Trip killer

<h2 id="serotonergic-psychedelic-antidotes">Serotonergic psychedelic antidotes</h2>
<h3>Serotonin 5-HT2A receptor antagonists</h3>
See also: <a href="/facts/Trazodone/ncFDxzGF">Trazodone § Antagonism of serotonergic psychedelics</a>
<a href="/facts/Serotonergic_psychedelic/oyp10dgE">Serotonergic psychedelics</a>, such as <a href="/facts/Psilocybin/0jGynLUX">psilocybin</a> (found in <a href="/facts/Psilocybin_mushroom/tJ29VHJY">psilocybin mushrooms</a>), <a href="/facts/Lysergic_acid_diethylamide/o5qq0grH">lysergic acid diethylamide</a> (LSD), <a href="/facts/Mescaline/Y6gXHD9T">mescaline</a> (found in <a href="/facts/Peyote/dEbKaL6t">peyote</a> <a href="/facts/Cactus/JTf3NFBj">cactii</a>), and <a href="/facts/Dimethyltryptamine/oIPCXryU">dimethyltryptamine</a> (DMT) (found in <a href="/facts/Ayahuasca/jLkugAhS">ayahuasca</a>), mediate their hallucinogenic effects by acting as <a href="/facts/Agonist/nz8U5NNp">agonists</a> of the <a href="/facts/Serotonin/EzY58q4a">serotonin</a> <a href="/facts/5-HT2A_receptor/YfTglQKQ">5-HT2A receptor</a>.<a class="footnote-ref" id="fnref:21" href="#fn:21">21</a><a class="footnote-ref" id="fnref:22" href="#fn:22">22</a><a class="footnote-ref" id="fnref:23" href="#fn:23">23</a> As a result, serotonin 5-HT2A receptor <a href="/facts/Receptor_antagonist/PuXHVNdV">antagonists</a> would theoretically be expected to block the hallucinogenic effects of serotonergic psychedelics.<a class="footnote-ref" id="fnref:24" href="#fn:24">24</a> Accordingly, the serotonin 5-HT2A receptor antagonists <a href="/facts/Ketanserin/UANlgLWq">ketanserin</a>, an <a href="/facts/Antihypertensive_agent/K63MbxN0">antihypertensive agent</a>, and <a href="/facts/Risperidone/xpFEYzoF">risperidone</a>, an <a href="/facts/Antipsychotic/7bNTg7T3">antipsychotic</a>, have been shown to block the effects of serotonergic psychedelics in <a href="/facts/Clinical_study/q8LMr832">clinical studies</a>.<a class="footnote-ref" id="fnref:25" href="#fn:25">25</a><a class="footnote-ref" id="fnref:26" href="#fn:26">26</a><a class="footnote-ref" id="fnref:27" href="#fn:27">27</a><a class="footnote-ref" id="fnref:28" href="#fn:28">28</a> This includes the effects of psilocybin,<a class="footnote-ref" id="fnref:29" href="#fn:29">29</a><a class="footnote-ref" id="fnref:30" href="#fn:30">30</a><a class="footnote-ref" id="fnref:31" href="#fn:31">31</a> LSD,<a class="footnote-ref" id="fnref:32" href="#fn:32">32</a><a class="footnote-ref" id="fnref:33" href="#fn:33">33</a> mescaline,<a class="footnote-ref" id="fnref:34" href="#fn:34">34</a> and ayahuasca.<a class="footnote-ref" id="fnref:35" href="#fn:35">35</a> Ketanserin is under formal clinical investigation as a "neutralizer" or "off-switch" for psychedelics.<a class="footnote-ref" id="fnref:36" href="#fn:36">36</a><a class="footnote-ref" id="fnref:37" href="#fn:37">37</a><a class="footnote-ref" id="fnref:38" href="#fn:38">38</a><a class="footnote-ref" id="fnref:39" href="#fn:39">39</a><a class="footnote-ref" id="fnref:40" href="#fn:40">40</a> The more <a href="/facts/Binding_selectivity/RryTsdGv">selective</a> serotonin 5-HT2A receptor antagonist <a href="/facts/Pimavanserin/tGbBLkts">pimavanserin</a> is also being studied as a blocker of the effects of psychedelics.<a class="footnote-ref" id="fnref:41" href="#fn:41">41</a>
Other <a href="/facts/Potency_(pharmacology)/D38FDyPh">potent</a> serotonin 5-HT2A receptor antagonists that may block or reduce the effects of serotonergic psychedelics besides the above-listed drugs include other antipsychotics like <a href="/facts/Quetiapine/hI3hPqEH">quetiapine</a>, <a href="/facts/Olanzapine/8BhqJuPM">olanzapine</a>, <a href="/facts/Aripiprazole/A6g2UwMz">aripiprazole</a>, and <a href="/facts/Pipamperone/85v5drH9">pipamperone</a>, antidepressants like <a href="/facts/Trazodone/ncFDxzGF">trazodone</a>, <a href="/facts/Mirtazapine/VyxPQttv">mirtazapine</a>, <a href="/facts/Mianserin/pV7Q1lnL">mianserin</a>, <a href="/facts/Nefazodone/E0X334wJ">nefazodone</a>, and <a href="/facts/Etoperidone/eVQPaxKp">etoperidone</a>, and the <a href="/facts/Antimigraine_agent/bz43mSYn">antimigraine agent</a> <a href="/facts/Pizotifen/XJRDMwc3">pizotifen</a>, among others.<a class="footnote-ref" id="fnref:42" href="#fn:42">42</a><a class="footnote-ref" id="fnref:43" href="#fn:43">43</a><a class="footnote-ref" id="fnref:44" href="#fn:44">44</a> The <a href="/facts/Typical_antipsychotic/TpHx2fqp">typical antipsychotic</a> <a href="/facts/Chlorpromazine/oFja1FYA">chlorpromazine</a>, which has significant but less-potent serotonin 5-HT2A receptor antagonism than many other antipsychotics, has shown incomplete and inconsistent effects in reversing psychedelic effects in clinical studies,<a class="footnote-ref" id="fnref:45" href="#fn:45">45</a><a class="footnote-ref" id="fnref:46" href="#fn:46">46</a><a class="footnote-ref" id="fnref:47" href="#fn:47">47</a> while the typical antipsychotic <a href="/facts/Haloperidol/ue4TJKmu">haloperidol</a>, which is a <a href="/facts/Dopamine/5gNy8Xkd">dopamine</a> <a href="/facts/D2_receptor/SmmP3QyU">D2 receptor</a> antagonist but not a significant serotonin 5-HT2A receptor antagonist, is ineffective and has actually been found to increase anxiety and <a href="/facts/Dysphoria/ltFryLsg">dysphoria</a> in the setting of psychedelic experiences.<a class="footnote-ref" id="fnref:48" href="#fn:48">48</a><a class="footnote-ref" id="fnref:49" href="#fn:49">49</a><a class="footnote-ref" id="fnref:50" href="#fn:50">50</a><a class="footnote-ref" id="fnref:51" href="#fn:51">51</a> In spite of variably acting as serotonin 5-HT2A receptor antagonists, <a href="/facts/Tricyclic_antidepressant/vpBLER2Q">tricyclic antidepressants</a> (TCAs), including <a href="/facts/Desipramine/1NvuPY6M">desipramine</a>, <a href="/facts/Imipramine/3ppWvEKp">imipramine</a>, and <a href="/facts/Clomipramine/wnhL4NfS">clomipramine</a>, have paradoxically been reported to potentiate the effects of serotonergic psychedelics rather than diminish them, albeit based on very limited data.<a class="footnote-ref" id="fnref:52" href="#fn:52">52</a><a class="footnote-ref" id="fnref:53" href="#fn:53">53</a>
<a href="/facts/Cyproheptadine/qsprhcYl">Cyproheptadine</a>, a <a href="/facts/Binding_selectivity/RryTsdGv">non-selective</a> <a href="/facts/Serotonin_receptor_antagonist/Fp9DX8oW">serotonin receptor antagonist</a> including of the serotonin 5-HT2A receptor, is used as an antidote in the treatment of <a href="/facts/Serotonin_syndrome/PqLvx901">serotonin syndrome</a> (serotonin toxicity) caused by <a href="/facts/Serotonergic_drug/EzY58q4a">serotonergic drugs</a>, including the toxicity of serotonergic psychedelics like the <a href="/facts/25-NB/dgahclhS">NBOMe</a> drugs.<a class="footnote-ref" id="fnref:54" href="#fn:54">54</a><a class="footnote-ref" id="fnref:55" href="#fn:55">55</a><a class="footnote-ref" id="fnref:56" href="#fn:56">56</a> Certain other serotonin receptor antagonists, like chlorpromazine, have also been used for such purposes.<a class="footnote-ref" id="fnref:57" href="#fn:57">57</a><a class="footnote-ref" id="fnref:58" href="#fn:58">58</a>
Non-hallucinogenic partial agonists of the serotonin 5-HT2A receptor with sufficiently low <a href="/facts/Intrinsic_activity/wRugal9r">intrinsic activity</a>, such as <a href="/facts/2-bromo-LSD/VNeSbw22">2-bromo-LSD</a> (bromolysergide; BOL-148) and <a href="/facts/Lisuride/bJUPphfB">lisuride</a>, are effective in blocking the hallucinogenic-related effects of psychedelics in animals and/or humans as well.<a class="footnote-ref" id="fnref:59" href="#fn:59">59</a><a class="footnote-ref" id="fnref:60" href="#fn:60">60</a> However, it has been argued that lisuride may actually be a psychedelic or hallucinogen itself at sufficiently high doses in humans.<a class="footnote-ref" id="fnref:61" href="#fn:61">61</a>
Serotonergic psychedelics are being developed as novel treatments for <a href="/facts/Psychiatric_disorder/EPNjFtFf">psychiatric disorders</a> and other conditions such as <a href="/facts/Depression_(mood)/GDNFWm1L">depression</a>.<a class="footnote-ref" id="fnref:62" href="#fn:62">62</a><a class="footnote-ref" id="fnref:63" href="#fn:63">63</a><a class="footnote-ref" id="fnref:64" href="#fn:64">64</a> A practical limitation in terms of clinical use of many major psychedelics, for instance psilocybin, LSD, and mescaline, is their long <a href="/facts/Duration_of_action/zdvfFshl">durations of action</a> (4–12 hours), which may require a whole day of clinical monitoring.<a class="footnote-ref" id="fnref:65" href="#fn:65">65</a><a class="footnote-ref" id="fnref:66" href="#fn:66">66</a><a class="footnote-ref" id="fnref:67" href="#fn:67">67</a> In relation to this, shorter-acting psychedelics, like DMT, <a href="/facts/5-MeO-DMT/loYNtULA">5-MeO-DMT</a> (mebufotenin), and <a href="/facts/Bretisilocin/bqnGgJbk">bretisilocin</a> (5-fluoro-MET; GM-2505), are also being investigated for potential therapeutic use.<a class="footnote-ref" id="fnref:68" href="#fn:68">68</a><a class="footnote-ref" id="fnref:69" href="#fn:69">69</a><a class="footnote-ref" id="fnref:70" href="#fn:70">70</a><a class="footnote-ref" id="fnref:71" href="#fn:71">71</a> However, an alternative approach that is being investigated is use of serotonin 5-HT2A receptor antagonists like ketanserin as trip killers to shorten the experiences of psychedelics.<a class="footnote-ref" id="fnref:72" href="#fn:72">72</a><a class="footnote-ref" id="fnref:73" href="#fn:73">73</a><a class="footnote-ref" id="fnref:74" href="#fn:74">74</a> In a <a href="/facts/Clinical_trial/q8LMr832">clinical trial</a>, ketanserin given 1 hour after LSD shortened its duration from 8.5 hours to 3.5 hours (by ~60%).<a class="footnote-ref" id="fnref:75" href="#fn:75">75</a><a class="footnote-ref" id="fnref:76" href="#fn:76">76</a> It did not modify the <a href="/facts/Pharmacokinetics/x4CUUnle">pharmacokinetics</a> of LSD, and its <a href="/facts/Side_effect/PhuX2haY">side effects</a>, such as <a href="/facts/Nasal_congestion/xClWzxrg">nasal congestion</a>, were minimal.<a class="footnote-ref" id="fnref:77" href="#fn:77">77</a><a class="footnote-ref" id="fnref:78" href="#fn:78">78</a>

