Safety Database

Comprehensive safety information for psychedelic substances

This information is for educational and harm reduction purposes only. It does not constitute medical advice. Always consult qualified healthcare professionals before any substance use. In case of emergency, call your local emergency number immediately.

Adverse Events

Critical Events

Severe Events

Emergency Protocols

Filter by Substance

QT Prolongation

Ibogaine

critical

Frequency30-50%

Duration: 12-24 hours

Management: ECG monitoring mandatory, cardiac screening pre-treatment

Cardiac Arrest (rare)

Ibogaine

critical

Frequency<1%

Duration: acute

Management: Emergency cardiac care, pre-screening essential

Psychotic Break (rare)

LSD

critical

Frequency<0.5%

Duration: hours-days

Management: Emergency psychiatric care, benzodiazepines first-line (avoid antipsychotics initially), safe environment, continuous monitoring

Serotonin Syndrome Risk

DMT / Ayahuasca

critical

Frequencydose-dependent

Duration: acute

Management: CRITICAL with concurrent SSRIs/MAOIs. Stop all serotonergic drugs. Cyproheptadine 12mg PO, cooling measures, emergency services

MAOI-Drug Interactions

DMT / Ayahuasca

critical

Frequencyvaries

Duration: varies

Management: Ayahuasca contains MAOIs — screen ALL medications. Contraindicated with SSRIs, SNRIs, tramadol, DXM, stimulants, tyramine-rich food

Respiratory Depression/Apnea

5-MeO-DMT

critical

Frequency10-20%

Duration: 1-5 minutes

Management: CRITICAL: Maintain airway, recovery position, pulse oximetry mandatory, supplemental O2 available, trained sitter essential

Hyponatremia

MDMA

severe

Frequency<5%

Duration: acute

Management: Emergency medical care, restrict water intake

Suicidal Ideation (post)

MDMA

severe

Frequency2-5%

Duration: days

Management: Psychological support, safety planning, monitoring

Urinary Tract Damage

Ketamine

severe

Frequencyrare (chronic use)

Duration: chronic

Management: Limit frequency, urological monitoring

Extreme Panic/Terror

5-MeO-DMT

severe

Frequency15-30%

Duration: 5-30 minutes

Management: Cannot be aborted once inhaled; trained sitter must provide physical safety; benzodiazepine post-peak if needed

Psychological Destabilization

5-MeO-DMT

severe

Frequency5-10%

Duration: days-weeks

Management: Integration therapy essential; may trigger depersonalization/derealization; psychiatric follow-up if persistent

Challenging Psychological Experience

Psilocybin

moderate-severe

Frequency10-20%

Duration: 1-6 hours

Management: Trained therapist support, grounding techniques

Hyperthermia

MDMA

moderate-severe

Frequency10-20%

Duration: 2-4 hours

Management: Cool environment, hydration (not excess), monitoring

HPPD (Hallucinogen Persisting Perception Disorder)

LSD

moderate-severe

Frequency1-5%

Duration: weeks-years

Management: Avoid further psychedelic use, benzodiazepines for acute episodes, clonidine may help; refer to psychiatrist

Intense Fear/Panic

DMT / Ayahuasca

moderate-severe

Frequency20-35%

Duration: 1-4 hours

Management: Trained sitter support, grounding techniques, reassurance; reminder that experience is temporary and substance-induced

Reactivations (Spontaneous Re-experiencing)

5-MeO-DMT

moderate-severe

Frequency5-15%

Duration: days-weeks post

Management: Normalize as part of integration process; grounding techniques; therapy referral; avoid additional psychedelics

Anxiety/Panic

Psilocybin

moderate

Frequency20-30%

Duration: 1-4 hours

Management: Reassurance, calm environment, benzodiazepines if severe

HPPD (rare)

Psilocybin

moderate

Frequency<1%

Duration: weeks-months

Management: Benzodiazepines, avoid further psychedelic use

Elevated Blood Pressure

Ketamine

moderate

Frequency30-50%

Duration: 30-60 min

Management: Monitor, contraindicated in uncontrolled hypertension

Dependence Potential

Ketamine

moderate

Frequency5-15% (repeated use)

Duration: chronic

Management: Limit treatment frequency, screening

Ataxia

Ibogaine

moderate

Frequency80-100%

Duration: 24-72 hours

Management: Bed rest, supervision

Anxiety/Panic Reaction

LSD

moderate

Frequency15-25%

Duration: 2-6 hours

Management: Reassurance, calm environment, grounding techniques; benzodiazepines if severe (diazepam 5-10mg PO)

