Cardiovascular effects and safety of classic psychedelics.

Psychedelics, long used in spiritual and healing contexts, are being studied as treatments for depression, PTSD, substance use disorders, and anxiety. However, data on their cardiovascular safety are limited. This review categorizes cardiovascular effects into three areas: electrophysiological effects and arrhythmia risk, structural effects and valvular heart disease risk, and vascular effects including hypertension and ischemia. It highlights crucial knowledge gaps, such as the need for studies in people with underlying cardiovascular disease, characterization of drug-drug interactions, and research on the safety of repetitive, long-term exposure, including microdosing.

Study at a glance

Abstract

Psychedelics, used for millennia in spiritual and healing practices, have emerged as promising treatments for mental health conditions including depression, post-traumatic stress disorder (PTSD), substance use disorders and anxiety. Despite the therapeutic potential of psychedelics and their increasing use in both medical and nonmedical settings, there is a paucity of data on their cardiovascular safety. Here we review current evidence on the cardiovascular effects and safety of this unique class of therapeutic agents. The cardiovascular effects and associated risks of classic psychedelics are categorized into three areas: electrophysiological effects and arrhythmia risk, structural effects and valvular heart disease risk, and vascular effects including hypertension and ischemia risks. The Review also emphasizes crucial knowledge gaps that require further basic and clinical investigation including studies in individuals with underlying cardiovascular disease, characterization of important drug-drug interactions and studies on the safety of repetitive, long-term (including microdosing) exposure to classic psychedelics.