<h3>GABAA receptor positive allosteric modulators</h3>
<a href="/facts/Benzodiazepine/IgbJr4jy">Benzodiazepines</a>, such as <a href="/facts/Diazepam/h7lIGqkM">diazepam</a> and <a href="/facts/Alprazolam/nfMPlLFa">alprazolam</a>, are sometimes used to manage the effects of serotonergic psychedelics, including clinically.<a class="footnote-ref" id="fnref:79" href="#fn:79">79</a><a class="footnote-ref" id="fnref:80" href="#fn:80">80</a><a class="footnote-ref" id="fnref:81" href="#fn:81">81</a> They act as <a href="/facts/Positive_allosteric_modulator/Gg1It5Cj">positive allosteric modulators</a> of the <a href="/facts/GABAA_receptor/6G4rAGb3">GABAA receptor</a>, and do not specifically antagonize hallucinogenic effects (i.e., are not <a href="/facts/Antidote/l9rHGlko">antidotes</a>), but instead have <a href="/facts/Anxiolytic/uEWpGca9">anxiolytic</a>, <a href="/facts/Sedative/JWzvq66P">sedative</a>, and <a href="/facts/Amnesia/PaMeGJH7">memory-impairing</a> effects that can lessen the negative effects of psychedelic experiences.<a class="footnote-ref" id="fnref:82" href="#fn:82">82</a> <a href="/facts/Alcohol_(drug)/IeK2fVd5">Alcohol</a>, which is also a GABAA receptor positive allosteric modulator with similar effects, has been used for such purposes as well.<a class="footnote-ref" id="fnref:83" href="#fn:83">83</a><a class="footnote-ref" id="fnref:84" href="#fn:84">84</a>

<h3>Other agents</h3>
Besides serotonin 5-HT2A receptor antagonists, chronic use of other serotonergic drugs may also diminish the effects of serotonergic psychedelics.<a class="footnote-ref" id="fnref:85" href="#fn:85">85</a><a class="footnote-ref" id="fnref:86" href="#fn:86">86</a> Examples include serotonin <a href="/facts/5-HT1A_receptor/aMCB3tvc">5-HT1A receptor</a> agonists like <a href="/facts/Buspirone/IeoGp3eD">buspirone</a>, <a href="/facts/Serotonin_reuptake_inhibitor/aAWCuaD5">serotonin reuptake inhibitors</a> such as <a href="/facts/Selective_serotonin_reuptake_inhibitor/L6jjcmEH">selective serotonin reuptake inhibitors</a> (SSRIs) like <a href="/facts/Fluoxetine/U28lM3Pm">fluoxetine</a>, <a href="/facts/Paroxetine/FIR7QqMP">paroxetine</a>, and <a href="/facts/Sertraline/SBk6L0Jr">sertraline</a> and <a href="/facts/Serotonin%25E2%2580%2593norepinephrine_reuptake_inhibitor/PSr56Vxh">serotonin–norepinephrine reuptake inhibitors</a> (SNRIs) like <a href="/facts/Venlafaxine/x99jcWk6">venlafaxine</a>, <a href="/facts/Duloxetine/HeNxMrBw">duloxetine</a>, and <a href="/facts/Milnacipran/yseGMSSy">milnacipran</a>, and <a href="/facts/Monoamine_oxidase_inhibitor/obewT56a">monoamine oxidase inhibitors</a> (MAOIs) such as <a href="/facts/Phenelzine/lwCH0IDJ">phenelzine</a>, <a href="/facts/Tranylcypromine/YVIArwgA">tranylcypromine</a>, and <a href="/facts/Moclobemide/vtr3h3D9">moclobemide</a>.<a class="footnote-ref" id="fnref:87" href="#fn:87">87</a><a class="footnote-ref" id="fnref:88" href="#fn:88">88</a> Buspirone, a <a href="/facts/Partial_agonist/VLm2vmgU">partial agonist</a> of the serotonin 5-HT1A receptor, has specifically been found to markedly attenuate the visual and certain other effects of psilocybin, although it did not completely block the hallucinogenic effects of psilocybin.<a class="footnote-ref" id="fnref:89" href="#fn:89">89</a><a class="footnote-ref" id="fnref:90" href="#fn:90">90</a><a class="footnote-ref" id="fnref:91" href="#fn:91">91</a> The reduced effects of psychedelics in the case of concomitant drugs that elevate serotonin levels may be due to <a href="/facts/Receptor_downregulation/tjTAC76a">desensitization</a> of serotonin 5-HT2A receptors.<a class="footnote-ref" id="fnref:92" href="#fn:92">92</a><a class="footnote-ref" id="fnref:93" href="#fn:93">93</a> In contrast to earlier studies however, other more recent studies have found that SSRIs like <a href="/facts/Escitalopram/qoCbRxWA">escitalopram</a> may not diminish the hallucinogenic effects of psychedelics like psilocybin and DMT.<a class="footnote-ref" id="fnref:94" href="#fn:94">94</a><a class="footnote-ref" id="fnref:95" href="#fn:95">95</a> Instead, in one study, escitalopram resulted in greater <a href="/facts/Mystical_experience/JgSs5tTb">mystical experience</a>, <a href="/facts/Emotional_breakthrough/d2XlUo6w">emotional breakthrough</a>, and <a href="/facts/Ego_dissolution/UuU2H9cs">ego dissolution</a> scores with DMT than in people not on escitalopram.<a class="footnote-ref" id="fnref:96" href="#fn:96">96</a>
Although MAOIs can diminish the effects of serotonergic psychedelics, some serotonergic psychedelics, such as DMT, are highly susceptible <a href="/facts/Substrate_(biochemistry)/6MnaV19h">substrates</a> for <a href="/facts/Monoamine_oxidase/4bJuxUFy">monoamine oxidase</a> (MAO), and hence can simultaneously be greatly potentiated by MAOIs (as in ayahuasca).<a class="footnote-ref" id="fnref:97" href="#fn:97">97</a><a class="footnote-ref" id="fnref:98" href="#fn:98">98</a> The <a href="/facts/2C_drug/CwHza8Wg">2C drugs</a>, such as <a href="/facts/2C-B/TerpnRXS">2C-B</a>, <a href="/facts/2C-I/r2eLGaVJ">2C-I</a>, and <a href="/facts/2C-E/nawulo5a">2C-E</a>, are also notable substrates of both <a href="/facts/MAO-A/VXqw1LUU">MAO-A</a> and <a href="/facts/MAO-B/wa0xq7KL">MAO-B</a>, and may likewise be greatly potentiated by MAOIs.<a class="footnote-ref" id="fnref:99" href="#fn:99">99</a><a class="footnote-ref" id="fnref:100" href="#fn:100">100</a>
High-dose <a href="/facts/Nicotinic_acid/UAAqPpk6">nicotinic acid</a> (niacin, a B3 <a href="/facts/Vitamer/heV18pH1">vitamer</a>) was reported to reduce and block the effects of LSD in one early clinical study.<a class="footnote-ref" id="fnref:101" href="#fn:101">101</a><a class="footnote-ref" id="fnref:102" href="#fn:102">102</a><a class="footnote-ref" id="fnref:103" href="#fn:103">103</a> However, a subsequent clinical study attempting to <a href="/facts/Reproducibility/yh5pawMj">replicate</a> the findings found that it was not effective for this purpose.<a class="footnote-ref" id="fnref:104" href="#fn:104">104</a> <a href="/facts/Azacyclonol/y6eUuBod">Azacyclonol</a>, a claimed <a href="/facts/Ataractive/h9CS0St1">ataractive</a> (i.e., non-antipsychotic <a href="/facts/Hallucination/5eUvLcnp">hallucination</a>-suppressing medication) that is no longer marketed, likewise seems to be ineffective.<a class="footnote-ref" id="fnref:105" href="#fn:105">105</a> Other non-serotonergic drugs that may block or reduce the effects of serotonergic psychedelics based on <a href="/facts/Animal_study/mHMf98y8">animal studies</a> include <a href="/facts/AMPA_receptor/FJHDlvkg">AMPA receptor</a> antagonists, <a href="/facts/Metabotropic_glutamate_receptor/01pA40Kg">metabotropic glutamate</a> <a href="/facts/MGlu2/AFXUBqu9">mGlu2</a> and <a href="/facts/MGlu3/7d9HNS1g">mGlu3 receptor</a> agonists, <a href="/facts/%25CE%259C-opioid_receptor/8a3wdeTc">μ-opioid receptor</a> agonists, and <a href="/facts/Adenosine/MwyTJ2wR">adenosine</a> <a href="/facts/A1_receptor/JbPCT974">A1 receptor</a> agonists.<a class="footnote-ref" id="fnref:106" href="#fn:106">106</a><a class="footnote-ref" id="fnref:107" href="#fn:107">107</a><a class="footnote-ref" id="fnref:108" href="#fn:108">108</a>
Some drugs that have been reported to potentiate rather than inhibit the effects of serotonergic psychedelics include <a href="/facts/Lithium_(medication)/G6Gy0nJU">lithium</a>, <a href="/facts/Reserpine/Hkb4T1oE">reserpine</a>, <a href="/facts/Pindolol/gtbedlPC">pindolol</a>, and <a href="/facts/Methysergide/Hblg2Wh8">methysergide</a>.<a class="footnote-ref" id="fnref:109" href="#fn:109">109</a> Pindolol, a <a href="/facts/Beta_blocker/PRsWgpLV">beta blocker</a> and serotonin 5-HT1A receptor antagonist, has been reported to potentiate the hallucinogenic effects of DMT by 2- to 3-fold in humans.<a class="footnote-ref" id="fnref:110" href="#fn:110">110</a><a class="footnote-ref" id="fnref:111" href="#fn:111">111</a> A high rate of <a href="/facts/Seizure/zuIrQyze">seizures</a> has been reported with the combination of lithium and psychedelics.<a class="footnote-ref" id="fnref:112" href="#fn:112">112</a><a class="footnote-ref" id="fnref:113" href="#fn:113">113</a><a class="footnote-ref" id="fnref:114" href="#fn:114">114</a>

<h3>Use by recreational psychedelic users</h3>
Trip killers on Reddit<a class="footnote-ref" id="fnref:115" href="#fn:115">115</a><table><tbody><tr><th>Drug</th><th>Dose</th></tr><tr><td><a href="/facts/Alprazolam/nfMPlLFa">Alprazolam</a></td><td>0.5–4 mg</td></tr><tr><td><a href="/facts/Diazepam/h7lIGqkM">Diazepam</a></td><td>3–20 mg</td></tr><tr><td><a href="/facts/Quetiapine/hI3hPqEH">Quetiapine</a></td><td>25–600 mg</td></tr><tr><td><a href="/facts/Trazodone/ncFDxzGF">Trazodone</a></td><td>50–150 mg</td></tr></tbody></table>
