News outlets and clinical studies report positive effects of psilocybin therapy at nearly the same rate, according to a new systematic review published in JAMA Network Open. However, while scientific papers tend to emphasize small sample sizes and study design flaws, news articles frequently present the compound’s medical benefits as established fact and extend them to conditions with little or no clinical trial backing. The findings suggest a gap between preliminary scientific evidence and public media narratives surrounding psychedelic medicine.
Psilocybin is a naturally occurring psychoactive compound found in hallucinogenic mushrooms. When a person ingests psilocybin, the body converts it into psilocin, a chemical that binds primarily to serotonin receptors in the brain and alters mood, emotion, and sensory perception. Medical researchers first began studying psychedelics in the 1940s, though legal restrictions in the 1970s slowed clinical studies to a near standstill for decades. Since the 1990s, scientific interest has rebounded, with modern researchers testing whether psilocybin can help treat mental health and substance use disorders.
Despite the surge in scientific interest, the clinical evidence supporting psilocybin remains in its early stages. For instance, a 2024 scoping review by several of the same researchers, which cataloged 193 published and 80 ongoing psilocybin studies, found that only 12 percent were randomized clinical trials, the standard medical test in which participants are randomly assigned to receive either an active treatment or a comparison substance. Most of the existing studies were small preliminary tests with a median of 22 participants.
Additionally, a 2023 systematic review of 10 psychedelic trials found that blinding, which keeps participants and staff unaware of who received the active drug versus a placebo, was either unsuccessful or never checked, likely because the drugs’ effects are so noticeable.
The authors argue that public interest has outpaced this preliminary evidence base. Between 2018 and 2021, the use of hallucinogens other than LSD, such as psilocybin, nearly doubled from 3.4 percent to 6.6 percent among young adults in the United States, and some people now use the substance off-label for mental health conditions without regulatory approval. Because many people rely on news coverage to inform health decisions, lead author Kim Madden of McMaster University’s Department of Anesthesia, senior author Anthony Adili, and their colleagues set out to compare the tone, safety details, and effectiveness claims in news articles against clinical trial publications.
“Psychedelics are having a renaissance, receiving increasing media coverage in recent years,” said Adili, a professor and vice chair of the Department of Surgery and an associate member of the School of Biomedical Engineering at McMaster University, as well as the chief innovation officer, head of orthopedics, an orthopedic surgeon, and director of the Centre for Health Innovation and Research in Psychedelics at St. Joseph’s Healthcare Hamilton. “While the socialization of these substances is helping facilitate research initiatives, we wanted to investigate how aligned media reporting is with the current published trials.”
To conduct their two-part systematic review, the researchers updated their earlier scoping review, searching four medical databases for English-language clinical trials of psilocybin targeting any medical condition between January 1, 2014, and October 10, 2024. They included randomized clinical trials and phase 1 or phase 2 nonrandomized trials, excluding review papers and studies on recreational use.
Next, the team searched the Factiva database for English-language news articles discussing clinical uses of psilocybin published between January 1, 2014, and April 22, 2025. They extended the media search six months past the trial cutoff to account for the delay between a study’s publication and subsequent news coverage, while excluding press releases, stock reports, and brief summaries.
Two reviewers independently screened and extracted data from every eligible trial publication and news story, with a third researcher resolving disagreements. For the trials, the team recorded the medical condition treated, sample size, dosing details, whether psychotherapy was included, safety outcomes, and the authors’ conclusions on whether the treatment worked. They also assessed randomized trials for bias using the Cochrane Risk of Bias tool. For the media articles, reviewers logged the target audience, specific health claims, discussions of side effects or drug policy, and overall tone, which they classified as favorable (combining optimistic and cautiously optimistic pieces), neutral, or skeptical.
The final dataset included 70 trial publications and 172 online news articles. Annual counts for both trial publications and media stories climbed starting in 2018, when trial publications rose from zero in 2017 to eight, and peaked in 2023. Most of the trials were conducted in the United States and the United Kingdom, while most news articles came from outlets in the United States and Canada. Nearly all media articles (163, or 95 percent) targeted the general public rather than medical professionals (9, or 5 percent), and 115 articles (67 percent) referenced at least one published clinical trial.
Of the 70 trial publications, 36 (51 percent) were randomized clinical trials, 30 (43 percent) were nonrandomized experimental studies, and 4 (6 percent) consisted of two nonrandomized crossover studies, one pooled analysis, and one secondary analysis. Nearly all of the trial publications described small sample sizes of fewer than 100 participants, accounting for 65 of the 70 papers (93 percent), and follow-up durations were often short or incompletely reported. Quality assessments indicated that 19 of the 36 randomized trials had a high or uncertain risk of bias regarding the blinding of participants and personnel, alongside concerns related to for-profit funding.
When comparing overall conclusions, trial publications and news stories reported positive outcomes at similar frequencies, though the two figures measure different things: a trial’s own conclusion about its main outcome versus any favorable claim in a news story. Forty-nine of the 70 trial publications (70 percent) concluded that psilocybin benefited patients on the primary clinical outcome, 5 (7 percent) reported mixed effectiveness, 1 (1 percent) found no benefit, 4 (6 percent) had inconclusive findings, and 11 (16 percent) provided no efficacy conclusion.
