In the reviewed studies, no serious adverse events were linked to psilocybin or LSD administration. Most side effects were anticipated, manageable, and temporary. However, concerns persist about certain effects like dissociation, paranoia, and confusion. The authors conclude that larger randomized controlled trials are needed to confirm therapeutic benefits and further assess safety and tolerability.
A commentary critiques a prior article on psychedelic research, arguing it underrepresents the role of glutamate in psychedelic neurochemistry and incorrectly claims that psilocybin is the only classic psychedelic studied with human neuroimaging. The commentary notes that head-twitch behavior, a mouse proxy for human psychedelic action, depends on metabotropic glutamate 2 receptors co-expressed with 5-HT2A receptors. It also lists human neuroimaging studies of mescaline, dimethyltryptamine, and ayahuasca. The commentary raises unresolved questions about discrepancies between intravenous psilocybin studies showing decreased cerebral blood flow and oral psilocybin studies showing increased glucose metabolism.