<a href="/facts/Recreational_drug_use/eoBD3vKn">Recreational psychedelic users</a> sometimes employ trip killers to abort psychedelic trips.<a class="footnote-ref" id="fnref:116" href="#fn:116">116</a><a class="footnote-ref" id="fnref:117" href="#fn:117">117</a><a class="footnote-ref" id="fnref:118" href="#fn:118">118</a> The most commonly encountered putative trip killers in a 2024 online study of <a href="/facts/Reddit/PAJjm63I">Reddit</a> <a href="/facts/Social_media/kUIkfpIA">social media</a> postings were the <a href="/facts/Benzodiazepine/IgbJr4jy">benzodiazepines</a> <a href="/facts/Alprazolam/nfMPlLFa">alprazolam</a> and <a href="/facts/Diazepam/h7lIGqkM">diazepam</a>, the antipsychotic <a href="/facts/Quetiapine/hI3hPqEH">quetiapine</a>, the <a href="/facts/Antidepressant/N62ND3Fa">antidepressant</a> <a href="/facts/Trazodone/ncFDxzGF">trazodone</a>, and <a href="/facts/Alcohol_(drug)/IeK2fVd5">alcohol</a>.<a class="footnote-ref" id="fnref:119" href="#fn:119">119</a><a class="footnote-ref" id="fnref:120" href="#fn:120">120</a><a class="footnote-ref" id="fnref:121" href="#fn:121">121</a> Others used less frequently included the benzodiazepines <a href="/facts/Lorazepam/59gNSrMN">lorazepam</a>, <a href="/facts/Clonazepam/D06A47Ed">clonazepam</a>, and <a href="/facts/Etizolam/1gGPYgR6">etizolam</a>, the antipsychotic <a href="/facts/Olanzapine/8BhqJuPM">olanzapine</a>, and the antidepressant <a href="/facts/Mirtazapine/VyxPQttv">mirtazapine</a>, among others.<a class="footnote-ref" id="fnref:122" href="#fn:122">122</a><a class="footnote-ref" id="fnref:123" href="#fn:123">123</a> While employed by recreational users for harm-reduction purposes, the use of trip killers to abort the effects of psychedelics is not fully characterized and could pose medical risks.<a class="footnote-ref" id="fnref:124" href="#fn:124">124</a><a class="footnote-ref" id="fnref:125" href="#fn:125">125</a><a class="footnote-ref" id="fnref:126" href="#fn:126">126</a><a class="footnote-ref" id="fnref:127" href="#fn:127">127</a> In addition, doses of trip killers used by recreational psychedelic users may be non-optimal or excessive and increase risks.<a class="footnote-ref" id="fnref:128" href="#fn:128">128</a><a class="footnote-ref" id="fnref:129" href="#fn:129">129</a>

<h2 id="antidotes-of-other-hallucinogens">Antidotes of other hallucinogens</h2>
<a href="/facts/Cannabinoid/MHcltwTn">Cannabinoid</a> <a href="/facts/CB1_receptor/7b2tfePV">CB1 receptor</a> <a href="/facts/Cannabinoid_receptor_antagonist/lHjM7Mwm">antagonists</a> like <a href="/facts/Rimonabant/mySKelkE">rimonabant</a>, <a href="/facts/Drinabant/3LsngEuz">drinabant</a>, <a href="/facts/Surinabant/sAqyqfnU">surinabant</a>, and <a href="/facts/Selonabant/DNgVBXXD">selonabant</a> have been found to block or reduce the psychoactive effects of <a href="/facts/Cannabinoid/MHcltwTn">cannabinoids</a> in clinical studies and could be useful as antidotes against <a href="/facts/Cannabinoid/MHcltwTn">cannabinoid</a> <a href="/facts/Toxicity/qa96rs60">toxicity</a>.<a class="footnote-ref" id="fnref:130" href="#fn:130">130</a><a class="footnote-ref" id="fnref:131" href="#fn:131">131</a><a class="footnote-ref" id="fnref:132" href="#fn:132">132</a> Likewise, the hallucinogenic and other effects of <a href="/facts/%25CE%259A-opioid_receptor/zJRo3NoF">κ-opioid receptor</a> <a href="/facts/Agonist/nz8U5NNp">agonists</a> like <a href="/facts/Salvinorin_A/MXfeqlem">salvinorin A</a> (found in <a href="/facts/Salvia_divinorum/c1RTXx7b">Salvia divinorum</a>), <a href="/facts/Butorphanol/bsJcCje7">butorphanol</a>, and <a href="/facts/Pentazocine/DuoNIw3f">pentazocine</a> have been shown to be blocked by the <a href="/facts/Binding_selectivity/RryTsdGv">non-selective</a> <a href="/facts/Opioid_receptor_antagonist/IRDdEk8N">opioid receptor antagonist</a> <a href="/facts/Naltrexone/SVduEm3W">naltrexone</a> in clinical studies.<a class="footnote-ref" id="fnref:133" href="#fn:133">133</a><a class="footnote-ref" id="fnref:134" href="#fn:134">134</a><a class="footnote-ref" id="fnref:135" href="#fn:135">135</a><a class="footnote-ref" id="fnref:136" href="#fn:136">136</a> Although clinical management of <a href="/facts/Antimuscarinic/802fuzgC">antimuscarinic</a> <a href="/facts/Deliriant/QVjeDyda">deliriant</a> <a href="/facts/Drug_intoxication/LRnMxrKd">intoxication</a> and <a href="/facts/Poisoning/oKDkhLbz">poisoning</a>, for instance due to <a href="/facts/Scopolamine/Fy2S6Lgf">scopolamine</a>, is usually supportive, <a href="/facts/Acetylcholinesterase_inhibitor/VbN36u7y">acetylcholinesterase inhibitors</a>, such as <a href="/facts/Physostigmine/wgYhxpcV">physostigmine</a>, have sometimes been used in this context as well.<a class="footnote-ref" id="fnref:137" href="#fn:137">137</a><a class="footnote-ref" id="fnref:138" href="#fn:138">138</a> <a href="/facts/Benzodiazepine/IgbJr4jy">Benzodiazepines</a> and <a href="/facts/Antipsychotic/7bNTg7T3">antipsychotics</a> have also been used in such situations.<a class="footnote-ref" id="fnref:139" href="#fn:139">139</a><a class="footnote-ref" id="fnref:140" href="#fn:140">140</a>
Although trip killers exist for certain types of hallucinogens, <a href="/facts/Antidote/l9rHGlko">antidotes</a> do not exist for all types of hallucinogens, for instance <a href="/facts/NMDA_receptor_antagonist/4VJvEpdK">NMDA receptor antagonist</a> <a href="/facts/Dissociative_drug/5aaD39vM">dissociatives</a> like <a href="/facts/Ketamine/BtNSoqvh">ketamine</a> and <a href="/facts/Phencyclidine/4LaNo5Cl">phencyclidine</a> (PCP).<a class="footnote-ref" id="fnref:141" href="#fn:141">141</a><a class="footnote-ref" id="fnref:142" href="#fn:142">142</a><a class="footnote-ref" id="fnref:143" href="#fn:143">143</a> <a href="/facts/NMDA_receptor/BqMhXEbU">NMDA receptor</a> agonists, which theoretically could reverse the effects of NMDA receptor antagonists, can produce <a href="/facts/Excitotoxicity/DKnHA79x">excitotoxic</a> <a href="/facts/Neurotoxicity/FrgTICfX">neurotoxicity</a> and <a href="/facts/Convulsion/4xL3VfkE">convulsions</a>, which restricts their potential medical use.<a class="footnote-ref" id="fnref:144" href="#fn:144">144</a><a class="footnote-ref" id="fnref:145" href="#fn:145">145</a><a class="footnote-ref" id="fnref:146" href="#fn:146">146</a> In any case, benzodiazepines can be useful in managing dissociative intoxication, but can also augment <a href="/facts/Sedation/wFWEChs8">sedation</a> and associated risks.<a class="footnote-ref" id="fnref:147" href="#fn:147">147</a><a class="footnote-ref" id="fnref:148" href="#fn:148">148</a><a class="footnote-ref" id="fnref:149" href="#fn:149">149</a> As with NMDA receptor antagonists, there is no antidote for <a href="/facts/Amanita_muscaria/2VybE2L2">Amanita muscaria</a> intoxication, in which the hallucinogenic <a href="/facts/GABAA_receptor/6G4rAGb3">GABAA receptor</a> <a href="/facts/Agonist/nz8U5NNp">agonist</a> <a href="/facts/Muscimol/B0vIWlcv">muscimol</a> is the active constituent.<a class="footnote-ref" id="fnref:150" href="#fn:150">150</a><a class="footnote-ref" id="fnref:151" href="#fn:151">151</a>
<a href="/facts/Entactogen/hxo3LqDS">Entactogens</a> like <a href="/facts/MDMA/WYDACxGN">MDMA</a> and <a href="/facts/Methylenedioxyamphetamine/VY3nE55f">MDA</a> are generally only mildly hallucinogenic at best, but use of "trip killers" to reverse the effects of these drugs has also been described.<a class="footnote-ref" id="fnref:152" href="#fn:152">152</a> Entactogens act primarily as <a href="/facts/Serotonin_releasing_agent/p19Sjpqx">serotonin releasing agents</a> that indirectly activate <a href="/facts/Serotonin_receptor/D6656QzQ">serotonin receptors</a> and require entry into <a href="/facts/Serotonin/EzY58q4a">serotonergic</a> <a href="/facts/Neuron/G7CyTVdH">neurons</a> via the <a href="/facts/Serotonin_transporter/VPh5wtCy">serotonin transporter</a> (SERT) to induce their entactogenic effects.<a class="footnote-ref" id="fnref:153" href="#fn:153">153</a><a class="footnote-ref" id="fnref:154" href="#fn:154">154</a> <a href="/facts/Serotonin_reuptake_inhibitor/aAWCuaD5">Serotonin reuptake inhibitors</a> (SRIs), for instance <a href="/facts/Selective_serotonin_reuptake_inhibitor/L6jjcmEH">selective serotonin reuptake inhibitors</a> (SSRIs) like <a href="/facts/Fluoxetine/U28lM3Pm">fluoxetine</a> and <a href="/facts/Citalopram/qepx3XJy">citalopram</a> and <a href="/facts/Serotonin%25E2%2580%2593norepinephrine_reuptake_inhibitor/PSr56Vxh">serotonin–norepinephrine reuptake inhibitors</a> (SNRIs) like <a href="/facts/Duloxetine/HeNxMrBw">duloxetine</a>, can markedly block or abolish the serotonin release induced by entactogens by preventing their transport into these neurons, and thus can strongly reduce most of their subjective effects in humans.<a class="footnote-ref" id="fnref:155" href="#fn:155">155</a><a class="footnote-ref" id="fnref:156" href="#fn:156">156</a><a class="footnote-ref" id="fnref:157" href="#fn:157">157</a> The serotonin <a href="/facts/5-HT2A_receptor/YfTglQKQ">5-HT2A receptor</a> <a href="/facts/Receptor_antagonist/PuXHVNdV">antagonist</a> <a href="/facts/Ketanserin/UANlgLWq">ketanserin</a> has also been found to partially reduce some of the subjective effects of MDMA, particularly its <a href="/facts/Perceptual_disturbance/PLRtY5SI">perceptual effects</a>, whereas the serotonin <a href="/facts/5-HT1A_receptor/aMCB3tvc">5-HT1A receptor</a> antagonist <a href="/facts/Pindolol/gtbedlPC">pindolol</a> was largely ineffective.<a class="footnote-ref" id="fnref:158" href="#fn:158">158</a><a class="footnote-ref" id="fnref:159" href="#fn:159">159</a><a class="footnote-ref" id="fnref:160" href="#fn:160">160</a><a class="footnote-ref" id="fnref:161" href="#fn:161">161</a> <a href="/facts/Binding_selectivity/RryTsdGv">Non-selective</a> <a href="/facts/Serotonin_receptor_antagonist/Fp9DX8oW">serotonin receptor antagonists</a> like <a href="/facts/Cyproheptadine/qsprhcYl">cyproheptadine</a> have been used in the clinical management of serotonin toxicity induced by MDMA, for instance in <a href="/facts/Overdose/Jlo2AX3Y">overdose</a> or precipitated by <a href="/facts/Drug_interaction/T5VcSVGd">drug interactions</a> like with <a href="/facts/Monoamine_oxidase_inhibitor/obewT56a">monoamine oxidase inhibitors</a> (MAOIs).<a class="footnote-ref" id="fnref:162" href="#fn:162">162</a><a class="footnote-ref" id="fnref:163" href="#fn:163">163</a><a class="footnote-ref" id="fnref:164" href="#fn:164">164</a>

