Safety and settings Flashcards
Overall Harm/ Risks
Psilocybin, like any psychoactive substance, carries potential risks and harms, including:
Acute psychological distress: While relatively rare, some individuals may experience acute anxiety, panic attacks, or psychosis during a psilocybin experience.
Risk of accidents: Psilocybin can impair coordination and judgment, increasing the risk of accidents or injury, especially if used in unsafe environments.
Flashbacks or HPPD: Some users may experience flashbacks or develop Hallucinogen Persisting Perception Disorder (HPPD), characterized by recurring visual disturbances, after using psilocybin.
Exacerbation of mental health conditions: Psilocybin use can exacerbate underlying mental health conditions such as schizophrenia, bipolar disorder, or anxiety disorders.
Rare physical risks: Although rare, adverse physical reactions like increased heart rate, high blood pressure, and allergic reactions can occur.
What are more common side effects of Psilocybin?
Nausea and vomiting: Common during the early stages of ingestion. Management involves staying hydrated, taking anti-nausea medication like ondansetron, and consuming ginger to alleviate symptoms.
Anxiety or panic reactions: Some individuals may experience heightened anxiety or panic attacks. Supportive care, reassurance, and a calm environment are essential. Benzodiazepines may be administered in severe cases.
Confusion and disorientation: Users may become confused or disoriented during the peak of the trip. Providing a safe, supportive environment with minimal stimulation can help manage these effects.
Increased heart rate and blood pressure: Psilocybin can cause temporary increases in heart rate and blood pressure. Monitoring vital signs and ensuring the individual is in a calm environment are key. Benzodiazepines or beta-blockers may be used if necessary.
Hallucinations: Visual and auditory hallucinations are common with psilocybin use. Providing reassurance and guiding the individual through the experience can help manage this side effect.
Paranoia or psychosis: In rare cases, psilocybin can induce psychosis or exacerbate underlying mental health conditions. Close monitoring and psychiatric evaluation may be necessary, with the administration of antipsychotic medication if needed.
What are less common side effects but can occur?
Fever: If a person experiences a fever after taking psilocybin, it’s essential to monitor their temperature and ensure they remain hydrated. Over-the-counter fever reducers such as acetaminophen (Tylenol) or ibuprofen (Advil) can be used if the fever is causing discomfort. If the fever persists or is accompanied by other concerning symptoms, medical attention should be sought.
Headaches: Headaches can occur during or after a psilocybin trip. Adequate hydration and rest can help alleviate mild headaches. Over-the-counter pain relievers such as acetaminophen or ibuprofen can also be effective. Ensuring the individual is in a calm and comfortable environment can aid in headache relief. If headaches are severe or persistent, medical evaluation may be necessary to rule out other causes.
Side effects 24 hours after Psilocybin dosing?
Fatigue: Get plenty of rest and allow your body time to recuperate. Avoid strenuous activities and prioritize relaxation.
Difficulty concentrating: Practice gentle activities that require minimal mental effort, such as listening to calming music or going for a leisurely walk. Avoid tasks that demand intense focus.
Lack of appetite: Focus on consuming small, nutritious meals and snacks that are easy to digest. Stay hydrated by drinking water or herbal teas.
Headaches: Take over-the-counter pain relievers such as acetaminophen or ibuprofen if needed. Ensure you’re well-hydrated and consider applying a cold compress to your forehead for relief.
According to Johnson, 2008 what are some distressing events that can occur after dosing?
Frightening sensory illusions
Disturbing somatic illusions
Troubling thoughts about one’s own life
According to Griffiths study with 51 cancer patients what is the frequency that experienced an adverse psychological effects?
High Dose
Anxiety - 20%
Paranoia - 2%
Episodes of physical discomfort - 21 %
Psychological discomfort - 32%
Low Dose
Anxiety - 15%
Paranoia - 0%
Episodes of physical discomfort - 8%
Psychological discomfort - 12%
What do patient qualitative reports state regarding potential side effects?
Patients describe:
Transient moments of intense fear, overwhelming anxiety or panic.
However, overall experience as personally meaningful. Reassurance of the supervisor to provide guidance as invaluable.
What is the likelihood of prolonged negative psychological reactions?
According to reacher in Zurich, prolonged negative reactions are very rare. Around 0.08% of 110 participants across studied from 1999 to 2008.
According to Carbonaro, 2016 what are the findings of the survey on difficult psilocybin experiences with 2000 people under non medical circumstances?
11% reported that they put themselves or others at risk of physical harm.
39% reported that the experiences was among the top five most challenging experiences.
2.6% reported exhibiting physical aggression or violent behaviour.
According to the 2020 textual analysis on recreational trip reports what four clusters were developed to categories bad trips?
Cluster 1 - Bad Trips (30.47%). Containing words such as feel, think, death, crazy and fear and more likely written by female users.
Cluster 2 - Bad Trips, Train wrecks, trip disasters (21%). Single high dose ingestion linked to fear and hospitalisation fear.
Cluster 3 - Perceptual changes and visual distortions (20%). No negative association.
Cluster 4 - Administation methods, doses (20%).
What does the 8 factor analysis for drug approval for the FDA consist of?
Factor 1 - Actual or relative potential for abuse.
Factor 2 - Scientific evidence of its pharmacological effect.
Factor 3 - Current scientific knowledge regarding the drug.
Factor 4 - History and current pattern of abuse.
Factor 5 - The scope duration and significance of abuse
Factor 6 - Risk to public health.
Factor 7 - Psychic or physiological dependence liability.
Factor 8 - Immediate precursor of substance controlled.
What are some contraindicated and medical diagnoses for use of psilocybin?
Antipsychotic drugs such as those used for Schizophrenia, bipolar or adjunct medication for depression. This may interfere with the desired effect of psilocybin. This includes Olanzapine, Ketanserin.
Mood stabilizers, that are commonly used to treat bipolar disorder such as lithium mized with psilocybin may cause seizures.
When serotonergic drugs such as SSRIs and SNRIs are taken with psilocybin the psychedelic effect may be blunted. This may impact subjective effect but it does not appear to cause a physical risk of toxicity.
An appropriate taper period for a given medication is necessary to avoid withdrawal symptoms. Most studies recommend 2 weeks break period.
What are some medical diagnosis that should be avoided for psilocybin usage?
Uncontrolled Hypertension
- Systolic >140 mm hg
- Diastolic > 90 mm hg
Cardiovascular conditions.
Pregnancy or breastfeeding.
Bipolar or Schizophrenia - personal or 1st degree relative - Psychedelics may exacerbate psychiatric symptoms such as paranoia, hallucinations, delusions, mania and depression for days, weeks or in rare cases months.
Increased risk for negative experiences with those with antisocial or borderline personality disorders.
