Overview

Psilocybin is a chemical found in a group of mushrooms that are commonly known as magic mushrooms. People take psilocybin for various mental health problems, but its benefits are not well defined. Common side effects include hallucinations, fast heartbeat, increased blood pressure, muscle weakness or twitching, trouble with balance or coordination, nausea, vomiting, or paranoia. Serious side effects are less common and include psychotic or dangerous behavior. Before taking psilocybin, make sure to tell your health care provider about any health conditions you have or medicines you are taking.

Uses

What is psilocybin used for?

Psilocybin, a chemical found naturally in certain mushrooms, is used for various mental health problems. However, its benefits are not well defined.

If you are having symptoms of a mental health problem, do not try to treat these symptoms on your own. Talk to your health care provider about your treatment options. If you are already taking a medicine for a mental health problem, talk to your health care provider before starting psilocybin. Psilocybin may interact with some medicines.

Note: Psilocybin is not approved by the FDA for any use. The FDA also does not consider psilocybin to be a legal dietary ingredient in the U.S. It is a Schedule I controlled substance, which means that it does not have an acceptable medical use and has a high risk for misuse. Learn more about the regulation of psilocybin here.

How does psilocybin work (mechanism of action)?

Psilocybin is a chemical found in psilocybe mushrooms. These mushrooms are commonly known as magic mushrooms because they act as psychedelics, which means that they can affect the mind and cause hallucinations.

Psilocybin causes most of these psychedelic effects. Your body changes psilocybin into another chemical called psilocin. Psilocin can bind to certain receptors in your brain, changing the way you experience the world around you. This can cause a “psychedelic trip,” which can involve hallucinations, reliving old memories, or being in a dream-like state. There is growing interest in using psilocybin to help manage certain mental health problems, such as anxiety, depression, posttraumatic stress disorder (PTSD), and substance use disorders. But the benefits of psilocybin are not well defined.

The dream-like experiences and hallucinations that occur with larger doses of psilocybin may be pleasant for some people and frightening for others. Your experience can depend on your own personal history, as well as the environment around you while you are using psilocybin. In most research studies, psilocybin is given in a health care facility in the presence of a trained professional who will be with you through the entire day. In some cases, this person will help to talk you through your feelings and hallucinations so that you are less likely to have a frightening, paranoid, or panicked experience. Although the best way to guide someone through the use of psilocybin is unclear, this type of assistance may reduce your risk of having a “bad trip” while using psilocybin.

When most people think of psilocybin and other psychedelics, they think of the large doses that can cause a “psychedelic trip.” But very small doses (microdoses) of psilocybin usually do not cause psychedelic effects. These “microdoses” are usually less than one-tenth of the dose that would cause a psychedelic trip. Some people have proposed that taking regular microdoses of psilocybin, such as every day or every other day, may help with certain mental health problems. But the benefits and risks of microdoses are poorly studied and not well defined.

Pure psilocybin is removed from mushrooms so that it can be given in controlled doses (usually as part of a research study). This is very different from taking magic mushrooms, which naturally contain many different chemicals in different amounts. Some other chemicals in magic mushrooms may have effects on the body and brain. These effects will vary depending on how much of each chemical, including psilocybin, is found in the specific batch of mushrooms you are taking.

How should I store psilocybin?

Psilocybin should be stored according to the product label. If you will store psilocybin at home, follow the instructions given by your health care provider.

Side Effects

What are the most common side effects of psilocybin?

The most common side effects of psilocybin are listed below. These side effects may vary depending on the dose you are taking and whether you are taking pure psilocybin (usually as part of a research study) or mushrooms that contain psilocybin. Tell your health care provider if you have any of these side effects that bother you.

• Hallucinations (see below)
• Fast heartbeat
• Increased blood pressure
• Muscle weakness or twitching
• Nausea or vomiting
• Paranoia or fear
• Trouble with balance or coordination

There may be other side effects of psilocybin that are not listed here. Contact your health care provider if you think you are having a side effect. In the U.S., you can report side effects to the FDA at www.safetyreporting.hhs.gov or by calling 888-SAFEFOOD (888-723-3366). In Canada, you can report side effects to Health Canada at www.health.gc.ca/medeffect or by calling 866-234-2345.