<h2 id="see-also">See also</h2>
<ul><li><a href="/facts/Psychedelic_drug/aj9GNANW">Psychedelic drug § Interactions</a></li></ul>

<h2 id="external-links">External links</h2>
<ul><li><a href="https://doubleblindmag.com/dangers-of-trip-killers/">Reddit Says Xanax Is the Best “Trip Killer,” But Is It Safe? - Double Blind Magazine</a></li>
<li><a href="https://psychedelicreview.com/how-to-stop-a-psychedelic-trip-the-promise-of-ketanserin/">How To Stop A Psychedelic Trip: The Promise of Ketanserin - Psychedelic Science Review (PSR)</a></li>
<li><a href="https://psychedelicreview.com/stopping-bad-lsd-trips-with-off-switch-technology/">Stopping Bad LSD Trips with “Off-Switch” Technology - Psychedelic Science Review (PSR)</a></li>
<li><a href="https://theconversation.com/using-trip-killers-to-cut-short-bad-drug-trips-is-potentially-dangerous-222527">Using ‘trip killers’ to cut short bad drug trips is potentially dangerous - The Conversation</a></li></ul>

<h2 id="references">References</h2>

<ol>
<li id="fn:1">Muir OS, Shinozuka K, Beutler BD, Arenas A, Cherian K, Evans VD, Fasano C, Tabaac BJ (2024). "Psychedelic Therapy: A Primer for Primary Care Clinicians-The Strengths, Weaknesses, Opportunities, and Threats of Psychedelic Therapeutics". Am J Ther. 31 (2): e178 – e182. doi:10.1097/MJT.0000000000001720. PMID 38518273. When psychedelics are used in recreational contexts without adequate supervision, they can lead to tragic outcomes.20 There are rare reports of serious adverse effects, including psychosis and even suicide, arising from recreational use.21 Methods for subduing socalled "bad trips" in recreational settings include potentially dangerous habits, such as taking benzodiazepines, which are known to be "trip killers."22 <a href="https://www.researchgate.net/publication/379188134" target="_blank">https://www.researchgate.net/publication/379188134</a> <a href="#fnref:1" class="footnote-back-ref">↩</a></li>
<li id="fn:2">Bellanavidanalage Gothami Ayanthie Vis Jayasinha (8 February 2024). Towards Safer Trips: Exploring Harm Reduction Strategies for Recreational Psychedelic Use in Aotearoa New Zealand (Thesis). University of Otago. Retrieved 3 October 2024. Another form of mixing substances involves the use of trip killers; a pharmacological coping strategy aimed to reduce the negative effects of a psychedelic experience by consuming a different substance (Suran, 2024). While this is a new concept and an under researched area, there are reports of trip killers being effective in reducing the negative effects of a psychedelic experience (Suran, 2024). One study gathered research from reddit, an online social media platform, investigating the usage of trip killers during challenging psychedelic experiences (Suran, 2024). The most popular and effective trip killers used were prescription medication, with 47% reporting the use of benzodiazepines as they reduce anxiety, followed by the use of antipsychotic and antidepressant medication (Suran, 2024). However, there are risks in mixing substances with psychedelic drugs, and subjectivity in the effectiveness. As some individuals may experience positive effects, while for others it may lead to negative effects (Suran, 2024). Therefore, it is recommended that before using trip killers, individuals should try other non- pharmacological coping strategies to reduce the negative effects of the psychedelic drug (Gable, 2004; Van Amsterdam et al., 2011). These factors discussed above, demonstrate the effectiveness of protective behaviours and harm reduction practices, in promoting safe psychedelic use and reducing harm. <a href="https://ourarchive.otago.ac.nz/esploro/outputs/graduate/Towards-Safer-Trips-Exploring-Harm-Reduction/9926550679501891" target="_blank">https://ourarchive.otago.ac.nz/esploro/outputs/graduate/Towards-Safer-Trips-Exploring-Harm-Reduction/9926550679501891</a> <a href="#fnref:2" class="footnote-back-ref">↩</a></li>
<li id="fn:3">Leikin, Jerrold B.; Krantz, Anne J.; Zell-Kanter, Michele; Barkin, Robert L.; Hryhorczuk, Daniel O. (1989). "Clinical Features and Management of Intoxication Due to Hallucinogenic Drugs". Medical Toxicology and Adverse Drug Experience. 4 (5). Springer Science and Business Media LLC: 324–350. doi:10.1007/bf03259916. ISSN 0113-5244. PMID 2682130. <a href="/wiki/Doi_(identifier)" target="_blank">/wiki/Doi_(identifier)</a> <a href="#fnref:3" class="footnote-back-ref">↩</a></li>
<li id="fn:4">Yates G, Melon E (January 2024). "Trip-killers: a concerning practice associated with psychedelic drug use" (PDF). Emerg Med J. 41 (2): 112–113. doi:10.1136/emermed-2023-213377. PMID 38123961. <a href="https://web.archive.org/web/20250511111827oe_/https://s3.amazonaws.com/crawl.prod.proquest.com/fpcache/71f445805bfb61341cbc438c8ae23bd3.pdf?X-Amz-Security-Token=IQoJb3JpZ2luX2VjEBMaCXVzLWVhc3QtMSJIMEYCIQDETX7YpaG5THA%2FNbKR0d92wr6h%2Bgg9preNcKjAsEqo%2BQIhAIlPGGWOeUc23LqhBzRYbxvSXB9aqSe2vVonl4nacAhhKp0CCLz%2F%2F%2F%2F%2F%2F%2F%2F%2F%2FwEQABoMNTE4MzQ2ODQ4MzQxIgy9ji58Qtbi%2BavuKeYq8QEDL1U5KZDQ0bXFyVapeqJgE%2FX6x8DcJfFU8DAXYZPSQEwrIdfPbZWcYsH340deru%2FUHnNaGGpuHFoVzui%2FMbqBz7MANcowj%2FL1%2BQZzQ5hXh5KM3BW8E6NRzrQyuPRmBy7kQUkx8%2BjTN%2BXSMgF%2FCAs6Dn9fScgBGz3ddkwRZXDkjasqMP65RCPKhagK68cyMbf3oX%2BKS8a4Kltc2rk3CnWEhOKrZU4mIxq07DikLAXQbl8YRZJIkeOhN5TgBaLWJqyn1td2VWCMymAaFsqtPWHwXnEfsolRlfDooe6QXfE2YwX5PxBVJU7GPXRgrAqPjwtJMOCHgsEGOpwBYif%2BaDMBdz3IEghuvCvorAS0mkHzdcOz%2Fi7AzuN9nch%2FIm8llhMsN41aAWHuSG25pnhhftauFsg7rbGsrW2nl2kq2upi9zP7y%2Fnqk93jcP0kr0jM8zU12bYoSTsToQJsshH4N%2BTQUMwlzRQfeVv8MXdq%2BgSTTzJrWNwT1yNzye3rSHjvOumbNl6sgBISw7QqRzhB6hZTuf8AcI%2B7&X-Amz-Algorithm=AWS4-HMAC-SHA256&X-Amz-Date=20250511T111826Z&X-Amz-SignedHeaders=host&X-Amz-Credential=ASIAXRL7BHBKRAKCQVVB%2F20250511%2Fus-east-1%2Fs3%2Faws4_request&X-Amz-Expires=3600&X-Amz-Signature=20bb1b90e4c8dbaa4115c954387617ebe2f55269bdd517692f1380193ed3f769" target="_blank">https://web.archive.org/web/20250511111827oe_/https://s3.amazonaws.com/crawl.prod.proquest.com/fpcache/71f445805bfb61341cbc438c8ae23bd3.pdf?X-Amz-Security-Token=IQoJb3JpZ2luX2VjEBMaCXVzLWVhc3QtMSJIMEYCIQDETX7YpaG5THA%2FNbKR0d92wr6h%2Bgg9preNcKjAsEqo%2BQIhAIlPGGWOeUc23LqhBzRYbxvSXB9aqSe2vVonl4nacAhhKp0CCLz%2F%2F%2F%2F%2F%2F%2F%2F%2F%2FwEQABoMNTE4MzQ2ODQ4MzQxIgy9ji58Qtbi%2BavuKeYq8QEDL1U5KZDQ0bXFyVapeqJgE%2FX6x8DcJfFU8DAXYZPSQEwrIdfPbZWcYsH340deru%2FUHnNaGGpuHFoVzui%2FMbqBz7MANcowj%2FL1%2BQZzQ5hXh5KM3BW8E6NRzrQyuPRmBy7kQUkx8%2BjTN%2BXSMgF%2FCAs6Dn9fScgBGz3ddkwRZXDkjasqMP65RCPKhagK68cyMbf3oX%2BKS8a4Kltc2rk3CnWEhOKrZU4mIxq07DikLAXQbl8YRZJIkeOhN5TgBaLWJqyn1td2VWCMymAaFsqtPWHwXnEfsolRlfDooe6QXfE2YwX5PxBVJU7GPXRgrAqPjwtJMOCHgsEGOpwBYif%2BaDMBdz3IEghuvCvorAS0mkHzdcOz%2Fi7AzuN9nch%2FIm8llhMsN41aAWHuSG25pnhhftauFsg7rbGsrW2nl2kq2upi9zP7y%2Fnqk93jcP0kr0jM8zU12bYoSTsToQJsshH4N%2BTQUMwlzRQfeVv8MXdq%2BgSTTzJrWNwT1yNzye3rSHjvOumbNl6sgBISw7QqRzhB6hZTuf8AcI%2B7&X-Amz-Algorithm=AWS4-HMAC-SHA256&X-Amz-Date=20250511T111826Z&X-Amz-SignedHeaders=host&X-Amz-Credential=ASIAXRL7BHBKRAKCQVVB%2F20250511%2Fus-east-1%2Fs3%2Faws4_request&X-Amz-Expires=3600&X-Amz-Signature=20bb1b90e4c8dbaa4115c954387617ebe2f55269bdd517692f1380193ed3f769</a> <a href="#fnref:4" class="footnote-back-ref">↩</a></li>
<li id="fn:5">Suran M (February 2024). "Study Finds Hundreds of Reddit Posts on "Trip-Killers" for Psychedelic Drugs". JAMA. 331 (8): 632–634. doi:10.1001/jama.2023.28257. PMID 38294772. <a href="/wiki/Doi_(identifier)" target="_blank">/wiki/Doi_(identifier)</a> <a href="#fnref:5" class="footnote-back-ref">↩</a></li>
<li id="fn:6">Halman A, Kong G, Sarris J, Perkins D (January 2024). "Drug-drug interactions involving classic psychedelics: A systematic review". J Psychopharmacol. 38 (1): 3–18. doi:10.1177/02698811231211219. PMC 10851641. PMID 37982394. <a href="https://www.ncbi.nlm.nih.gov/pmc/articles/PMC10851641" target="_blank">https://www.ncbi.nlm.nih.gov/pmc/articles/PMC10851641</a> <a href="#fnref:6" class="footnote-back-ref">↩</a></li>
<li id="fn:7">Skolnick P, Crystal R (February 2020). "Cannabinoid1 (CB-1) receptor antagonists: a molecular approach to treating acute cannabinoid overdose". J Neural Transm (Vienna). 127 (2): 279–286. doi:10.1007/s00702-019-02132-7. PMC 7035232. PMID 31893308. <a href="https://www.ncbi.nlm.nih.gov/pmc/articles/PMC7035232" target="_blank">https://www.ncbi.nlm.nih.gov/pmc/articles/PMC7035232</a> <a href="#fnref:7" class="footnote-back-ref">↩</a></li>
<li id="fn:8">Clark SD, Abi-Dargham A (October 2019). "The Role of Dynorphin and the Kappa Opioid Receptor in the Symptomatology of Schizophrenia: A Review of the Evidence". Biol Psychiatry. 86 (7): 502–511. doi:10.1016/j.biopsych.2019.05.012. PMID 31376930. Finally, in a double-blind study of 24 healthy volunteers, Maqueda et al. (27) found that salvinorin A produced both visual and auditory changes that could be blocked by the kappa, mu, and delta receptor antagonist naltrexone (Table 2). <a href="https://doi.org/10.1016%2Fj.biopsych.2019.05.012" target="_blank">https://doi.org/10.1016%2Fj.biopsych.2019.05.012</a> <a href="#fnref:8" class="footnote-back-ref">↩</a></li>
<li id="fn:9">Halman A, Kong G, Sarris J, Perkins D (January 2024). "Drug-drug interactions involving classic psychedelics: A systematic review". J Psychopharmacol. 38 (1): 3–18. doi:10.1177/02698811231211219. PMC 10851641. PMID 37982394. <a href="https://www.ncbi.nlm.nih.gov/pmc/articles/PMC10851641" target="_blank">https://www.ncbi.nlm.nih.gov/pmc/articles/PMC10851641</a> <a href="#fnref:9" class="footnote-back-ref">↩</a></li>
