People who use the psychoactive mushroom Amanita muscaria (fly agaric) report more positive than negative effects, and the negative effects are typically mild and temporary. This conclusion comes from analyzing 998 main posts and 9,542 comments on the Reddit forum r/AmanitaMuscaria. Users described reasons for consumption, modes of use, and both beneficial and adverse outcomes. The findings suggest that medical providers may not easily learn about a patient's use of this mushroom unless severe side effects occur. Further research into the mushroom's pharmacology and deeper analysis of online discussions is recommended to inform safe practices.
A review of human studies on ibogaine and its metabolite noribogaine found only three randomized controlled trials. In one pilot study, a single 1800 mg dose of ibogaine reduced cocaine craving versus placebo over up to 24 weeks in 20 adults. Noribogaine doses of 3-60 mg were safe in 36 healthy volunteers. In 27 opioid-dependent patients, noribogaine 60-180 mg caused dose-dependent QTc prolongation with non-significant reductions in withdrawal symptoms. Adverse effects include neurologic, psychiatric, and cardiac events, and fatalities have occurred with comorbidities. Microdosing protocols lack standardized definitions and are supported only by preliminary observational data. The authors conclude that clinical use cannot be recommended without larger, well-controlled trials due to cardiotoxicity and a narrow therapeutic margin.