Older adults find psychological benefits in psychedelic retreats, despite milder acute effects

A recent study published in the American Journal of Geriatric Psychiatry provides new insight into the impact of psychedelic retreats on older adults. The research shows that older adults, despite experiencing less intense immediate effects from psychedelics compared to younger participants, reported similar improvements in well-being after attending these retreats.

Serotonergic psychedelics, like psilocybin, LSD, and DMT, have shown promise in treating affective symptoms in various disorders. These substances induce an altered state of consciousness, including intensified emotions and perceptions, which have been linked to therapeutic outcomes. However, older adults have been largely excluded from psychedelic research, and the safety and efficacy of these treatments for this age group remain uncertain.

“Psychedelic substances have seen a resurging interest, primarily due to their fast and sustained positive effects on well-being among diverse clinical populations,” said co-author Lorenzo Pasquini, an assistant professor of neurology at the UCSF Weill Institute for Neurosciences.

“Yet little research has been conducted in older adults so far. To target this question is crucial, since affective changes in older adults are widespread, difficult to treat with classical antidepressant medications, and often precede the emergence of more severe neuropsychiatric and neurological disorders.”

“Something that makes psychedelics an equally intriguing and challenging research topic, is the combined intensity and kaleidoscopic variety of their subjective effects – Humphrey Osmond’s eponymous quote from the 1950’s comes to mind: ‘To fathom hell or soar angelic, just take a pinch of psychedelic,’” added co-author Hannes Kettner, a PhD candidate at the Imperial College London Centre for Psychedelic Research and visiting scholar in UCSF Carhart-Harris lab.

“To make these substances safer and more broadly useful, I believe we need more studies trying to get into the weeds of how different types of people respond differently to these substances, and like Lorenzo mentioned, older adults constitute a population that has an unmet need for better neuropsychiatric treatment options, while usually not being included in psychedelic studies.”

The study employed a prospective cohort design, targeting individuals planning to attend psychedelic retreats or group-based guided psychedelic sessions. Participants were recruited through social media, newsletters, forums, and retreat facilitators. They completed surveys at four points: before the session, immediately after, one day after leaving the retreat, and at two weeks, four weeks, and six months post-experience.

Eligibility criteria included being 18 years or older, understanding English, and planning to attend a psychedelic ceremony involving substances like psilocybin, LSD, ayahuasca, or mescaline. From the 882 participants who signed up, 62 older adults (aged 60 and above) and a matched group of 62 younger adults (aged below 60) were selected for comparison.

Baseline predictors such as age, gender, education, prior psychedelic use, and psychiatric history were assessed. The primary outcome measure was the Warwick-Edinburgh Mental Wellbeing Scale (WEMWBS). Acute psychedelic effects were measured using several scales, including the Ego-Dissolution Inventory (EDI), Mystical Experience Questionnaire (MEQ), and Communitas Scale (COMS), among others.

The researchers found that older adults experienced significant improvements in their mental well-being after participating in psychedelic retreats, comparable to those observed in younger adults. These retreats typically involved the use of substances such as psilocybin (found in magic mushrooms), LSD, ayahuasca, and mescaline.

“We found that adults aged 60+ who use psychedelic substances like psilocybin truffles or ayahuasca in the setting of group ceremonies experience improvements in psychological well-being similar to younger adults,” Pasquini told PsyPost.

One of the most surprising findings was that the well-being improvements in older adults were not directly linked to the acute effects of the psychedelics themselves. Unlike younger adults, for whom the intensity of the psychedelic experience — characterized by altered states of consciousness, vivid imagery, and mystical experiences — played a key role in their mental health benefits, older adults showed a different pattern.

“Older adults had significantly less intense acute psychedelic effects – subjective experiences such as ego-dissolution or emotional breakthroughs were up to 50% lower in those aged 60+, but this seemingly didn’t affect the observed improvements in well-being,” Kettner explained.

Instead, the sense of “communitas,” or togetherness and shared joy, during group activities emerged as a significant predictor of well-being improvements in older adults. This concept of communitas involves deep emotional bonds and collective experiences that foster a sense of belonging and mutual support.

Older adults reported that these group interactions and the emotional intimacy developed during the retreats were central to their positive outcomes. This finding suggests that the social and relational aspects of the retreat experience may be particularly beneficial for older adults, who often face social isolation and loneliness.

“A major surprise was to see that subjective psychedelic effects did not seem to predict well-being changes in older adults the same way that we got used to seeing it in psychedelic research,” Pasquini said. “Typically, the quality of the acute psychedelic state is associated with changes in psychological outcomes. In adults 60+ this did not hold up. Instead, the feeling of togetherness with others emerged as the only significant predictor of changes – highlighting the crucial role that social connection plays in older adults.”

Interestingly, the study also found that the well-being improvements in older adults were more pronounced in those with a history of psychiatric diagnoses. This group showed even greater increases in well-being scores compared to those without such a history. This indicates that older adults with pre-existing mental health conditions may derive substantial therapeutic benefits from participating in these psychedelic retreats, potentially addressing gaps in the effectiveness of conventional treatments.

However, as with all research, there are some caveats to consider. The context of psychedelic use was limited to retreat and ceremony settings, which may not be generalizable to other environments or individual use. The sample was also biased towards highly educated, white participants.

“This was an observational study and as such lacks control groups and experimental supervision of clinical trials,” Pasquini noted. “We also had a significant amount of people drop out from the study which could bias the results.”

“Additionally, by recruiting only those people who already plan to attend a psychedelic retreat, we obviously don’t have a sample that is very representative of the general population,” Kettner added. “It’s therefore hard to say if the results would extend to older adults that don’t start with a strong inherent interest in psychedelics.”

The findings highlight the need for further research into the unique effects of psychedelics on older adults. Future studies should explore the impact of psychedelics in various settings, including more controlled environments, and with more diverse populations. Investigating the long-term stability of well-being improvements and the specific psychosocial mechanisms at play will also be important.

“My long-term goal is to implement psychedelic-based interventions in older adults,” Pasquini explained. “Following this first, observational findings, placebo-controlled randomized trials are needed to understand whether psychedelics can have beneficial effects on well-being or even disease modifying properties in healthy and clinical populations of older adults.”

“As more and more people gain access to psychedelics, it will be crucial to understand their risks, benefits, and underlying mechanisms across a variety of different populations and settings,” Kettner said. “Where clinical trials are needed for medicalization, more studies like these, sampling real-world psychedelic use in uncontrolled settings, will be necessary if we want to provide education and minimize harms for the rapidly growing number of people using psychedelics outside of clinical trials every year.”

“If you are planning to participate in a psychedelic retreat yourself, consider contributing to our research: https://ceremonystudy.com/. My colleagues at ICL are running other fantastic studies that you can participate in, including a microdosing online survey and a psychedelics-for-couples survey: https://www.imperial.ac.uk/psychedelic-research-centre/participate-in-a-trial/.”

The study, “Effects of Psychedelics in Older Adults: A Prospective Cohort Study,” was authored by Hannes Kettner, Leor Roseman, Adam Gazzaley, Robin L. Carhart-Harris, and Lorenzo Pasquini.