Effects of psychedelic drug use on neurocognitive function and the psychological and social domains of quality of life: an international online study

Background The past few decades have seen a revived interest in psychedelic-assisted and ketamine-assisted therapy for mental health disorders, but data concerning the acute, subacute, and long-term effects of serotonergic psychedelics on cognitive functioning are scarce. This international, online study (N = 759) sought to investigate the potential acute, subacute, and long-term effects of psychedelic drug use on cognition through cognitive task assessment. Questionnaires assessing mental health and quality of life were also administered. Methods Participants completed cognitive tasks assessing working memory, selective attention, and visual/spatial perception, as well as questionnaires assessing mental health outcomes and quality of life. Based on self-reported substance use, participants were classified as non-users, lifetime users, and recent users. Results Recent users had significantly lower accuracy across all cognitive tasks, and lifetime users had the highest task accuracy without corresponding reaction time deficits, with the exception of the 2D mental rotation task. Lifetime use was not associated with long-term cognitive decline. Recent users reported more depressive and dissociative symptoms, whereas lifetime users reported lower scores. Lifetime users scored lower on psychological and social quality of life domains, indicating possible long-term psychosocial effects. Conclusions These findings highlight the need to differentiate between the acute and long-term effects of psychedelics; lab-controlled, longitudinal studies are needed to enable safe clinical application.