<li id="fn:10">Leikin, Jerrold B.; Krantz, Anne J.; Zell-Kanter, Michele; Barkin, Robert L.; Hryhorczuk, Daniel O. (1989). "Clinical Features and Management of Intoxication Due to Hallucinogenic Drugs". Medical Toxicology and Adverse Drug Experience. 4 (5). Springer Science and Business Media LLC: 324–350. doi:10.1007/bf03259916. ISSN 0113-5244. PMID 2682130. <a href="/wiki/Doi_(identifier)" target="_blank">/wiki/Doi_(identifier)</a> <a href="#fnref:10" class="footnote-back-ref">↩</a></li>
<li id="fn:11">Yates G, Melon E (January 2024). "Trip-killers: a concerning practice associated with psychedelic drug use" (PDF). Emerg Med J. 41 (2): 112–113. doi:10.1136/emermed-2023-213377. PMID 38123961. <a href="https://web.archive.org/web/20250511111827oe_/https://s3.amazonaws.com/crawl.prod.proquest.com/fpcache/71f445805bfb61341cbc438c8ae23bd3.pdf?X-Amz-Security-Token=IQoJb3JpZ2luX2VjEBMaCXVzLWVhc3QtMSJIMEYCIQDETX7YpaG5THA%2FNbKR0d92wr6h%2Bgg9preNcKjAsEqo%2BQIhAIlPGGWOeUc23LqhBzRYbxvSXB9aqSe2vVonl4nacAhhKp0CCLz%2F%2F%2F%2F%2F%2F%2F%2F%2F%2FwEQABoMNTE4MzQ2ODQ4MzQxIgy9ji58Qtbi%2BavuKeYq8QEDL1U5KZDQ0bXFyVapeqJgE%2FX6x8DcJfFU8DAXYZPSQEwrIdfPbZWcYsH340deru%2FUHnNaGGpuHFoVzui%2FMbqBz7MANcowj%2FL1%2BQZzQ5hXh5KM3BW8E6NRzrQyuPRmBy7kQUkx8%2BjTN%2BXSMgF%2FCAs6Dn9fScgBGz3ddkwRZXDkjasqMP65RCPKhagK68cyMbf3oX%2BKS8a4Kltc2rk3CnWEhOKrZU4mIxq07DikLAXQbl8YRZJIkeOhN5TgBaLWJqyn1td2VWCMymAaFsqtPWHwXnEfsolRlfDooe6QXfE2YwX5PxBVJU7GPXRgrAqPjwtJMOCHgsEGOpwBYif%2BaDMBdz3IEghuvCvorAS0mkHzdcOz%2Fi7AzuN9nch%2FIm8llhMsN41aAWHuSG25pnhhftauFsg7rbGsrW2nl2kq2upi9zP7y%2Fnqk93jcP0kr0jM8zU12bYoSTsToQJsshH4N%2BTQUMwlzRQfeVv8MXdq%2BgSTTzJrWNwT1yNzye3rSHjvOumbNl6sgBISw7QqRzhB6hZTuf8AcI%2B7&X-Amz-Algorithm=AWS4-HMAC-SHA256&X-Amz-Date=20250511T111826Z&X-Amz-SignedHeaders=host&X-Amz-Credential=ASIAXRL7BHBKRAKCQVVB%2F20250511%2Fus-east-1%2Fs3%2Faws4_request&X-Amz-Expires=3600&X-Amz-Signature=20bb1b90e4c8dbaa4115c954387617ebe2f55269bdd517692f1380193ed3f769" target="_blank">https://web.archive.org/web/20250511111827oe_/https://s3.amazonaws.com/crawl.prod.proquest.com/fpcache/71f445805bfb61341cbc438c8ae23bd3.pdf?X-Amz-Security-Token=IQoJb3JpZ2luX2VjEBMaCXVzLWVhc3QtMSJIMEYCIQDETX7YpaG5THA%2FNbKR0d92wr6h%2Bgg9preNcKjAsEqo%2BQIhAIlPGGWOeUc23LqhBzRYbxvSXB9aqSe2vVonl4nacAhhKp0CCLz%2F%2F%2F%2F%2F%2F%2F%2F%2F%2FwEQABoMNTE4MzQ2ODQ4MzQxIgy9ji58Qtbi%2BavuKeYq8QEDL1U5KZDQ0bXFyVapeqJgE%2FX6x8DcJfFU8DAXYZPSQEwrIdfPbZWcYsH340deru%2FUHnNaGGpuHFoVzui%2FMbqBz7MANcowj%2FL1%2BQZzQ5hXh5KM3BW8E6NRzrQyuPRmBy7kQUkx8%2BjTN%2BXSMgF%2FCAs6Dn9fScgBGz3ddkwRZXDkjasqMP65RCPKhagK68cyMbf3oX%2BKS8a4Kltc2rk3CnWEhOKrZU4mIxq07DikLAXQbl8YRZJIkeOhN5TgBaLWJqyn1td2VWCMymAaFsqtPWHwXnEfsolRlfDooe6QXfE2YwX5PxBVJU7GPXRgrAqPjwtJMOCHgsEGOpwBYif%2BaDMBdz3IEghuvCvorAS0mkHzdcOz%2Fi7AzuN9nch%2FIm8llhMsN41aAWHuSG25pnhhftauFsg7rbGsrW2nl2kq2upi9zP7y%2Fnqk93jcP0kr0jM8zU12bYoSTsToQJsshH4N%2BTQUMwlzRQfeVv8MXdq%2BgSTTzJrWNwT1yNzye3rSHjvOumbNl6sgBISw7QqRzhB6hZTuf8AcI%2B7&X-Amz-Algorithm=AWS4-HMAC-SHA256&X-Amz-Date=20250511T111826Z&X-Amz-SignedHeaders=host&X-Amz-Credential=ASIAXRL7BHBKRAKCQVVB%2F20250511%2Fus-east-1%2Fs3%2Faws4_request&X-Amz-Expires=3600&X-Amz-Signature=20bb1b90e4c8dbaa4115c954387617ebe2f55269bdd517692f1380193ed3f769</a> <a href="#fnref:11" class="footnote-back-ref">↩</a></li>
<li id="fn:12">Halman A, Kong G, Sarris J, Perkins D (January 2024). "Drug-drug interactions involving classic psychedelics: A systematic review". J Psychopharmacol. 38 (1): 3–18. doi:10.1177/02698811231211219. PMC 10851641. PMID 37982394. <a href="https://www.ncbi.nlm.nih.gov/pmc/articles/PMC10851641" target="_blank">https://www.ncbi.nlm.nih.gov/pmc/articles/PMC10851641</a> <a href="#fnref:12" class="footnote-back-ref">↩</a></li>
<li id="fn:13">Holze F, Liechti ME, Müller F (July 2024). "Pharmacological Properties of Psychedelics with a Special Focus on Potential Harms". Current Topics in Behavioral Neurosciences. Curr Top Behav Neurosci. doi:10.1007/7854_2024_510. PMID 39080236. <a href="/wiki/Doi_(identifier)" target="_blank">/wiki/Doi_(identifier)</a> <a href="#fnref:13" class="footnote-back-ref">↩</a></li>
<li id="fn:14">Leikin, Jerrold B.; Krantz, Anne J.; Zell-Kanter, Michele; Barkin, Robert L.; Hryhorczuk, Daniel O. (1989). "Clinical Features and Management of Intoxication Due to Hallucinogenic Drugs". Medical Toxicology and Adverse Drug Experience. 4 (5). Springer Science and Business Media LLC: 324–350. doi:10.1007/bf03259916. ISSN 0113-5244. PMID 2682130. <a href="/wiki/Doi_(identifier)" target="_blank">/wiki/Doi_(identifier)</a> <a href="#fnref:14" class="footnote-back-ref">↩</a></li>
<li id="fn:15">Bey T, Patel A (February 2007). "Phencyclidine intoxication and adverse effects: a clinical and pharmacological review of an illicit drug". Cal J Emerg Med. 8 (1): 9–14. PMC 2859735. PMID 20440387. <a href="https://www.ncbi.nlm.nih.gov/pmc/articles/PMC2859735" target="_blank">https://www.ncbi.nlm.nih.gov/pmc/articles/PMC2859735</a> <a href="#fnref:15" class="footnote-back-ref">↩</a></li>
<li id="fn:16">Suran M (February 2024). "Study Finds Hundreds of Reddit Posts on "Trip-Killers" for Psychedelic Drugs". JAMA. 331 (8): 632–634. doi:10.1001/jama.2023.28257. PMID 38294772. <a href="/wiki/Doi_(identifier)" target="_blank">/wiki/Doi_(identifier)</a> <a href="#fnref:16" class="footnote-back-ref">↩</a></li>
<li id="fn:17">Bellanavidanalage Gothami Ayanthie Vis Jayasinha (8 February 2024). Towards Safer Trips: Exploring Harm Reduction Strategies for Recreational Psychedelic Use in Aotearoa New Zealand (Thesis). University of Otago. Retrieved 3 October 2024. Another form of mixing substances involves the use of trip killers; a pharmacological coping strategy aimed to reduce the negative effects of a psychedelic experience by consuming a different substance (Suran, 2024). While this is a new concept and an under researched area, there are reports of trip killers being effective in reducing the negative effects of a psychedelic experience (Suran, 2024). One study gathered research from reddit, an online social media platform, investigating the usage of trip killers during challenging psychedelic experiences (Suran, 2024). The most popular and effective trip killers used were prescription medication, with 47% reporting the use of benzodiazepines as they reduce anxiety, followed by the use of antipsychotic and antidepressant medication (Suran, 2024). However, there are risks in mixing substances with psychedelic drugs, and subjectivity in the effectiveness. As some individuals may experience positive effects, while for others it may lead to negative effects (Suran, 2024). Therefore, it is recommended that before using trip killers, individuals should try other non- pharmacological coping strategies to reduce the negative effects of the psychedelic drug (Gable, 2004; Van Amsterdam et al., 2011). These factors discussed above, demonstrate the effectiveness of protective behaviours and harm reduction practices, in promoting safe psychedelic use and reducing harm. <a href="https://ourarchive.otago.ac.nz/esploro/outputs/graduate/Towards-Safer-Trips-Exploring-Harm-Reduction/9926550679501891" target="_blank">https://ourarchive.otago.ac.nz/esploro/outputs/graduate/Towards-Safer-Trips-Exploring-Harm-Reduction/9926550679501891</a> <a href="#fnref:17" class="footnote-back-ref">↩</a></li>
<li id="fn:18">Yates G, Melon E (January 2024). "Trip-killers: a concerning practice associated with psychedelic drug use" (PDF). Emerg Med J. 41 (2): 112–113. doi:10.1136/emermed-2023-213377. PMID 38123961. <a href="https://web.archive.org/web/20250511111827oe_/https://s3.amazonaws.com/crawl.prod.proquest.com/fpcache/71f445805bfb61341cbc438c8ae23bd3.pdf?X-Amz-Security-Token=IQoJb3JpZ2luX2VjEBMaCXVzLWVhc3QtMSJIMEYCIQDETX7YpaG5THA%2FNbKR0d92wr6h%2Bgg9preNcKjAsEqo%2BQIhAIlPGGWOeUc23LqhBzRYbxvSXB9aqSe2vVonl4nacAhhKp0CCLz%2F%2F%2F%2F%2F%2F%2F%2F%2F%2FwEQABoMNTE4MzQ2ODQ4MzQxIgy9ji58Qtbi%2BavuKeYq8QEDL1U5KZDQ0bXFyVapeqJgE%2FX6x8DcJfFU8DAXYZPSQEwrIdfPbZWcYsH340deru%2FUHnNaGGpuHFoVzui%2FMbqBz7MANcowj%2FL1%2BQZzQ5hXh5KM3BW8E6NRzrQyuPRmBy7kQUkx8%2BjTN%2BXSMgF%2FCAs6Dn9fScgBGz3ddkwRZXDkjasqMP65RCPKhagK68cyMbf3oX%2BKS8a4Kltc2rk3CnWEhOKrZU4mIxq07DikLAXQbl8YRZJIkeOhN5TgBaLWJqyn1td2VWCMymAaFsqtPWHwXnEfsolRlfDooe6QXfE2YwX5PxBVJU7GPXRgrAqPjwtJMOCHgsEGOpwBYif%2BaDMBdz3IEghuvCvorAS0mkHzdcOz%2Fi7AzuN9nch%2FIm8llhMsN41aAWHuSG25pnhhftauFsg7rbGsrW2nl2kq2upi9zP7y%2Fnqk93jcP0kr0jM8zU12bYoSTsToQJsshH4N%2BTQUMwlzRQfeVv8MXdq%2BgSTTzJrWNwT1yNzye3rSHjvOumbNl6sgBISw7QqRzhB6hZTuf8AcI%2B7&X-Amz-Algorithm=AWS4-HMAC-SHA256&X-Amz-Date=20250511T111826Z&X-Amz-SignedHeaders=host&X-Amz-Credential=ASIAXRL7BHBKRAKCQVVB%2F20250511%2Fus-east-1%2Fs3%2Faws4_request&X-Amz-Expires=3600&X-Amz-Signature=20bb1b90e4c8dbaa4115c954387617ebe2f55269bdd517692f1380193ed3f769" target="_blank">https://web.archive.org/web/20250511111827oe_/https://s3.amazonaws.com/crawl.prod.proquest.com/fpcache/71f445805bfb61341cbc438c8ae23bd3.pdf?X-Amz-Security-Token=IQoJb3JpZ2luX2VjEBMaCXVzLWVhc3QtMSJIMEYCIQDETX7YpaG5THA%2FNbKR0d92wr6h%2Bgg9preNcKjAsEqo%2BQIhAIlPGGWOeUc23LqhBzRYbxvSXB9aqSe2vVonl4nacAhhKp0CCLz%2F%2F%2F%2F%2F%2F%2F%2F%2F%2FwEQABoMNTE4MzQ2ODQ4MzQxIgy9ji58Qtbi%2BavuKeYq8QEDL1U5KZDQ0bXFyVapeqJgE%2FX6x8DcJfFU8DAXYZPSQEwrIdfPbZWcYsH340deru%2FUHnNaGGpuHFoVzui%2FMbqBz7MANcowj%2FL1%2BQZzQ5hXh5KM3BW8E6NRzrQyuPRmBy7kQUkx8%2BjTN%2BXSMgF%2FCAs6Dn9fScgBGz3ddkwRZXDkjasqMP65RCPKhagK68cyMbf3oX%2BKS8a4Kltc2rk3CnWEhOKrZU4mIxq07DikLAXQbl8YRZJIkeOhN5TgBaLWJqyn1td2VWCMymAaFsqtPWHwXnEfsolRlfDooe6QXfE2YwX5PxBVJU7GPXRgrAqPjwtJMOCHgsEGOpwBYif%2BaDMBdz3IEghuvCvorAS0mkHzdcOz%2Fi7AzuN9nch%2FIm8llhMsN41aAWHuSG25pnhhftauFsg7rbGsrW2nl2kq2upi9zP7y%2Fnqk93jcP0kr0jM8zU12bYoSTsToQJsshH4N%2BTQUMwlzRQfeVv8MXdq%2BgSTTzJrWNwT1yNzye3rSHjvOumbNl6sgBISw7QqRzhB6hZTuf8AcI%2B7&X-Amz-Algorithm=AWS4-HMAC-SHA256&X-Amz-Date=20250511T111826Z&X-Amz-SignedHeaders=host&X-Amz-Credential=ASIAXRL7BHBKRAKCQVVB%2F20250511%2Fus-east-1%2Fs3%2Faws4_request&X-Amz-Expires=3600&X-Amz-Signature=20bb1b90e4c8dbaa4115c954387617ebe2f55269bdd517692f1380193ed3f769</a> <a href="#fnref:18" class="footnote-back-ref">↩</a></li>