Thought Loops / Cognitive Distortion

LSD

moderate

Frequency20-40%

Duration: 2-6 hours

Management: Change setting, music, or physical position; gentle verbal redirect; benzodiazepine if distressing

Hypertension

DMT / Ayahuasca

moderate

Frequency20-40%

Duration: 2-4 hours

Management: BP monitoring; sublingual nifedipine if systolic >180; reduce stimulation; contraindicated in uncontrolled hypertension

Cardiovascular Stress

DMT / Ayahuasca

moderate

Frequency15-30%

Duration: 2-4 hours

Management: Cardiac screening pre-ceremony; continuous pulse monitoring; contraindicated in cardiovascular disease

Cardiovascular Stimulation

5-MeO-DMT

moderate

Frequency30-50%

Duration: 15-45 minutes

Management: BP and HR monitoring throughout; contraindicated in cardiovascular disease and uncontrolled hypertension

Severe Nausea/Vomiting

Mescaline

moderate

Frequency50-70%

Duration: 1-3 hours

Management: Common during onset; ginger, lying down, small sips of water; ondansetron 4mg if severe; fasting beforehand reduces severity

Anxiety/Dysphoria

Mescaline

moderate

Frequency15-25%

Duration: 2-6 hours

Management: Grounding techniques, change of setting, calm reassurance; benzodiazepine if escalating

Serotonin Depletion (post)

MDMA

mild-moderate

Frequency30-50%

Duration: 1-5 days

Management: Rest, nutrition, 5-HTP (24h+ after), time

Dissociation

Ketamine

mild-moderate

Frequency50-80%

Duration: 30-90 min

Management: Expected effect, safe environment

Vasoconstriction (peripheral)

LSD

mild-moderate

Frequency20-40%

Duration: 6-12 hours

Management: Warm blankets, magnesium supplement, avoid additional vasoconstrictors; monitor extremities

Purging (Vomiting/Diarrhea)

DMT / Ayahuasca

mild-moderate

Frequency60-80%

Duration: 1-3 hours

Management: Considered normal in ceremonial context; provide buckets, water, electrolyte replacement; monitor for dehydration

Vasoconstriction

Mescaline

mild-moderate

Frequency20-35%

Duration: 4-8 hours

Management: Warm environment, magnesium supplement, avoid additional vasoconstrictors; monitor extremities for color changes

Tachycardia

Mescaline

mild-moderate

Frequency25-40%

Duration: 4-8 hours

Management: Monitor heart rate; usually self-resolving; contraindicated in cardiac arrhythmias; beta-blockers if persistent

Nausea/Vomiting

Psilocybin

mild

Frequency15-25%

Duration: 30-60 min

Management: Ginger tea, lying down, small sips of water

Headache

Psilocybin

mild

Frequency10-20%

Duration: 4-24 hours

Management: Standard analgesics (not NSAIDs during session)

Elevated Blood Pressure

Psilocybin

mild

Frequency10-15%

Duration: 2-4 hours

Management: Monitor, usually self-resolving

Bruxism/Jaw Clenching

MDMA

mild

Frequency60-80%

Duration: 3-6 hours

Management: Magnesium supplement, chewing gum

Nausea/Vomiting

Ketamine

mild

Frequency20-40%

Duration: 30-60 min

Management: Ondansetron pretreatment, fasting

Insomnia

LSD

mild

Frequency60-80%

Duration: 12-24 hours

Management: Expected due to 8-12h duration; dose in morning, melatonin or low-dose benzodiazepine for sleep if needed

Safety Database

Comprehensive safety information for psychedelic substances

Adverse Events

Critical Events

Severe Events

Emergency Protocols

Filter by Substance

QT Prolongation

Ibogaine

critical

Frequency30-50%

Duration: 12-24 hours

Management: ECG monitoring mandatory, cardiac screening pre-treatment

Cardiac Arrest (rare)

Ibogaine

critical

Frequency<1%

Duration: acute

Management: Emergency cardiac care, pre-screening essential

Psychotic Break (rare)

LSD

critical

Frequency<0.5%

Duration: hours-days

Management: Emergency psychiatric care, benzodiazepines first-line (avoid antipsychotics initially), safe environment, continuous monitoring

Serotonin Syndrome Risk

DMT / Ayahuasca

critical

Frequencydose-dependent

Duration: acute

Management: CRITICAL with concurrent SSRIs/MAOIs. Stop all serotonergic drugs. Cyproheptadine 12mg PO, cooling measures, emergency services

