Prolonged adverse effects from repeated psilocybin use in an underground psychedelic therapy training program: a case report
John Perna, Justin Trop, Roman Palitsky, Zachary Bosshardt, Helen Vantine, Boadie W Dunlop, Ali John Zarrabi
BMC Psychiatry February 28, 2025 DOI: 10.1186/s12888-024-06303-z (opens in new tab)
Study at a glance
AI-extracted from the abstract| Characteristics | Case study Case report Peer reviewed |
|---|---|
| Interventions | ECT energy medicine |
| Topics | Psilocybin Psychedelic-assisted therapy |
| Keywords | Hallucinogen Adverse effect Psychotherapist Clinical psychology |
| Citations | 15 |
| Key findings | Clinicians should be aware of conflicts between psychiatric conceptualizations of prolonged adverse effects from psychedelics and frameworks in psychedelic community practices, as these affect patients' symptoms, decision making, and emotional challenges. |
Abstract
This case highlights the tensions between legal and underground psychedelic use within psychedelic therapy training programs, psychiatry and neo-shamanism, and the use of psychiatric interventions (i.e., ECT) and energy medicine to address prolonged adverse effects from psychedelics. Clinicians should be aware of these potential conflicts between psychiatric conceptualizations of PAEs and frameworks maintained in psychedelic community practices and their impacts on patients' presenting symptoms, decision making, and emotional challenges.
Comparable studies
Other case reports and case series on psilocybin and psychedelic-assisted therapy, most cited first.
| Study | Year | Design | Participants |
|---|---|---|---|
| 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 |
| Refractory CRPS pain treated with psilocybin: A case report A patient with refractory complex regional pain syndrome | 2024 | Case study | n = 1 |
| Underground small-group therapy of treatment-resistant depression and complex post-traumatic stress disorder (C-PTSD) with psilocybin—A retrospective case study A woman in her early forties with early complex trauma and treatment-resistant depression | 2023 | Case report | n = 1 |
| Psilocybin-assisted psychotherapy for methamphetamine dependence: a case report involving daily methamphetamine use A 36-year-old transwoman who was a daily methamphetamine user | 2024 | Case study | n = 1 |
| Long‐COVID symptoms improved after MDMA and psilocybin therapy: A case report 41-year-old fully vaccinated female with Long-COVID syndrome | 2024 | Case report | n = 1 |
Citations in the library
Cited by 16
- On Minimizing Risk and Harm in the Use of Psychedelics. Psychiatric Research and Clinical Practice February 11, 2025
- The science of psychedelic medicine. Nature Medicine February 6, 2026
- Reported Safety Practices of Publicly Advertised Psychedelic Retreats. JAMA Network Open January 2, 2026
- Psychedelics and Mental Health Treatment Seeking Among Asians and Hawaiians Psychoactives September 4, 2025
- Trends in the psychedelic renaissance: applying artificial intelligence to measure media portrayal of psychedelic drugs in the 21st century BJPsych Open February 12, 2026
and 11 more in the library
Cites 30
- Human hallucinogen research: guidelines for safety. Journal of Psychopharmacology July 1, 2008
- Global Street Food: la cocina de la calle Diseño interior 2009
- Classic psychedelics: An integrative review of epidemiology, therapeutics, mystical experience, and brain network function. Pharmacology & Therapeutics May 1, 2019
- Prediction of Psilocybin Response in Healthy Volunteers PLoS One February 17, 2012
- Antidepressive, anxiolytic, and antiaddictive effects of ayahuasca, psilocybin and lysergic acid diethylamide (LSD): a systematic review of clinical trials published in the last 25 years Therapeutic Advances in Psychopharmacology March 18, 2016
and 25 more in the library