<li id="fn:19">Bellanavidanalage Gothami Ayanthie Vis Jayasinha (8 February 2024). Towards Safer Trips: Exploring Harm Reduction Strategies for Recreational Psychedelic Use in Aotearoa New Zealand (Thesis). University of Otago. Retrieved 3 October 2024. Another form of mixing substances involves the use of trip killers; a pharmacological coping strategy aimed to reduce the negative effects of a psychedelic experience by consuming a different substance (Suran, 2024). While this is a new concept and an under researched area, there are reports of trip killers being effective in reducing the negative effects of a psychedelic experience (Suran, 2024). One study gathered research from reddit, an online social media platform, investigating the usage of trip killers during challenging psychedelic experiences (Suran, 2024). The most popular and effective trip killers used were prescription medication, with 47% reporting the use of benzodiazepines as they reduce anxiety, followed by the use of antipsychotic and antidepressant medication (Suran, 2024). However, there are risks in mixing substances with psychedelic drugs, and subjectivity in the effectiveness. As some individuals may experience positive effects, while for others it may lead to negative effects (Suran, 2024). Therefore, it is recommended that before using trip killers, individuals should try other non- pharmacological coping strategies to reduce the negative effects of the psychedelic drug (Gable, 2004; Van Amsterdam et al., 2011). These factors discussed above, demonstrate the effectiveness of protective behaviours and harm reduction practices, in promoting safe psychedelic use and reducing harm. <a href="https://ourarchive.otago.ac.nz/esploro/outputs/graduate/Towards-Safer-Trips-Exploring-Harm-Reduction/9926550679501891" target="_blank">https://ourarchive.otago.ac.nz/esploro/outputs/graduate/Towards-Safer-Trips-Exploring-Harm-Reduction/9926550679501891</a> <a href="#fnref:19" class="footnote-back-ref">↩</a></li>
<li id="fn:20">Yates G, Melon E (January 2024). "Trip-killers: a concerning practice associated with psychedelic drug use" (PDF). Emerg Med J. 41 (2): 112–113. doi:10.1136/emermed-2023-213377. PMID 38123961. <a href="https://web.archive.org/web/20250511111827oe_/https://s3.amazonaws.com/crawl.prod.proquest.com/fpcache/71f445805bfb61341cbc438c8ae23bd3.pdf?X-Amz-Security-Token=IQoJb3JpZ2luX2VjEBMaCXVzLWVhc3QtMSJIMEYCIQDETX7YpaG5THA%2FNbKR0d92wr6h%2Bgg9preNcKjAsEqo%2BQIhAIlPGGWOeUc23LqhBzRYbxvSXB9aqSe2vVonl4nacAhhKp0CCLz%2F%2F%2F%2F%2F%2F%2F%2F%2F%2FwEQABoMNTE4MzQ2ODQ4MzQxIgy9ji58Qtbi%2BavuKeYq8QEDL1U5KZDQ0bXFyVapeqJgE%2FX6x8DcJfFU8DAXYZPSQEwrIdfPbZWcYsH340deru%2FUHnNaGGpuHFoVzui%2FMbqBz7MANcowj%2FL1%2BQZzQ5hXh5KM3BW8E6NRzrQyuPRmBy7kQUkx8%2BjTN%2BXSMgF%2FCAs6Dn9fScgBGz3ddkwRZXDkjasqMP65RCPKhagK68cyMbf3oX%2BKS8a4Kltc2rk3CnWEhOKrZU4mIxq07DikLAXQbl8YRZJIkeOhN5TgBaLWJqyn1td2VWCMymAaFsqtPWHwXnEfsolRlfDooe6QXfE2YwX5PxBVJU7GPXRgrAqPjwtJMOCHgsEGOpwBYif%2BaDMBdz3IEghuvCvorAS0mkHzdcOz%2Fi7AzuN9nch%2FIm8llhMsN41aAWHuSG25pnhhftauFsg7rbGsrW2nl2kq2upi9zP7y%2Fnqk93jcP0kr0jM8zU12bYoSTsToQJsshH4N%2BTQUMwlzRQfeVv8MXdq%2BgSTTzJrWNwT1yNzye3rSHjvOumbNl6sgBISw7QqRzhB6hZTuf8AcI%2B7&X-Amz-Algorithm=AWS4-HMAC-SHA256&X-Amz-Date=20250511T111826Z&X-Amz-SignedHeaders=host&X-Amz-Credential=ASIAXRL7BHBKRAKCQVVB%2F20250511%2Fus-east-1%2Fs3%2Faws4_request&X-Amz-Expires=3600&X-Amz-Signature=20bb1b90e4c8dbaa4115c954387617ebe2f55269bdd517692f1380193ed3f769" target="_blank">https://web.archive.org/web/20250511111827oe_/https://s3.amazonaws.com/crawl.prod.proquest.com/fpcache/71f445805bfb61341cbc438c8ae23bd3.pdf?X-Amz-Security-Token=IQoJb3JpZ2luX2VjEBMaCXVzLWVhc3QtMSJIMEYCIQDETX7YpaG5THA%2FNbKR0d92wr6h%2Bgg9preNcKjAsEqo%2BQIhAIlPGGWOeUc23LqhBzRYbxvSXB9aqSe2vVonl4nacAhhKp0CCLz%2F%2F%2F%2F%2F%2F%2F%2F%2F%2FwEQABoMNTE4MzQ2ODQ4MzQxIgy9ji58Qtbi%2BavuKeYq8QEDL1U5KZDQ0bXFyVapeqJgE%2FX6x8DcJfFU8DAXYZPSQEwrIdfPbZWcYsH340deru%2FUHnNaGGpuHFoVzui%2FMbqBz7MANcowj%2FL1%2BQZzQ5hXh5KM3BW8E6NRzrQyuPRmBy7kQUkx8%2BjTN%2BXSMgF%2FCAs6Dn9fScgBGz3ddkwRZXDkjasqMP65RCPKhagK68cyMbf3oX%2BKS8a4Kltc2rk3CnWEhOKrZU4mIxq07DikLAXQbl8YRZJIkeOhN5TgBaLWJqyn1td2VWCMymAaFsqtPWHwXnEfsolRlfDooe6QXfE2YwX5PxBVJU7GPXRgrAqPjwtJMOCHgsEGOpwBYif%2BaDMBdz3IEghuvCvorAS0mkHzdcOz%2Fi7AzuN9nch%2FIm8llhMsN41aAWHuSG25pnhhftauFsg7rbGsrW2nl2kq2upi9zP7y%2Fnqk93jcP0kr0jM8zU12bYoSTsToQJsshH4N%2BTQUMwlzRQfeVv8MXdq%2BgSTTzJrWNwT1yNzye3rSHjvOumbNl6sgBISw7QqRzhB6hZTuf8AcI%2B7&X-Amz-Algorithm=AWS4-HMAC-SHA256&X-Amz-Date=20250511T111826Z&X-Amz-SignedHeaders=host&X-Amz-Credential=ASIAXRL7BHBKRAKCQVVB%2F20250511%2Fus-east-1%2Fs3%2Faws4_request&X-Amz-Expires=3600&X-Amz-Signature=20bb1b90e4c8dbaa4115c954387617ebe2f55269bdd517692f1380193ed3f769</a> <a href="#fnref:20" class="footnote-back-ref">↩</a></li>
<li id="fn:21">Nichols DE (April 2016). "Psychedelics". Pharmacol Rev. 68 (2): 264–355. doi:10.1124/pr.115.011478. PMC 4813425. PMID 26841800. <a href="https://www.ncbi.nlm.nih.gov/pmc/articles/PMC4813425" target="_blank">https://www.ncbi.nlm.nih.gov/pmc/articles/PMC4813425</a> <a href="#fnref:21" class="footnote-back-ref">↩</a></li>
<li id="fn:22">Nichols DE (2018). Chemistry and Structure-Activity Relationships of Psychedelics. Current Topics in Behavioral Neurosciences. Vol. 36. pp. 1–43. doi:10.1007/7854_2017_475. ISBN 978-3-662-55878-2. PMID 28401524. <a href="978-3-662-55878-2" target="_blank">978-3-662-55878-2</a> <a href="#fnref:22" class="footnote-back-ref">↩</a></li>
<li id="fn:23">Halman A, Kong G, Sarris J, Perkins D (January 2024). "Drug-drug interactions involving classic psychedelics: A systematic review". J Psychopharmacol. 38 (1): 3–18. doi:10.1177/02698811231211219. PMC 10851641. PMID 37982394. <a href="https://www.ncbi.nlm.nih.gov/pmc/articles/PMC10851641" target="_blank">https://www.ncbi.nlm.nih.gov/pmc/articles/PMC10851641</a> <a href="#fnref:23" class="footnote-back-ref">↩</a></li>
<li id="fn:24">Halman A, Kong G, Sarris J, Perkins D (January 2024). "Drug-drug interactions involving classic psychedelics: A systematic review". J Psychopharmacol. 38 (1): 3–18. doi:10.1177/02698811231211219. PMC 10851641. PMID 37982394. <a href="https://www.ncbi.nlm.nih.gov/pmc/articles/PMC10851641" target="_blank">https://www.ncbi.nlm.nih.gov/pmc/articles/PMC10851641</a> <a href="#fnref:24" class="footnote-back-ref">↩</a></li>
<li id="fn:25">Halman A, Kong G, Sarris J, Perkins D (January 2024). "Drug-drug interactions involving classic psychedelics: A systematic review". J Psychopharmacol. 38 (1): 3–18. doi:10.1177/02698811231211219. PMC 10851641. PMID 37982394. <a href="https://www.ncbi.nlm.nih.gov/pmc/articles/PMC10851641" target="_blank">https://www.ncbi.nlm.nih.gov/pmc/articles/PMC10851641</a> <a href="#fnref:25" class="footnote-back-ref">↩</a></li>
<li id="fn:26">Halberstadt AL, Nichols DE (2020). "Serotonin and serotonin receptors in hallucinogen action". Handbook of the Behavioral Neurobiology of Serotonin. Handbook of Behavioral Neuroscience. Vol. 31. pp. 843–863. doi:10.1016/B978-0-444-64125-0.00043-8. ISBN 9780444641250. ISSN 1569-7339. S2CID 241134396. Pretreatment with the selective 5-HT reuptake inhibitors citalopram, fluoxetine, and paroxetine significantly attenuated most of the subjective effects of MDMA, consistent with the proposed involvement of carriermediated 5-HT release in the effects of MDMA (Farre et al., 2007; Liechti, Baumann, et al., 2000; Tancer & Johanson, 2007). Citalopram also inhibits the effect of MDMA on PPI (Liechti, Geyer, Hell, & Vollenweider, 2001). According to another report (Hysek, Simmler et al., 2012), the mixed SERT/NET inhibitor duloxetine robustly blocked most of the subjective response to MDMA, raising the possibility that NE release contributes to its effects. In a follow-up study, the selective NET inhibitor reboxetine significantly reduced the emotional excitation and feelings of stimulation produced by MDMA but did not alter its entactogenic or mood-elevating effects (Hysek et al., 2011). Therefore, although NE release contributes to the stimulant effects produced by MDMA, 5-HT release appears to be principally responsible for the unique entactogenic effects of the drug. [...] Several studies have examined the contribution of 5-HT and DA receptors to the effects of MDMA. Pretreatment with ketanserin produced some attenuation of the subjective effects of MDMA (Liechti, Saur, et al., 2000). However, the most significant reduction of MDMA effects by ketanserin occurred in the VR dimension of the APZ, indicating that 5-HT2A receptors are responsible for the effects of MDMA on perception. Ketanserin also blocked MDMA-induced impairment of performance on a verbal memory task (van Wel et al., 2011), but had no effect on the ability of MDMA to induce depersonalization and derealization (Puxty et al., 2017). <a href="9780444641250" target="_blank">9780444641250</a> <a href="#fnref:26" class="footnote-back-ref">↩</a></li>
<li id="fn:27">Canal CE (2018). "Serotonergic Psychedelics: Experimental Approaches for Assessing Mechanisms of Action". Handb Exp Pharmacol. Handbook of Experimental Pharmacology. 252: 227–260. doi:10.1007/164_2018_107. ISBN 978-3-030-10560-0. PMC 6136989. PMID 29532180. Reports from clinical trials conclude that the psychedelic effects of psilocybin and LSD are mediated by 5-HT2A receptors, because they are blocked by ketanserin (40 mg, P.O.), typically viewed as a selective 5-HT2A antagonist (Kometer et al. 2012; Kraehenmann et al. 2017; Preller et al. 2017; Quednow et al. 2012). Haloperidol, typically viewed as a selective dopamine D2 antagonist, is much less effective than ketanserin at blocking psilocybin's effects, but risperidone, an antipsychotic with combined D2/5-HT2 activity, is as effective as ketanserin (Vollenweider et al. 1998). <a href="978-3-030-10560-0" target="_blank">978-3-030-10560-0</a> <a href="#fnref:27" class="footnote-back-ref">↩</a></li>