MAOI-Drug Interactions

DMT / Ayahuasca

critical

Frequencyvaries

Duration: varies

Management: Ayahuasca contains MAOIs — screen ALL medications. Contraindicated with SSRIs, SNRIs, tramadol, DXM, stimulants, tyramine-rich food

Respiratory Depression/Apnea

5-MeO-DMT

critical

Frequency10-20%

Duration: 1-5 minutes

Management: CRITICAL: Maintain airway, recovery position, pulse oximetry mandatory, supplemental O2 available, trained sitter essential

Hyponatremia

MDMA

severe

Frequency<5%

Duration: acute

Management: Emergency medical care, restrict water intake

Suicidal Ideation (post)

MDMA

severe

Frequency2-5%

Duration: days

Management: Psychological support, safety planning, monitoring

Urinary Tract Damage

Ketamine

severe

Frequencyrare (chronic use)

Duration: chronic

Management: Limit frequency, urological monitoring

Extreme Panic/Terror

5-MeO-DMT

severe

Frequency15-30%

Duration: 5-30 minutes

Management: Cannot be aborted once inhaled; trained sitter must provide physical safety; benzodiazepine post-peak if needed

Psychological Destabilization

5-MeO-DMT

severe

Frequency5-10%

Duration: days-weeks

Management: Integration therapy essential; may trigger depersonalization/derealization; psychiatric follow-up if persistent

Challenging Psychological Experience

Psilocybin

moderate-severe

Frequency10-20%

Duration: 1-6 hours

Management: Trained therapist support, grounding techniques

Hyperthermia

MDMA

moderate-severe

Frequency10-20%

Duration: 2-4 hours

Management: Cool environment, hydration (not excess), monitoring

HPPD (Hallucinogen Persisting Perception Disorder)

LSD

moderate-severe

Frequency1-5%

Duration: weeks-years

Management: Avoid further psychedelic use, benzodiazepines for acute episodes, clonidine may help; refer to psychiatrist

Intense Fear/Panic

DMT / Ayahuasca

moderate-severe

Frequency20-35%

Duration: 1-4 hours

Management: Trained sitter support, grounding techniques, reassurance; reminder that experience is temporary and substance-induced

Reactivations (Spontaneous Re-experiencing)

5-MeO-DMT

moderate-severe

Frequency5-15%

Duration: days-weeks post

Management: Normalize as part of integration process; grounding techniques; therapy referral; avoid additional psychedelics

Anxiety/Panic

Psilocybin

moderate

Frequency20-30%

Duration: 1-4 hours

Management: Reassurance, calm environment, benzodiazepines if severe

HPPD (rare)

Psilocybin

moderate

Frequency<1%

Duration: weeks-months

Management: Benzodiazepines, avoid further psychedelic use

Elevated Blood Pressure

Ketamine

moderate

Frequency30-50%

Duration: 30-60 min

Management: Monitor, contraindicated in uncontrolled hypertension

Dependence Potential

Ketamine

moderate

Frequency5-15% (repeated use)

Duration: chronic

Management: Limit treatment frequency, screening

Ataxia

Ibogaine

moderate

Frequency80-100%

Duration: 24-72 hours

Management: Bed rest, supervision

Anxiety/Panic Reaction

LSD

moderate

Frequency15-25%

Duration: 2-6 hours

Management: Reassurance, calm environment, grounding techniques; benzodiazepines if severe (diazepam 5-10mg PO)

Thought Loops / Cognitive Distortion

LSD

moderate

Frequency20-40%

Duration: 2-6 hours

Management: Change setting, music, or physical position; gentle verbal redirect; benzodiazepine if distressing

Hypertension

DMT / Ayahuasca

moderate

Frequency20-40%

Duration: 2-4 hours

Management: BP monitoring; sublingual nifedipine if systolic >180; reduce stimulation; contraindicated in uncontrolled hypertension

Cardiovascular Stress

DMT / Ayahuasca

moderate

Frequency15-30%

Duration: 2-4 hours

Management: Cardiac screening pre-ceremony; continuous pulse monitoring; contraindicated in cardiovascular disease

Cardiovascular Stimulation

5-MeO-DMT

moderate

Frequency30-50%

Duration: 15-45 minutes

Management: BP and HR monitoring throughout; contraindicated in cardiovascular disease and uncontrolled hypertension

Severe Nausea/Vomiting

Mescaline

moderate

Frequency50-70%

Duration: 1-3 hours

Management: Common during onset; ginger, lying down, small sips of water; ondansetron 4mg if severe; fasting beforehand reduces severity

Anxiety/Dysphoria

Mescaline

moderate

Frequency15-25%

Duration: 2-6 hours

Management: Grounding techniques, change of setting, calm reassurance; benzodiazepine if escalating

