Don’t Be Afraid, Try to Meditate- Potential Effects on Neural Activity and Connectivity of Psilocybin-Assisted Mindfulness-Based Intervention for Social Anxiety Disorder: A systematic review

This systematic review (2022) explores the potential mechanisms by which combined psilocybin and mindfulness treatment could adjust anomalous neural activity underlying social anxiety disorder (SAD) and exert therapeutic effects. Proposed mechanisms include changes in cognitive processes like biased attention to threats linked to SAD by modulating connectivity of the salience network and more. 

Abstract

“Background: Current first-line treatment for social anxiety disorder (SAD), one of the most prevalent anxiety disorders, is limited in its efficacy. Hence, novel treatment approaches are urgently needed. The current review suggests a combination of meditation-based interventions and the administration of a psychedelic as a future alternative treatment approach. While both separate treatments show promise in the treatment of (other) clinical conditions, their combination has not yet been investigated in the treatment of psychopathologies.

Aim: With a systematic literature review, we aim to identify the potential mechanisms by which combined psilocybin and mindfulness treatment could adjust anomalous neural activity underlying SAD and exert therapeutic effects.

Results: Thirty experimental studies investigating the neural effects of meditation or psilocybin treatment in healthy and patient samples were included. Findings suggest that psilocybin-assisted meditation interventions might change cognitive processes like biased attention to threats linked to SAD by modulating connectivity of the salience network, balancing the activity and connectivity of cortical-midline structures, and increasing frontoparietal control over amygdala reactivity.

Conclusions: Future studies should investigate whether psilocybin-assisted mindfulness-based intervention can provide therapeutic benefits to SAD patients who are do not remit following conventional therapy.

Highlights

• Complementary effects of psychedelic administration and MM training on neurological mechanisms implicated in the symptomatology of SAD are suggested
• Psilocybin can cause acute disintegration of core neural networks involved in SAD symptomatology
• MM intervention can exert modulatory effects during the post-psilocybin period when neural networks are reintegrated
• The combined approach might stop the maintenance of SAD by decreasing self-focused attention and altering negative self-perception and emotion regulation via complementary effects on frontoparietal control over the limbic cortex

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