Guiding Through Challenging Psychedelic Experiences and “Bad Trips”
Michael Koslowski, Peter Gasser
Psychedelic Harm Reduction 2026 DOI: 10.1007/7854_2024_515 (opens in new tab)
Study at a glance
AI-extracted from the abstract| Characteristics | Case series Case report Peer reviewed |
|---|---|
| Sample size | 3 |
| Population | Individuals experiencing challenging psychedelic episodes |
| Topics | Psychedelic-assisted therapy |
| Keywords | Bad trips Challenging experiences Emergency room Rescue medication Supportive care |
| Citations | 6 |
| Key findings | A stepwise approach involving supportive care and rescue medication can manage challenging psychedelic experiences and prevent harm. |
Abstract
Psychedelic substances have gained recognition for their therapeutic potential, but they also present challenges, with individuals occasionally experiencing distressing episodes referred to as challenging experiences or, in the recreational setting, “bad trips”. Trial therapists and physicians, but also healthcare professionals in emergency rooms, need a comprehensive strategy to effectively manage these cases. Three case reports are presented to underline the problem and propose strategies for handling these situations. Finally, this article outlines a stepwise approach, encompassing helpful interventions, supportive care, and rescue medication, to ensure the well-being of individuals undergoing challenging psychedelic experiences and prevent further complications and long-term harm.
Comparable studies
Other case reports and case series on psychedelic-assisted therapy, most cited first.
| Study | Year | Design | Participants |
|---|---|---|---|
| Psychedelic Therapy (Utilizing LSD) with Cancer Patients Cancer patients | 1970 | Clinical description and case report | |
| Ketamine-assisted psychotherapy in adolescents with multiple psychiatric diagnoses. Adolescents aged 14–19 with comorbid psychiatric diagnoses including... | 2023 | Case series | n = 4 |
| Prolonged adverse effects from repeated psilocybin use in an underground psychedelic therapy training program: a case report | 2025 | Case study | |
| Suicide of a patient shortly after psilocybin-assisted psychedelic therapy: A case report 60-year-old man with recurrent depression and history of delusions | 2025 | Case study | n = 1 |
| Cannabis-assisted psychotherapy for complex dissociative posttraumatic stress disorder: A case report 28-year-old female with complex dissociative posttraumatic stress disorder | 2023 | Case study | n = 1 |
Citations in the library
Cited by 6
- Phenomenology of Psychedelic Experiences and Psychedelic-Associated Distressing Effects: Quantifying Subjective Experiences. Current Topics in Behavioral Neurosciences December 31, 2024
- Exploring serotonergic psychedelics as a treatment for personality disorders. Neuropharmacology July 1, 2025
- Psychedelic-Related Psychosis: From Model Psychosis to Psychotherapy. Current Topics in Behavioral Neurosciences 2026
- Classifying Psychedelic-Related Complications Current Topics in Behavioral Neurosciences 2026
- Ayahuasca, DMT, and Mental Health: A Current Review of Scientific Studies Current Addiction Reports February 21, 2026
and 1 more in the library
Cites 15
- Human hallucinogen research: guidelines for safety. Journal of Psychopharmacology July 1, 2008
- Single-Dose Psilocybin for a Treatment-Resistant Episode of Major Depression. New England Journal of Medicine November 3, 2022
- Survey study of challenging experiences after ingesting psilocybin mushrooms: Acute and enduring positive and negative consequences Journal of Psychopharmacology August 31, 2016
- Predicting Responses to Psychedelics: A Prospective Study Frontiers in Pharmacology November 2, 2018
- MDMA-assisted therapy for moderate to severe PTSD: a randomized, placebo-controlled phase 3 trial. Nature Medicine October 1, 2023
and 10 more in the library