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Start with the decision, not the date. What are you hoping for? How are you doing at the moment? What support would you have?

Our Preparation Guidebook walks through health, intentions, setting and support. You do not need to decide to take a psychedelic to use it. Waiting, choosing another approach or deciding against it are all valid outcomes.

Psychedelics can change perception, mood and thought. Classic psychedelics include psilocybin, LSD, mescaline and DMT. MDMA and ketamine are often discussed alongside them, but they work differently and have different risks.

Each substance needs its own discussion of effects and risks. Our comparison of psychedelics explains the distinctions.

Sources: Classic psychedelics: pharmacology review — Nichols, 2016 · MDMA pharmacology and health review (2025) · Ketamine use disorder: systematic review (2024)

It varies from person to person, and from one experience to the next. With psilocybin, people may notice changes in perception, a different sense of time, strong emotions or vivid memories. Some feel connected or moved; others feel frightened, confused or overwhelmed.

You do not need a mystical experience or a dramatic insight for your experience to matter. Read what an experience can feel like.

Sources: Psilocybin: evidence and risks — NCCIH

You do not have to push past uncertainty to prove anything. Try to name what worries you: your health, the loss of control, the person supporting you, or pressure to do it at all.

Work through those questions before committing. If you feel pressured, do not trust the setting, or cannot get a clear answer to an important concern, pause. Our set and setting article is a useful starting point.

There is no blanket answer. Risk depends on the substance, your health, other drugs or medications, and the setting. Studies usually involve screened participants and substantial support; their results cannot establish safety for everyone outside those conditions.

Serious adverse events have occurred, and research has not consistently captured every harm. Preparation can reduce some risks, but it cannot remove them. Start with our medical-screening questions.

Sources: Adverse events: systematic review — Hinkle and colleagues, 2024

Pause if your mental or physical health is unstable, medication changes have left you unwell, or you cannot arrange reliable support. A booked date is not a reason to rush.

Particular caution is needed with bipolar disorder, psychosis or a relevant family history, significant suicidal thoughts, and serious medical conditions. Research often excludes people with these risks, so reassuring trial results may not apply. Pregnancy and breastfeeding also need specific medical advice; do not assume safety.

These examples are not a complete screening checklist. Review your situation with a clinician and use our screening information to prepare.

Sources: Research safety guidelines — Johnson and colleagues · Psilocybin: evidence and risks — NCCIH

Do not stop abruptly. Tapering is not automatically required. Small studies of psilocybin with ongoing SSRIs and LSD after one SSRI challenge a blanket stopping rule. They do not establish that every combination is safe. MDMA has different interactions.

Stopping can cause withdrawal and the condition being treated can return. Any medication change should be an individual decision with your prescriber. Read our SSRI article and medication considerations, including lithium, MAOIs and multiple medications.

Sources: Psilocybin with an ongoing SSRI — Goodwin and colleagues, 2023 · LSD and paroxetine trial — Becker and colleagues, 2025 · MDMA and paroxetine study — Farré and colleagues, 2007 · Stopping antidepressants — Royal College of Psychiatrists

Do not take more to try to overcome it. Feeling less does not reliably tell you how much drug is in your body. In controlled interaction studies, paroxetine increased LSD or MDMA exposure even though some subjective effects were reduced or unchanged.

There is no reliable adjustment you can make from a muted feeling. Bring the exact medication and substance to a prescriber or pharmacist for review. See the substance-specific evidence.

Sources: LSD and paroxetine trial — Becker and colleagues, 2025 · MDMA and paroxetine study — Farré and colleagues, 2007

With psilocybin, reported effects include nausea, headache, dizziness, anxiety and increases in heart rate or blood pressure. Distress, poor sleep or other difficulties can continue afterwards. Other substances have different risk profiles.

Do not assume a symptom is harmless because someone calls it part of the journey. Read health risks and the urgent-help guidance below.

