PLoS ONE
October 24, 2023
Jules Evans, Oliver Robinson, Eirini K. Argyri et al.
166 citations
Long-term adverse experiences after psychedelic use can last weeks, months, or even years and are understudied. A mixed-method study of 608 participants who reported extended difficulties found the most common challenges were anxiety and fear, existential struggle, social disconnection, depersonalization, and derealization. For about one-third of participants, problems persisted over a year; for one-sixth, they lasted more than three years. Shorter difficulties were predicted by knowing the dose and drug type and by lower difficulty during the experience; a narrower range of difficulties was predicted by taking the drug in a guided setting. Implications for harm reduction are discussed.
PloS one
January 1, 2025
Eirini K Argyri, Jules Evans, David Luke et al.
27 citations
Psychedelic experiences can sometimes trigger long-lasting existential distress, marked by confusion about existence and purpose, alongside cognitive, emotional, social, and bodily difficulties. Interviews with 26 people who experienced such distress revealed that ontological challenges—struggles with understanding reality—were common. Participants alleviated distress primarily through 'grounding' practices: embodiment, social connection, and cognitive normalization of their experience. The findings suggest psychedelic experiences act as pivotal mental states that can facilitate transformative learning, challenging and expanding meaning-making. This work contributes to understanding how people reestablish coherence and grow after ontologically challenging psychedelic experiences.
Frontiers in Psychology
May 28, 2024
Oliver Robinson, Jules Evans, David Luke et al.
24 citations
After a psychedelic experience, some people face difficulties that last at least a day. An international survey of 608 such individuals found they used a variety of coping strategies. The most common individual strategies were meditation and prayer, followed by self-educational activities like reading and journaling. Social coping most often involved seeking support from friends or family, then from a therapist or coach. Helpful features of social support included feeling heard and accepted, a non-judgmental attitude, and sharing similar experiences. These findings can inform therapeutic interventions and educational resources for those experiencing extended post-psychedelic difficulties.
April 28, 2023
Rosalind McAlpine, George Blackburne, Sunjeev K. Kamboj
22 citations
preprint
A new 20-item Psychedelic Preparedness Scale (PPS) measures how well participants are prepared for psychedelic experiences, addressing a gap in available assessment tools. Developed using an iterative Delphi-focus group method and validated in two large online samples (N = 516 and N = 716) plus a psilocybin retreat group (N = 46), the scale identifies four factors: Knowledge-Expectations, Intention-Preparation, Psychophysical-Readiness, and Support-Planning. It shows excellent reliability (ω = 0.954) and evidence of convergent, divergent, and discriminant validity. Higher pre-experience preparedness scores predicted better mental health and wellbeing outcomes after the experience, indicating the scale's predictive utility for assessing participants' psychological 'set' and potential benefit or reduced harm.
bioRxiv (Cold Spring Harbor Laboratory)
October 7, 2024
George Blackburne, Rosalind McAlpine, Marco S. Fabus et al.
8 citations
preprint
A high dose of the psychedelic drug 5-MeO-DMT radically reorganizes low-frequency brain activity in 29 healthy individuals. Inhaling 12 mg of vaporized synthetic 5-MeO-DMT caused neural activity flows to become incoherent, heterogeneous, viscous, fleeting, and nonrecurring, ceasing typical traveling waves across the cortex. This reorganization led to slower, more stable, low-dimensional broadband activity with increased energy barriers to rapid global shifts. The findings provide the first detailed empirical account of how 5-MeO-DMT alters human brain dynamics, revealing novel cortical slow wave behaviors.
February 9, 2024
Rosalind McAlpine, George Blackburne
3 citations
preprint
Group psychedelic therapies may help address suicidality by enhancing social connectedness, a key factor in suicide risk. The paper reviews psychosocial theories of suicide, emphasizing the role of perceived social support and interpersonal relationships. It proposes that psychedelic experiences in group settings can foster belonging and interconnectedness, potentially reducing suicidal thoughts and behaviors. Drawing on qualitative insights from participants in psychedelic retreats and existing literature, the paper explores theoretical foundations, historical context, and the need for rigorous research on efficacy and safety. Ethical considerations and the importance of nuanced approaches to psychedelics in suicide prevention are also discussed.
PLoS ONE
June 18, 2026
Elisa Liberati, Hv Curran, Peter Fonagy et al.
MDMA-assisted psychotherapy shows promise for treating PTSD, but the psychological mechanisms behind its effects are not well understood. This qualitative study will have approximately 25 experienced psychodynamic psychotherapists receive two doses of MDMA (80-120 mg, oral) in an open-label design. Participants will complete interviews before, during, and after MDMA sessions, plus daily journals. Researchers will use phenomenological and thematic analysis, along with grounded theory, to develop a model of MDMA's psychological mechanisms of action. The study treats therapists as expert observers of their own psychological processes, aiming to generate insights that can inform future treatment models and offer a framework for qualitative mechanistic research on psychedelics.
BMJ open
March 12, 2026
Rosalind McAlpine, Magdalena Jaglinska, Krisztina Jedlovszky et al.
A 21-day mobile-accessible programme called the Digital Intervention for Psychedelic Preparation (DIPP) is being tested for feasibility and preliminary efficacy in a randomised controlled trial. The study will recruit 40 non-treatment-seeking adults without a clinical diagnosis, randomly assigning them to either a guided meditation with music condition or a music-only condition. After the digital intervention, all participants will attend an in-person supervised psilocybin session with a standardised 25 mg dose. Primary outcomes include recruitment efficiency, retention, and adherence; secondary outcomes assess preparedness, quality of the psychedelic experience, and wellbeing, with follow-ups up to 9 months. The trial is registered as NCT06815653.
November 22, 2023
Rosalind McAlpine, Katarina Krajnović, Maisha M. Khan et al.
preprint
A self-directed, 21-day digital course (Digital Intervention for Psychedelic Preparation, DIPP) was developed to help people prepare for psychedelic experiences. The course is based on a four-factor model of psychedelic preparedness: Knowledge-Expectation, Psychophysical-Readiness, Safety-Planning, and Intention-Preparation. It includes daily meditation, weekly exercises, and mood tracking. Development followed the UK Medical Research Council framework for complex interventions and used a person-centred, co-design approach. Interviews with 19 past retreat attendees and co-design workshops with 28 current retreat attendees shaped the intervention. DIPP offers a scalable, digital solution to enhance preparedness, aiming to limit adverse reactions and improve therapeutic benefits.