Set and Setting: A Randomized Study of Different Musical Genres in Supporting Psychedelic Therapy

Mounting evidence supports the serotonin 2A receptor agonist psilocybin as a psychiatric pharmacotherapy. Little research has experimentally examined how session “set and setting” impacts subjective and therapeutic effects. We analyzed effects of musical genre played during sessions of a psilocybin study for tobacco smoking cessation. Participants (N=10) received psilocybin (20-30mg/70kg) in two sessions, each with a different genre (Western classical versus overtone-based), with order counterbalanced. Participants chose one genre for a third session (30mg/70kg). Mystical experiences scores tended to be higher in overtone-based than Western classical sessions. Six of ten participants chose overtone-based music for a third session. Biologically-confirmed smoking abstinence was similar based on musical choice, with a slight benefit for participants choosing the overtone-based playlist (66.7% versus 50%). These data call into question whether Western classical music typically used in psychedelic therapy holds unique benefit. Broadly, they call for experimentally examining session components toward optimizing psychedelic therapeutic protocols.