Serotonin Depletion (post)

MDMA

mild-moderate

Frequency30-50%

Duration: 1-5 days

Management: Rest, nutrition, 5-HTP (24h+ after), time

Dissociation

Ketamine

mild-moderate

Frequency50-80%

Duration: 30-90 min

Management: Expected effect, safe environment

Vasoconstriction (peripheral)

LSD

mild-moderate

Frequency20-40%

Duration: 6-12 hours

Management: Warm blankets, magnesium supplement, avoid additional vasoconstrictors; monitor extremities

Purging (Vomiting/Diarrhea)

DMT / Ayahuasca

mild-moderate

Frequency60-80%

Duration: 1-3 hours

Management: Considered normal in ceremonial context; provide buckets, water, electrolyte replacement; monitor for dehydration

Vasoconstriction

Mescaline

mild-moderate

Frequency20-35%

Duration: 4-8 hours

Management: Warm environment, magnesium supplement, avoid additional vasoconstrictors; monitor extremities for color changes

Tachycardia

Mescaline

mild-moderate

Frequency25-40%

Duration: 4-8 hours

Management: Monitor heart rate; usually self-resolving; contraindicated in cardiac arrhythmias; beta-blockers if persistent

Nausea/Vomiting

Psilocybin

mild

Frequency15-25%

Duration: 30-60 min

Management: Ginger tea, lying down, small sips of water

Headache

Psilocybin

mild

Frequency10-20%

Duration: 4-24 hours

Management: Standard analgesics (not NSAIDs during session)

Elevated Blood Pressure

Psilocybin

mild

Frequency10-15%

Duration: 2-4 hours

Management: Monitor, usually self-resolving

Bruxism/Jaw Clenching

MDMA

mild

Frequency60-80%

Duration: 3-6 hours

Management: Magnesium supplement, chewing gum

Nausea/Vomiting

Ketamine

mild

Frequency20-40%

Duration: 30-60 min

Management: Ondansetron pretreatment, fasting

Insomnia

LSD

mild

Frequency60-80%

Duration: 12-24 hours

Management: Expected due to 8-12h duration; dose in morning, melatonin or low-dose benzodiazepine for sleep if needed

Safety Database

QT Prolongation

Cardiac Arrest (rare)

Psychotic Break (rare)

Serotonin Syndrome Risk

MAOI-Drug Interactions

Respiratory Depression/Apnea

Hyponatremia

Suicidal Ideation (post)

Urinary Tract Damage

Extreme Panic/Terror

Psychological Destabilization

Challenging Psychological Experience

Hyperthermia

HPPD (Hallucinogen Persisting Perception Disorder)

Intense Fear/Panic

Reactivations (Spontaneous Re-experiencing)

Anxiety/Panic

HPPD (rare)

Elevated Blood Pressure

Dependence Potential

Ataxia

Anxiety/Panic Reaction

Thought Loops / Cognitive Distortion

Hypertension

Cardiovascular Stress

Cardiovascular Stimulation

Severe Nausea/Vomiting

Anxiety/Dysphoria

Serotonin Depletion (post)

Dissociation

Vasoconstriction (peripheral)

Purging (Vomiting/Diarrhea)

Vasoconstriction

Tachycardia

Nausea/Vomiting

Headache

Elevated Blood Pressure

Bruxism/Jaw Clenching

Nausea/Vomiting

Insomnia

Stay Updated

Safety Database

QT Prolongation

Cardiac Arrest (rare)

Psychotic Break (rare)

Serotonin Syndrome Risk

MAOI-Drug Interactions

Respiratory Depression/Apnea

Hyponatremia

Suicidal Ideation (post)

Urinary Tract Damage

Extreme Panic/Terror

Psychological Destabilization

Challenging Psychological Experience

Hyperthermia

HPPD (Hallucinogen Persisting Perception Disorder)

Intense Fear/Panic

Reactivations (Spontaneous Re-experiencing)

Anxiety/Panic

HPPD (rare)

Elevated Blood Pressure

Dependence Potential

Ataxia

Anxiety/Panic Reaction

Thought Loops / Cognitive Distortion

Hypertension

Cardiovascular Stress

Cardiovascular Stimulation

Severe Nausea/Vomiting

Anxiety/Dysphoria

Serotonin Depletion (post)

Dissociation

Vasoconstriction (peripheral)

Purging (Vomiting/Diarrhea)

Vasoconstriction

Tachycardia

Nausea/Vomiting

Headache

Elevated Blood Pressure