Anaesthetic implications of psilocybin and lysergic acid diethylamide: what is old is now new: A narrative review on psychedelics and anaesthesia.
European journal of anaesthesiology May 1, 2025 Mansi Dave, Ron Shore, Tracy Cupido et al.
Psychedelic drugs like psilocybin, LSD, and mescaline are increasingly used to treat mental health and pain disorders, raising safety concerns for anesthesiologists. Psilocybin activates 5HT serotonin receptors, causing sympathetic activation and haemodynamic instability, and chronic use elevates cortisol, affecting preoperative glucocorticoid dosing. LSD potentiates opioid analgesics and inhibits monoamine oxidase; historical reports suggest it may prolong neuromuscular block with depolarizing muscle relaxants. Mescaline has autonomic effects and historical associations with decreased neuromuscular transmission and malignant hyperthermia. Delaying surgery until acute intoxication subsides is recommended, and understanding management principles is vital for safe anesthesia.