In the press, 125 of the 172 media articles (73 percent) made at least one positive claim about psilocybin’s effectiveness for a health condition, while 47 (27 percent) made none. In total, 122 media articles (71 percent) adopted a favorable tone, comprising 98 (57 percent) optimistic and 24 (14 percent) cautiously optimistic pieces, while 45 (26 percent) were neutral and 5 (3 percent) were skeptical.
Beneath those parallel numbers, scientific papers and news outlets framed the evidence quite differently. “The most practical significance of this systematic review is that there is a disconnect between media publications and the hard science,” Adili told PsyPost.
While trial authors routinely emphasized methodological limitations and the preliminary nature of their work, news articles tended to present benefits as established fact. Both groups focused primarily on depression, which was examined in 47 trial publications (67 percent) and mentioned in 138 media articles (80 percent). Other conditions examined in the trial publications included substance use disorders in 11 papers (16 percent), cancer-related distress in 5 (7 percent), headaches or migraines in 4 (6 percent), anxiety in 4 (6 percent), bipolar II disorder in 3 (4 percent), and body dysmorphic disorder in 2 (3 percent), plus single publications (1 percent each) on obsessive-compulsive disorder (OCD), autism, anorexia nervosa, and demoralization.
In contrast, news coverage frequently promoted psilocybin for conditions with little or no clinical trial backing. Most notably, 74 media articles (43 percent) referenced PTSD and 5 (3 percent) mentioned Alzheimer disease or other neurodegenerative conditions as clinical uses, even though zero eligible trials tested psilocybin for those conditions. Similarly, 72 news stories (42 percent) highlighted anxiety and 18 (10 percent) discussed anorexia nervosa or other eating disorders, despite the trial literature containing only four studies on anxiety and one on anorexia nervosa. Media reports also occasionally cited OCD (12 articles, or 7 percent), chronic pain (5, or 3 percent), and long COVID (4, or 2 percent).
The researchers also found differences in how treatment context and safety were reported. In 51 trial publications (73 percent), psilocybin was administered alongside psychotherapy, typically at doses of 25 milligrams or higher. While 107 news articles (62 percent) mentioned psychotherapy, 143 (83 percent) omitted dosing information entirely.
For safety, 31 trial publications (44 percent) reported safety outcomes, with 24 (34 percent) documenting short-term adverse events like temporary anxiety, nausea, or headaches, and only 4 (6 percent) assessing long-term safety. Media coverage addressed safety even less often, with only 51 articles (30 percent) mentioning adverse effects. When news stories did discuss harms, they focused on psychosis or challenging psychological experiences, with 12 articles (7 percent) noting potential long-term psychological risks that were not consistently tied to specific trial findings.
“Something surprising to me was how minimally media articles reported on safety,” Adili noted. “Based on the lack of safety reporting, we want audiences to be more aware that media articles may bias positive results without discussing safety concerns. As a result, patients may enter into trials with preconceived notions of the outcomes leading to potential disappointment if their expectations aren’t met.”
Policy themes were also widespread in the press. Across the 172 media articles, 48 (28 percent) discussed legalizing or decriminalizing psilocybin for clinical use, and 45 (26 percent) advocated for expanding patient access. Another 28 articles (16 percent) discussed reducing stigma around psychedelics, whereas only 8 (5 percent) mentioned the potential for misuse or abuse. The authors noted that pairing calls for expanded legal access with optimistic efficacy claims could foster public expectations that exceed the current medical evidence.
“We hope that the average person is more critical of overly positive media portrayal of psychedelics and is empowered to do their own research,” Adili explained. “When possible, reference the study that the media article references, delve deeper into potential safety concerns, and conduct further research.”
As with all research, there are some caveats to consider. The findings concern how psilocybin research is communicated, not whether the compound works; the trials remain early-phase, while public enthusiasm and policy changes in places like Oregon and Colorado have moved ahead. Additionally, the media review was limited to English-language, text-based online news articles in the Factiva database, primarily from the United States and Canada. The analysis did not capture television, radio, podcasts, or social media, which may convey different narratives to the public.
On the clinical side, the 70 trial publications included several papers reporting different analyses of the same underlying trials, along with conference abstracts and a dissertation, so they do not represent 70 independent experiments. The review also relied on each paper’s own conclusions about whether psilocybin worked, rather than a formal grading of the strength of the evidence.
Evaluating the tone and messaging of news articles also involves some subjectivity. Even though two reviewers coded each article independently using predefined criteria, their initial agreement was moderate, meaning another research team might classify certain content differently. Moving forward, the authors suggest that scientists prioritize larger, high-quality randomized trials with longer follow-up periods and thorough safety reporting. The authors also suggest that media outlets can support informed health decisions by avoiding sensationalism and explaining study limitations, sample sizes, and remaining scientific uncertainties.
“At the Centre for Health Innovation and Research in Psychedelics (CHIRP), our next steps are to design and conduct rigorous randomized controlled trials to produce evidence and actionable outcomes that can improve patient care,” Adili added. “Long-term, we hope to provide novel solutions for patients with few alternate options across a wide range of subspecialties from gut-brain health to neurodegenerative disease, chronic pain, and women’s health.”
The study, “Clinical Evidence on Psilocybin and Its Representation in Media Reporting: A Systematic Review,” was authored by Kim Madden, Breanne Flood, Imad Kashir, Rayan Ahmad, Hiba Ali, Rotem Petranker, James MacKillop, and Anthony Adili.
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