Sources: Psilocybin: evidence and risks — NCCIH · Adverse events: systematic review — Hinkle and colleagues, 2024

Classic psychedelics such as psilocybin and LSD generally have low dependence potential. That does not mean use is always harmless or cannot become problematic.

Do not apply that reassurance to every substance discussed here. Ketamine and MDMA have different dependence and other health risks. If use is becoming difficult to control or is interfering with daily life, seek support.

Sources: Classic psychedelics: pharmacology review — Nichols, 2016 · Ketamine use disorder: systematic review (2024) · MDMA pharmacology and health review (2025)

Not necessarily. It is still unclear whether psilocybin microdosing is safe or effective. A small amount does not settle questions about interactions, suitability or repeated use.

Do not use microdosing as a substitute for assessing those questions or as a reason to change an effective treatment.

Sources: Psilocybin: evidence and risks — NCCIH

Think in three stages:

• Before: review your health and medications, discuss boundaries, and arrange trusted support.
• During: have a calm, physically safe setting and someone able to recognise when outside help is needed.
• After: leave time to rest, reflect and check in.

These are planning principles, not a guarantee of safety. Use the Preparation, Journey Day and Integration guides to work through the details.

Sources: Research safety guidelines — Johnson and colleagues

Choose someone you can say no to. Ask about their experience, training, boundaries, emergency plan and follow-up. Be cautious about anyone who guarantees a result, pressures you to proceed or treats medication changes as a simple requirement.

A sitter’s presence is not medical clearance, and calling someone a facilitator does not establish their qualifications. Bring our questions for a sitter or facilitator to the conversation.

Read the Sitter Guidebook together beforehand. Agree on your role, boundaries, practical needs and when to get outside help. Be honest about what you can and cannot handle.

Stay sober and available. Offer calm support without forcing an interpretation or insisting someone relive a memory. Discuss touch beforehand and keep checking comfort; earlier agreement is not permission to ignore a later no or signs of distress.

People use the term for experiences involving intense fear, confusion, panic or distress. It does not mean you failed. Preparation and support matter, but they do not guarantee an easy experience.

Some people later find meaning in a difficult experience. Others have lasting difficulties. You do not have to label suffering as healing or find a positive lesson in it. See support after a difficult experience.

Sources: Psilocybin: evidence and risks — NCCIH · Extended difficulties and support — Robinson and colleagues, 2024

Integration means making time to consider what happened and how, if at all, it relates to everyday life. It can be as simple as resting, writing a few notes, talking with someone you trust and trying one small, practical change.

You do not have to explain everything immediately or make a major life decision because an insight felt certain. Our Integration Guidebook offers reflection prompts and ways to begin.

Take it seriously, especially if sleep, mood, perception or daily functioning has changed. Contact a health professional and explain what you took, when, any medication changes and what is happening now.

Support needs vary; there is no single timeline everyone must follow. Do not use another psychedelic experience to try to fix the first. Our aftercare article explains what to notice and how to ask for help.

Sources: Extended difficulties and support — Robinson and colleagues, 2024

Call 911 in Canada, or your local emergency number, if someone is unconscious, is not breathing or is having a seizure. Do not wait for the experience to wear off. Tell responders what was taken, if known.

If you or someone else is in immediate danger, call emergency services. In Canada, you can call or text 9-8-8 for suicide crisis support. Entheo’s email is not an emergency service.

Sources: Poisoning and emergency help — HealthLink BC · Get help now — Canada’s 9-8-8 Suicide Crisis Helpline

Yes. Start with Preparation, then read Journey Day and Integration. Anyone supporting you should read the Sitter Guidebook too.

The books help you prepare questions and make plans. They do not replace medical screening, professional care or an individual medication review.

It depends on the substance, location and authorisation. In Canada, possessing, producing or selling psilocybin is illegal unless specifically authorised. Limited routes can include approved clinical trials, an exemption or Health Canada’s Special Access Program; access is not automatic.

Do not assume an online shop or a retreat is legally authorised because it operates openly. Check the rules where you are. Countries use different legal systems, and rules can change.

Sources: Psilocybin and legal access — Health Canada