family support, and drug-related judgment through education and open dialogue.
Adolescent care contexts warrant heightened ethical precaution, particularly regarding therapeutic touch during psychedelic therapy sessions. The option to include a trusted friend or relative in the therapeutic setting could enhance trust, safety, and ethical accountability.