A web-based survey of 541 people with bipolar disorder who had used psilocybin found that one-third reported new or worsening symptoms afterward, especially manic symptoms, insomnia, and anxiety. No difference in adverse event rates emerged between bipolar I and bipolar II. Emergency medical care was rare (3.3%). Despite adverse effects, respondents rated psilocybin use as more helpful than harmful. The findings suggest psilocybin may offer subjective mental health benefits for some people with bipolar disorder, but clinical trials should closely monitor symptoms because they may emerge or intensify.
Adults with bipolar disorder who used psilocybin-containing mushrooms reported both benefits and risks. Benefits included reduced depression severity, improved emotion processing, new perspectives, and better relaxation and sleep. Risks included changes in sleep, increased mania severity, hospitalization, and distressing sensory experiences. Contextual factors such as poly-substance use, psilocybin dose, solo versus social use, and pre-use sleep deprivation influenced outcomes. The findings highlight the need for carefully designed clinical trials to assess safety and preliminary efficacy of psilocybin therapy in this population.