<li id="fn:28">Holze F, Singh N, Liechti ME, D'Souza DC (May 2024). "Serotonergic Psychedelics: A Comparative Review of Efficacy, Safety, Pharmacokinetics, and Binding Profile". Biol Psychiatry Cogn Neurosci Neuroimaging. 9 (5): 472–489. doi:10.1016/j.bpsc.2024.01.007. PMID 38301886. <a href="https://doi.org/10.1016%2Fj.bpsc.2024.01.007" target="_blank">https://doi.org/10.1016%2Fj.bpsc.2024.01.007</a> <a href="#fnref:28" class="footnote-back-ref">↩</a></li>
<li id="fn:29">Vollenweider FX, Vollenweider-Scherpenhuyzen MF, Bäbler A, Vogel H, Hell D (December 1998). "Psilocybin induces schizophrenia-like psychosis in humans via a serotonin-2 agonist action". NeuroReport. 9 (17): 3897–3902. doi:10.1097/00001756-199812010-00024. PMID 9875725. <a href="/wiki/Doi_(identifier)" target="_blank">/wiki/Doi_(identifier)</a> <a href="#fnref:29" class="footnote-back-ref">↩</a></li>
<li id="fn:30">Carter OL, Hasler F, Pettigrew JD, Wallis GM, Liu GB, Vollenweider FX (December 2007). "Psilocybin links binocular rivalry switch rate to attention and subjective arousal levels in humans" (PDF). Psychopharmacology (Berl). 195 (3): 415–424. doi:10.1007/s00213-007-0930-9. PMID 17874073. <a href="http://doc.rero.ch/record/315131/files/213_2007_Article_930.pdf" target="_blank">http://doc.rero.ch/record/315131/files/213_2007_Article_930.pdf</a> <a href="#fnref:30" class="footnote-back-ref">↩</a></li>
<li id="fn:31">Quednow BB, Kometer M, Geyer MA, Vollenweider FX (February 2012). "Psilocybin-induced deficits in automatic and controlled inhibition are attenuated by ketanserin in healthy human volunteers". Neuropsychopharmacology. 37 (3): 630–640. doi:10.1038/npp.2011.228. PMC 3260978. PMID 21956447. <a href="https://www.ncbi.nlm.nih.gov/pmc/articles/PMC3260978" target="_blank">https://www.ncbi.nlm.nih.gov/pmc/articles/PMC3260978</a> <a href="#fnref:31" class="footnote-back-ref">↩</a></li>
<li id="fn:32">Holze F, Vizeli P, Ley L, Müller F, Dolder P, Stocker M, Duthaler U, Varghese N, Eckert A, Borgwardt S, Liechti ME (February 2021). "Acute dose-dependent effects of lysergic acid diethylamide in a double-blind placebo-controlled study in healthy subjects". Neuropsychopharmacology. 46 (3): 537–544. doi:10.1038/s41386-020-00883-6. PMC 8027607. PMID 33059356. <a href="https://www.ncbi.nlm.nih.gov/pmc/articles/PMC8027607" target="_blank">https://www.ncbi.nlm.nih.gov/pmc/articles/PMC8027607</a> <a href="#fnref:32" class="footnote-back-ref">↩</a></li>
<li id="fn:33">Becker AM, Klaiber A, Holze F, Istampoulouoglou I, Duthaler U, Varghese N, Eckert A, Liechti ME (February 2023). "Ketanserin Reverses the Acute Response to LSD in a Randomized, Double-Blind, Placebo-Controlled, Crossover Study in Healthy Participants". Int J Neuropsychopharmacol. 26 (2): 97–106. doi:10.1093/ijnp/pyac075. PMC 9926053. PMID 36342343. <a href="https://www.ncbi.nlm.nih.gov/pmc/articles/PMC9926053" target="_blank">https://www.ncbi.nlm.nih.gov/pmc/articles/PMC9926053</a> <a href="#fnref:33" class="footnote-back-ref">↩</a></li>
<li id="fn:34">Klaiber A, Schmid Y, Becker AM, Straumann I, Erne L, Jelusic A, Thomann J, Luethi D, Liechti ME (September 2024). "Acute dose-dependent effects of mescaline in a double-blind placebo-controlled study in healthy subjects". Transl Psychiatry. 14 (1): 395. doi:10.1038/s41398-024-03116-2. PMC 11442856. PMID 39349427. <a href="https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11442856" target="_blank">https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11442856</a> <a href="#fnref:34" class="footnote-back-ref">↩</a></li>
<li id="fn:35">Valle M, Maqueda AE, Rabella M, Rodríguez-Pujadas A, Antonijoan RM, Romero S, Alonso JF, Mañanas MÀ, Barker S, Friedlander P, Feilding A, Riba J (July 2016). "Inhibition of alpha oscillations through serotonin-2A receptor activation underlies the visual effects of ayahuasca in humans". Eur Neuropsychopharmacol. 26 (7): 1161–1175. doi:10.1016/j.euroneuro.2016.03.012. hdl:2117/101863. PMID 27039035. <a href="/wiki/Doi_(identifier)" target="_blank">/wiki/Doi_(identifier)</a> <a href="#fnref:35" class="footnote-back-ref">↩</a></li>
<li id="fn:36">Hallifax, James (30 November 2022). "New MindMed Study Shortens Trip with "LSD-Neutralizer"". Microdose. Retrieved 12 May 2025. <a href="https://microdose.buzz/news/new-mindmed-study-can-shorten-an-lsd-trip/" target="_blank">https://microdose.buzz/news/new-mindmed-study-can-shorten-an-lsd-trip/</a> <a href="#fnref:36" class="footnote-back-ref">↩</a></li>
<li id="fn:37">"LSD "off-switch" developed by psychedelic pharmaceutical company". New Atlas. 27 April 2020. Retrieved 12 May 2025. <a href="https://newatlas.com/science/lsd-off-switch-mindmed-liechti-psychedelic-science/" target="_blank">https://newatlas.com/science/lsd-off-switch-mindmed-liechti-psychedelic-science/</a> <a href="#fnref:37" class="footnote-back-ref">↩</a></li>
<li id="fn:38">"Delving into the Latest Updates on Ketanserin with Synapse". Synapse. 8 May 2025. Retrieved 12 May 2025. <a href="https://synapse.patsnap.com/drug/58c17006f00e495d96118ae65436560a" target="_blank">https://synapse.patsnap.com/drug/58c17006f00e495d96118ae65436560a</a> <a href="#fnref:38" class="footnote-back-ref">↩</a></li>
<li id="fn:39">Becker AM, Klaiber A, Holze F, Istampoulouoglou I, Duthaler U, Varghese N, Eckert A, Liechti ME (February 2023). "Ketanserin Reverses the Acute Response to LSD in a Randomized, Double-Blind, Placebo-Controlled, Crossover Study in Healthy Participants". Int J Neuropsychopharmacol. 26 (2): 97–106. doi:10.1093/ijnp/pyac075. PMC 9926053. PMID 36342343. <a href="https://www.ncbi.nlm.nih.gov/pmc/articles/PMC9926053" target="_blank">https://www.ncbi.nlm.nih.gov/pmc/articles/PMC9926053</a> <a href="#fnref:39" class="footnote-back-ref">↩</a></li>
<li id="fn:40">Holze F, Vizeli P, Ley L, Müller F, Dolder P, Stocker M, Duthaler U, Varghese N, Eckert A, Borgwardt S, Liechti ME (February 2021). "Acute dose-dependent effects of lysergic acid diethylamide in a double-blind placebo-controlled study in healthy subjects". Neuropsychopharmacology. 46 (3): 537–544. doi:10.1038/s41386-020-00883-6. PMC 8027607. PMID 33059356. <a href="https://www.ncbi.nlm.nih.gov/pmc/articles/PMC8027607" target="_blank">https://www.ncbi.nlm.nih.gov/pmc/articles/PMC8027607</a> <a href="#fnref:40" class="footnote-back-ref">↩</a></li>
<li id="fn:41">"Psilocybin Mechanism of Action (MOA)". ClinicalTrials.gov. Retrieved 13 November 2024. <a href="https://clinicaltrials.gov/study/NCT06592833" target="_blank">https://clinicaltrials.gov/study/NCT06592833</a> <a href="#fnref:41" class="footnote-back-ref">↩</a></li>
<li id="fn:42">Halman A, Kong G, Sarris J, Perkins D (January 2024). "Drug-drug interactions involving classic psychedelics: A systematic review". J Psychopharmacol. 38 (1): 3–18. doi:10.1177/02698811231211219. PMC 10851641. PMID 37982394. <a href="https://www.ncbi.nlm.nih.gov/pmc/articles/PMC10851641" target="_blank">https://www.ncbi.nlm.nih.gov/pmc/articles/PMC10851641</a> <a href="#fnref:42" class="footnote-back-ref">↩</a></li>
<li id="fn:43">Yates G, Melon E (January 2024). "Trip-killers: a concerning practice associated with psychedelic drug use" (PDF). Emerg Med J. 41 (2): 112–113. doi:10.1136/emermed-2023-213377. PMID 38123961. <a href="https://web.archive.org/web/20250511111827oe_/https://s3.amazonaws.com/crawl.prod.proquest.com/fpcache/71f445805bfb61341cbc438c8ae23bd3.pdf?X-Amz-Security-Token=IQoJb3JpZ2luX2VjEBMaCXVzLWVhc3QtMSJIMEYCIQDETX7YpaG5THA%2FNbKR0d92wr6h%2Bgg9preNcKjAsEqo%2BQIhAIlPGGWOeUc23LqhBzRYbxvSXB9aqSe2vVonl4nacAhhKp0CCLz%2F%2F%2F%2F%2F%2F%2F%2F%2F%2FwEQABoMNTE4MzQ2ODQ4MzQxIgy9ji58Qtbi%2BavuKeYq8QEDL1U5KZDQ0bXFyVapeqJgE%2FX6x8DcJfFU8DAXYZPSQEwrIdfPbZWcYsH340deru%2FUHnNaGGpuHFoVzui%2FMbqBz7MANcowj%2FL1%2BQZzQ5hXh5KM3BW8E6NRzrQyuPRmBy7kQUkx8%2BjTN%2BXSMgF%2FCAs6Dn9fScgBGz3ddkwRZXDkjasqMP65RCPKhagK68cyMbf3oX%2BKS8a4Kltc2rk3CnWEhOKrZU4mIxq07DikLAXQbl8YRZJIkeOhN5TgBaLWJqyn1td2VWCMymAaFsqtPWHwXnEfsolRlfDooe6QXfE2YwX5PxBVJU7GPXRgrAqPjwtJMOCHgsEGOpwBYif%2BaDMBdz3IEghuvCvorAS0mkHzdcOz%2Fi7AzuN9nch%2FIm8llhMsN41aAWHuSG25pnhhftauFsg7rbGsrW2nl2kq2upi9zP7y%2Fnqk93jcP0kr0jM8zU12bYoSTsToQJsshH4N%2BTQUMwlzRQfeVv8MXdq%2BgSTTzJrWNwT1yNzye3rSHjvOumbNl6sgBISw7QqRzhB6hZTuf8AcI%2B7&X-Amz-Algorithm=AWS4-HMAC-SHA256&X-Amz-Date=20250511T111826Z&X-Amz-SignedHeaders=host&X-Amz-Credential=ASIAXRL7BHBKRAKCQVVB%2F20250511%2Fus-east-1%2Fs3%2Faws4_request&X-Amz-Expires=3600&X-Amz-Signature=20bb1b90e4c8dbaa4115c954387617ebe2f55269bdd517692f1380193ed3f769" target="_blank">https://web.archive.org/web/20250511111827oe_/https://s3.amazonaws.com/crawl.prod.proquest.com/fpcache/71f445805bfb61341cbc438c8ae23bd3.pdf?X-Amz-Security-Token=IQoJb3JpZ2luX2VjEBMaCXVzLWVhc3QtMSJIMEYCIQDETX7YpaG5THA%2FNbKR0d92wr6h%2Bgg9preNcKjAsEqo%2BQIhAIlPGGWOeUc23LqhBzRYbxvSXB9aqSe2vVonl4nacAhhKp0CCLz%2F%2F%2F%2F%2F%2F%2F%2F%2F%2FwEQABoMNTE4MzQ2ODQ4MzQxIgy9ji58Qtbi%2BavuKeYq8QEDL1U5KZDQ0bXFyVapeqJgE%2FX6x8DcJfFU8DAXYZPSQEwrIdfPbZWcYsH340deru%2FUHnNaGGpuHFoVzui%2FMbqBz7MANcowj%2FL1%2BQZzQ5hXh5KM3BW8E6NRzrQyuPRmBy7kQUkx8%2BjTN%2BXSMgF%2FCAs6Dn9fScgBGz3ddkwRZXDkjasqMP65RCPKhagK68cyMbf3oX%2BKS8a4Kltc2rk3CnWEhOKrZU4mIxq07DikLAXQbl8YRZJIkeOhN5TgBaLWJqyn1td2VWCMymAaFsqtPWHwXnEfsolRlfDooe6QXfE2YwX5PxBVJU7GPXRgrAqPjwtJMOCHgsEGOpwBYif%2BaDMBdz3IEghuvCvorAS0mkHzdcOz%2Fi7AzuN9nch%2FIm8llhMsN41aAWHuSG25pnhhftauFsg7rbGsrW2nl2kq2upi9zP7y%2Fnqk93jcP0kr0jM8zU12bYoSTsToQJsshH4N%2BTQUMwlzRQfeVv8MXdq%2BgSTTzJrWNwT1yNzye3rSHjvOumbNl6sgBISw7QqRzhB6hZTuf8AcI%2B7&X-Amz-Algorithm=AWS4-HMAC-SHA256&X-Amz-Date=20250511T111826Z&X-Amz-SignedHeaders=host&X-Amz-Credential=ASIAXRL7BHBKRAKCQVVB%2F20250511%2Fus-east-1%2Fs3%2Faws4_request&X-Amz-Expires=3600&X-Amz-Signature=20bb1b90e4c8dbaa4115c954387617ebe2f55269bdd517692f1380193ed3f769</a> <a href="#fnref:43" class="footnote-back-ref">↩</a></li>