What are the serious side effects of psilocybin?

While less common, the most serious side effects of psilocybin are described below, along with what to do if they happen.

Severe Allergic Reactions. Psilocybin may cause allergic reactions, which can be serious. Stop taking psilocybin and get help right away if you have any of the following symptoms of a serious allergic reaction.

• Breathing problems or wheezing
• Racing heart
• Fever or general ill feeling
• Swollen lymph nodes
• Swelling of the face, lips, mouth, tongue, or throat
• Trouble swallowing or throat tightness
• Itching or skin rash
• Bumps on the skin called hives that can be red, pink, white, or brown depending on your skin tone
• Nausea or vomiting
• Dizziness, feeling lightheaded, or fainting
• Stomach cramps
• Joint pain

Hallucinations.Psilocybin can cause hallucinations that may involve hearing, seeing, smelling, tasting, or otherwise perceiving things that others do not. These hallucinations are often part of the reason that people take psilocybin. But some hallucinations can cause a negative experience during a psychedelic trip. Taking psilocybin in a safe setting with a trained professional who can monitor you may help reduce the risk of negative hallucinations.

Psychotic-like Behaviors. Psilocybin may cause psychotic-like behaviors. This risk may be higher in people who have a negative experience while taking psilocybin. Taking psilocybin in a safe setting with a trained professional who can monitor you may help reduce this risk. Tell your health care provider right away if you have any of the following symptoms or if you have been told by others that you have these symptoms.

• Delusional thoughts, such as false beliefs that you are being controlled
• Disorganized thoughts, such as jumping between topics or having a hard time focusing
• Sudden decline in self-care, such as personal hygiene or academic/work performance
• Aggressive behavior

Dangerous Behavior.Psilocybin has psychedelic effects, which can cause hallucinations and change the way that you experience the world around you. This may increase your risk of doing things that can be dangerous to you or others, such as walking into traffic or off of a tall ledge. To help reduce your risk of dangerous behavior, psilocybin should be taken in a safe setting with a trained professional who can monitor your health and safety.

Suicidal Thoughts or Actions. Psilocybin may increase the risk of suicidal thoughts or actions in some people. The risk is higher in people who had a negative experience while taking psilocybin. Taking psilocybin in a safe setting with a trained professional who can monitor you may help to reduce this risk. If you or someone you know is about to harm themselves, call 911 or call or text 988, the Suicide & Crisis Lifeline. Tell your health care provider right away if you have any of the following symptoms.

• New or increased thoughts of suicide or death
• Suicide attempt
• New or increased feelings of anxiety, depression, or other unusual changes in your mood or behavior

Precautions

Who should not use psilocybin?

Allergies to Ingredients. People who are allergic to any of the following should not take psilocybin.

• Psilocybin
• Any of the ingredients in the specific product

What should I know about psilocybin before using it?

The U.S. federal government does not consider psilocybin to be a legal ingredient. It is a Schedule I controlled substance, which means that it does not have any approved medical uses and is at high risk for misuse. Some U.S. states have laws that allow the use of psilocybin in certain cases, such as in approved treatment facilities. Psilocybin and magic mushrooms are not regulated and have not been tested to confirm that they contain the claimed ingredients.

Psilocybin is a controlled substance because it can be misused. If you will store psilocybin at home, keep it out of the reach of children and store it in a safe place.

Different doses of psilocybin can have very different effects on the brain. A psychedelic dose of psilocybin can produce a psychedelic trip, which involves hallucinations. Microdoses do not usually cause hallucinations because they are less than one-tenth of a psychedelic dose. But all doses of psilocybin can affect the brain and cause side effects.

