Last reviewed
LSD and psychedelics: mental health risks and what the research says
What LSD and other psychedelics do, who is most at risk of a bad reaction, dangerous medication combinations, and where the research stands.
Earl Johns, MSN, PMHNP-BC
Board-certified psychiatric nurse practitioner and founder of Wellthy Psychiatry & Wellness
✓ Medically reviewed by Earl Johns, MSN, PMHNP-BC
Photos are illustrative and don’t show actual patients.
Psychedelics like LSD and psilocybin (mushrooms) are getting a lot of attention, both in nightlife and in research. Here’s a balanced look at the mental health risks and where the science stands.
What LSD does
LSD changes perception, mood and sense of time, with effects lasting around 8 to 12 hours. It isn’t addictive in the usual sense, but its effects are unpredictable and strongly shaped by mindset and setting.
Who is most at risk
People with a personal or family history of psychosis, schizophrenia or bipolar disorder face a higher risk of a lasting psychiatric reaction. For them, psychedelics are best avoided.
Bad trips and accidents
Intense fear, paranoia and confusion can happen to anyone. Most short-term harms come from panic and accidents rather than the drug itself. A small number of people have lingering visual changes, called hallucinogen persisting perception disorder.
Medication interactions
Lithium combined with psychedelics has been linked to seizures and should be avoided. Antidepressants can dull the effects, which may lead people to take more. Talk with your prescriber before mixing anything.
What the research says
Studies of psilocybin and other psychedelics for depression, PTSD and addiction are promising but still early. These treatments happen in controlled settings with screening and support. Outside research, products aren’t tested and doses vary widely.
If something goes wrong
Stay with the person, keep the space calm and quiet, and call 911 for chest pain, seizures, overheating or if they might hurt themselves. Lingering anxiety, low mood or disturbing thoughts afterward are worth discussing with a clinician.
A gentle next step
Wellthy Psychiatry offers judgment-free, LGBTQ+ affirming care by telehealth across California. A free 15-minute phone consult is an easy way to see if we’re a good fit.
This article is for general education and isn’t medical advice. If you’re in crisis, call or text 988, the Suicide & Crisis Lifeline, or call 911.
About the author
Earl Johns, MSN, PMHNP-BC
Board-certified psychiatric nurse practitioner · UCSF-trained · Founder of Wellthy Psychiatry & Wellness
Earl provides LGBTQ+ and neurodivergent-affirming psychiatric care, blending medication management, therapy and whole-person approaches. His background includes inpatient psychiatry and community mental health at Glenn County Behavioral Health and Equity Health, a federally qualified health center. He sees clients in San Francisco and by telehealth across California.
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