Classifying Psychedelic-Related Complications
Tomislav Majić, Euphrosyne Gouzoulis‐mayfrank, Ricarda Evens
Current Topics in Behavioral Neurosciences 2026 DOI: 10.1007/7854_2026_614 (opens in new tab)
Study at a glance
AI-extracted from the abstract| Characteristics | Review Peer reviewed |
|---|---|
| Population | General population using psychedelics |
| Topics | LSD Psilocybin |
| Keywords | Psyche Mental health Context archaeology Hallucinogen Psychotherapist Health professionals Human health Consciousness |
| Citations | 2 |
| Key findings | Classic psychedelics carry overlooked risks and complications that unfold across acute, subacute, and long-term phases, necessitating a nuanced classification to balance therapeutic benefits with harm minimization. |
Abstract
Classic psychedelics such as psilocybin, lysergic acid diethylamide (LSD), and 5-methoxy-dimethyltryptamine (5-MeO-DMT) have shown promising effects in the treatment of certain mental health conditions. Enthusiastic claims about their therapeutic potential have led to overly optimistic reactions in the media and the public, subsequently resulting in increased use outside of clinical contexts and a heightened rate of psychedelic-related complications. As psychedelics exhibit low toxicity and hardly any habit-forming potential, the typical risks and harms of these substances are often overlooked by mental health professionals and under-assessed in psychedelic research. Similar to the medical history of other psychoactive substances introduced as medicines such as opioids, cocaine, and benzodiazepines, awareness for psychedelic-related complications has emerged with delay. Psychedelics are characterized by a wide range of acute effects on the human psyche and by a particular temporal dynamic in which these effects unfold, including acute, subacute, and long-term effects. Knowledge of how psychedelic effects unfold is not only essential for their use in therapy but also for the understanding and management of risks and complications.Here we provide an overview of complications that may be associated with the use of classic psychedelics, drawing on historical and current classification approaches and using the typical temporal dynamics of drug effects as a guiding thread. We will also discuss to what extent psychedelic-related disorders can be causally and specifically attributed to psychedelic use. Finally, considerations regarding the placement of psychedelic-related disorders within nosological-diagnostic classification systems will be discussed. The increasing interest in using psychedelics within the framework of psychotherapy and the rise of non-medical use underscore the need for a more nuanced classification of psychedelic-related risks and harms. The suggested classification can be used as a comprehensive starting point for the assessment of psychedelic-related complications, contributing to maximizing benefits and minimizing risks of these substances in research, therapy, and beyond.
Comparable studies
Other narrative reviews on LSD, most cited first.
| Study | Year | Design | Participants |
|---|---|---|---|
| Study of a New Schizophrenomimetic Drug—Sernyl | 1959 | Review | |
| Classic psychedelics: An integrative review of epidemiology, therapeutics, mystical experience, and brain network function. General population | 2019 | Integrative review | |
| The Pharmacology of Lysergic Acid Diethylamide: A Review | 2008 | Review | |
| Serotonin research: contributions to understanding psychoses | 2008 | Review | |
| ADVERSE REACTIONS TO PSYCHEDELIC DRUGS. A REVIEW OF THE LITERATURE | 1984 | Review |
Citations in the library
Cited by 3
- Psychedelic-Related Psychosis: From Model Psychosis to Psychotherapy. Current Topics in Behavioral Neurosciences 2026
- Klassische Halluzinogene in der Behandlung von Suchterkrankungen – Ein narrativer Überblick Suchttherapie August 1, 2026
- Meeting Grandmother: Breakdown, breakthrough, and the fear of madness in psychedelic research Psychedelics May 16, 2026
Cites 74
- Single-Dose Psilocybin for a Treatment-Resistant Episode of Major Depression. New England Journal of Medicine November 3, 2022
- Mystical-type experiences occasioned by psilocybin mediate the attribution of personal meaning and spiritual significance 14 months later Journal of Psychopharmacology May 30, 2008
- Percentage of Heavy Drinking Days Following Psilocybin-Assisted Psychotherapy vs Placebo in the Treatment of Adult Patients With Alcohol Use Disorder JAMA Psychiatry August 24, 2022
- The Standardized Psychometric Assessment of Altered States of Consciousness (ASCs) in Humans Pharmacopsychiatry July 1, 1998
- Acute, subacute and long-term subjective effects of psilocybin in healthy humans: a pooled analysis of experimental studies Journal of Psychopharmacology September 20, 2010
and 69 more in the library