Psilocybin can affect your alertness or coordination. If you are using a full psychedelic dose of psilocybin, do not drive or do other activities that require alertness or coordination until the next day. If you are taking microdoses of psilocybin, you should not do these activities until you know how psilocybin affects you.

Do not confuse psilocybin with magic mushrooms, which contain psilocybin. Psilocybin is removed from magic mushrooms or made in a lab so that it can be given in controlled doses. Mushrooms, on the other hand, naturally contain many chemicals in addition to psilocybin. The amount of each chemical in a specific batch of mushrooms can change for many reasons, including how the mushrooms were grown and the way that they were processed. Switching between batches of mushrooms can change the effects and side effects. Raw, dried, cooked, or powdered mushrooms may each have different effects on the body.

What should I tell my health care provider before using psilocybin?

Tell your health care provider about all of your health conditions and any prescription or over-the-counter (OTC) medicines, vitamins/minerals, herbal products, and other supplements you are using. This will help them know if psilocybin is right for you.

In particular, make sure that you discuss any of the following.

Current and Past Health Conditions.Tell your health care provider if you have any of the following.

• Heart problems
• Mental health problems, such as depression, a past suicide attempt, anxiety, hallucinations, paranoia, or psychosis
• History of misusing prescription medicines or street drugs
• Drink large amounts of alcohol

Other Medicines and Supplements.Psilocybin may interact with other medicines and supplements. Before taking psilocybin, tell your health care provider about any prescription or over-the-counter (OTC) medicines, vitamins/minerals, herbal products, and other supplements you are using. See the Interactions section for more details.

Pregnancy. It is not known if or how psilocybin could affect pregnancy or harm a fetus. Tell your health care provider if you are pregnant or plan to become pregnant.

Breastfeeding. It is not known if psilocybin passes into breast milk. Tell your health care provider if you are breastfeeding or plan to breastfeed.

Interactions

Does psilocybin interact with foods or drinks?

There are no known interactions between psilocybin and foods or drinks.

Drinking alcohol while taking psilocybin may alter the effects of both alcohol and psilocybin. This may increase your risk of having a “bad trip” and problems with your balance or coordination. It is best to avoid alcohol while you are taking psilocybin.

Does psilocybin interact with medicines (drug interactions)?

Always tell your health care provider about any prescription or over-the-counter (OTC) medicines, vitamins/minerals, herbal products, and other supplements you are using.

In particular, make sure that you discuss if you are using any of the following before taking psilocybin.

• A selective serotonin reuptake inhibitor (SSRI), such as fluoxetine, paroxetine, or sertraline, which is a medicine commonly used for anxiety and depression
• A serotonin and norepinephrine reuptake inhibitor (SNRI), such as duloxetine or venlafaxine, which is a medicine commonly used for anxiety and depression
• An antipsychotic, which is a medicine for certain mental health conditions
• A barbiturate, such as butalbital, phenobarbital, or primidone, which is a medicine that may be used to treat insomnia, migraines, or seizures
• A benzodiazepine, such as clonazepam (Klonopin), diazepam (Valium and others), or lorazepam (Ativan and others), which is a medicine used for anxiety, muscle spasms, or seizures
• A muscle relaxant, such as carisoprodol (Soma), cyclobenzaprine, metaxalone, or tizanidine (Zanaflex)
• An opioid, such as codeine, fentanyl, morphine, oxycodone, or tramadol, which is a medicine used to treat certain types of pain
• Street drugs, such as cocaine, heroin, or methamphetamine

The interactions between psilocybin and medicines are not fully understood. As with most unapproved products, the research on drug interactions with psilocybin is incomplete. Always check with your health care provider before taking psilocybin with any medicines.

Dosing

What should I do if I accidentally use too much psilocybin?

If you or someone else has used too much psilocybin, get medical help right away, call 911, or contact a Poison Control center at 800-222-1222.

In the U.S., psilocybin is a controlled substance. Its safety is not well understood. To reduce your risk of serious side effects, psychedelic doses of psilocybin should be taken under the supervision of a trained professional. Do not take double or extra doses.