<li id="fn:44">Fradet M, Kelly CM, Donnelly AJ, Suppes T (December 2024). "Psilocybin and hallucinogenic mushrooms". CNS Spectr. 29 (6): 611–632. doi:10.1017/S1092852924002487. PMID 39789676. <a href="https://doi.org/10.1017%2FS1092852924002487" target="_blank">https://doi.org/10.1017%2FS1092852924002487</a> <a href="#fnref:44" class="footnote-back-ref">↩</a></li>
<li id="fn:45">Brimblecombe RW, Pinder RM (1975). "Indolealkylamines and Related Compounds". Hallucinogenic Agents. Bristol: Wright-Scientechnica. pp. 98–144. ISBN 978-0-85608-011-1. OCLC 2176880. OL 4850660M. Chlorpromazine is the recommended treatment for those 'bad trips' (Consroe, 1973), although it is not a complete antagonist and can exacerbate the symptoms of other drugs which may be present in illicit samples of LSD or be mistaken for LSD. Usually, the dose is 25-50 mg. intramuscularly, repeated every 30 minutes until the situation is under control. <a href="978-0-85608-011-1" target="_blank">978-0-85608-011-1</a> <a href="#fnref:45" class="footnote-back-ref">↩</a></li>
<li id="fn:46">Halman A, Kong G, Sarris J, Perkins D (January 2024). "Drug-drug interactions involving classic psychedelics: A systematic review". J Psychopharmacol. 38 (1): 3–18. doi:10.1177/02698811231211219. PMC 10851641. PMID 37982394. <a href="https://www.ncbi.nlm.nih.gov/pmc/articles/PMC10851641" target="_blank">https://www.ncbi.nlm.nih.gov/pmc/articles/PMC10851641</a> <a href="#fnref:46" class="footnote-back-ref">↩</a></li>
<li id="fn:47">Fradet M, Kelly CM, Donnelly AJ, Suppes T (December 2024). "Psilocybin and hallucinogenic mushrooms". CNS Spectr. 29 (6): 611–632. doi:10.1017/S1092852924002487. PMID 39789676. <a href="https://doi.org/10.1017%2FS1092852924002487" target="_blank">https://doi.org/10.1017%2FS1092852924002487</a> <a href="#fnref:47" class="footnote-back-ref">↩</a></li>
<li id="fn:48">Halman A, Kong G, Sarris J, Perkins D (January 2024). "Drug-drug interactions involving classic psychedelics: A systematic review". J Psychopharmacol. 38 (1): 3–18. doi:10.1177/02698811231211219. PMC 10851641. PMID 37982394. <a href="https://www.ncbi.nlm.nih.gov/pmc/articles/PMC10851641" target="_blank">https://www.ncbi.nlm.nih.gov/pmc/articles/PMC10851641</a> <a href="#fnref:48" class="footnote-back-ref">↩</a></li>
<li id="fn:49">Halberstadt AL (January 2015). "Recent advances in the neuropsychopharmacology of serotonergic hallucinogens". Behav Brain Res. 277: 99–120. doi:10.1016/j.bbr.2014.07.016. PMC 4642895. PMID 25036425. <a href="https://www.ncbi.nlm.nih.gov/pmc/articles/PMC4642895" target="_blank">https://www.ncbi.nlm.nih.gov/pmc/articles/PMC4642895</a> <a href="#fnref:49" class="footnote-back-ref">↩</a></li>
<li id="fn:50">Holze F, Liechti ME, Müller F (July 2024). "Pharmacological Properties of Psychedelics with a Special Focus on Potential Harms". Current Topics in Behavioral Neurosciences. Curr Top Behav Neurosci. doi:10.1007/7854_2024_510. PMID 39080236. <a href="/wiki/Doi_(identifier)" target="_blank">/wiki/Doi_(identifier)</a> <a href="#fnref:50" class="footnote-back-ref">↩</a></li>
<li id="fn:51">Vollenweider FX, Vollenweider-Scherpenhuyzen MF, Bäbler A, Vogel H, Hell D (December 1998). "Psilocybin induces schizophrenia-like psychosis in humans via a serotonin-2 agonist action". NeuroReport. 9 (17): 3897–3902. doi:10.1097/00001756-199812010-00024. PMID 9875725. <a href="/wiki/Doi_(identifier)" target="_blank">/wiki/Doi_(identifier)</a> <a href="#fnref:51" class="footnote-back-ref">↩</a></li>
<li id="fn:52">Halman A, Kong G, Sarris J, Perkins D (January 2024). "Drug-drug interactions involving classic psychedelics: A systematic review". J Psychopharmacol. 38 (1): 3–18. doi:10.1177/02698811231211219. PMC 10851641. PMID 37982394. <a href="https://www.ncbi.nlm.nih.gov/pmc/articles/PMC10851641" target="_blank">https://www.ncbi.nlm.nih.gov/pmc/articles/PMC10851641</a> <a href="#fnref:52" class="footnote-back-ref">↩</a></li>
<li id="fn:53">Fradet M, Kelly CM, Donnelly AJ, Suppes T (December 2024). "Psilocybin and hallucinogenic mushrooms". CNS Spectr. 29 (6): 611–632. doi:10.1017/S1092852924002487. PMID 39789676. <a href="https://doi.org/10.1017%2FS1092852924002487" target="_blank">https://doi.org/10.1017%2FS1092852924002487</a> <a href="#fnref:53" class="footnote-back-ref">↩</a></li>
<li id="fn:54">Scotton WJ, Hill LJ, Williams AC, Barnes NM (2019). "Serotonin Syndrome: Pathophysiology, Clinical Features, Management, and Potential Future Directions". Int J Tryptophan Res. 12: 1178646919873925. doi:10.1177/1178646919873925. PMC 6734608. PMID 31523132. <a href="https://www.ncbi.nlm.nih.gov/pmc/articles/PMC6734608" target="_blank">https://www.ncbi.nlm.nih.gov/pmc/articles/PMC6734608</a> <a href="#fnref:54" class="footnote-back-ref">↩</a></li>
<li id="fn:55">Ordak M, Zmysłowska A, Bielski M, Rybak D, Tomaszewska M, Wyszomierska K, Kmiec A, Garlicka N, Zalewska M, Zalewski M, Nasierowski T, Muszynska E, Bujalska-Zadrozny M (2021). "Pharmacotherapy of Patients Taking New Psychoactive Substances: A Systematic Review and Analysis of Case Reports". Front Psychiatry. 12: 669921. doi:10.3389/fpsyt.2021.669921. PMC 8102790. PMID 33967865. <a href="https://www.ncbi.nlm.nih.gov/pmc/articles/PMC8102790" target="_blank">https://www.ncbi.nlm.nih.gov/pmc/articles/PMC8102790</a> <a href="#fnref:55" class="footnote-back-ref">↩</a></li>
<li id="fn:56">Jacobs, Elizabeth T; Akers, Katherine G; Vohra, Varun; King, Andrew M (10 October 2020). "Cyproheptadine for Serotonin Toxicity: an Updated Systematic Review and Grading of Evidence". Current Emergency and Hospital Medicine Reports. 8 (4). Springer Science and Business Media LLC: 151–159. doi:10.1007/s40138-020-00222-5. ISSN 2167-4884. <a href="/wiki/Doi_(identifier)" target="_blank">/wiki/Doi_(identifier)</a> <a href="#fnref:56" class="footnote-back-ref">↩</a></li>
<li id="fn:57">Jacobs, Elizabeth T; Akers, Katherine G; Vohra, Varun; King, Andrew M (10 October 2020). "Cyproheptadine for Serotonin Toxicity: an Updated Systematic Review and Grading of Evidence". Current Emergency and Hospital Medicine Reports. 8 (4). Springer Science and Business Media LLC: 151–159. doi:10.1007/s40138-020-00222-5. ISSN 2167-4884. <a href="/wiki/Doi_(identifier)" target="_blank">/wiki/Doi_(identifier)</a> <a href="#fnref:57" class="footnote-back-ref">↩</a></li>
<li id="fn:58">Chiew AL, Isbister GK (June 2024). "[Not Available]". Br J Clin Pharmacol (in French). 91 (3): 654–661. doi:10.1111/bcp.16152. PMC 11862804. PMID 38926083. <a href="https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11862804" target="_blank">https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11862804</a> <a href="#fnref:58" class="footnote-back-ref">↩</a></li>
<li id="fn:59">Lewis V, Bonniwell EM, Lanham JK, Ghaffari A, Sheshbaradaran H, Cao AB, Calkins MM, Bautista-Carro MA, Arsenault E, Telfer A, Taghavi-Abkuh FF, Malcolm NJ, El Sayegh F, Abizaid A, Schmid Y, Morton K, Halberstadt AL, Aguilar-Valles A, McCorvy JD (March 2023). "A non-hallucinogenic LSD analog with therapeutic potential for mood disorders". Cell Rep. 42 (3): 112203. doi:10.1016/j.celrep.2023.112203. PMC 10112881. PMID 36884348. <a href="https://www.ncbi.nlm.nih.gov/pmc/articles/PMC10112881" target="_blank">https://www.ncbi.nlm.nih.gov/pmc/articles/PMC10112881</a> <a href="#fnref:59" class="footnote-back-ref">↩</a></li>
<li id="fn:60">Glatfelter GC, Pottie E, Partilla JS, Stove CP, Baumann MH (March 2024). "Comparative Pharmacological Effects of Lisuride and Lysergic Acid Diethylamide Revisited". ACS Pharmacol Transl Sci. 7 (3): 641–653. doi:10.1021/acsptsci.3c00192. PMC 10928901. PMID 38481684. <a href="https://www.ncbi.nlm.nih.gov/pmc/articles/PMC10928901" target="_blank">https://www.ncbi.nlm.nih.gov/pmc/articles/PMC10928901</a> <a href="#fnref:60" class="footnote-back-ref">↩</a></li>
<li id="fn:61">Kehler J, Lindskov MS (May 2025). "Are the LSD-analogs lisuride and ergotamine examples of non-hallucinogenic serotonin 5-HT2A receptor agonists?". Journal of Psychopharmacology: 2698811251330741. doi:10.1177/02698811251330741. PMID 40322975. <a href="/wiki/Doi_(identifier)" target="_blank">/wiki/Doi_(identifier)</a> <a href="#fnref:61" class="footnote-back-ref">↩</a></li>
<li id="fn:62">McClure-Begley TD, Roth BL (June 2022). "The promises and perils of psychedelic pharmacology for psychiatry". Nat Rev Drug Discov. 21 (6): 463–473. doi:10.1038/s41573-022-00421-7. PMID 35301459. <a href="https://cdr.lib.unc.edu/downloads/jw827p78p" target="_blank">https://cdr.lib.unc.edu/downloads/jw827p78p</a> <a href="#fnref:62" class="footnote-back-ref">↩</a></li>
<li id="fn:63">Rhee TG, Davoudian PA, Sanacora G, Wilkinson ST (December 2023). "Psychedelic renaissance: Revitalized potential therapies for psychiatric disorders". Drug Discov Today. 28 (12): 103818. doi:10.1016/j.drudis.2023.103818. PMID 37925136. <a href="/wiki/Doi_(identifier)" target="_blank">/wiki/Doi_(identifier)</a> <a href="#fnref:63" class="footnote-back-ref">↩</a></li>
<li id="fn:64">Nutt, D. J.; Peill, J. M.; Weiss, B.; Godfrey, K.; Carhart-Harris, R. L.; Erritzoe, D. (2023). "Psilocybin and Other Classic Psychedelics in Depression". Emerging Neurobiology of Antidepressant Treatments. Vol. 66. Cham: Springer International Publishing. pp. 149–174. doi:10.1007/7854_2023_451. ISBN 978-3-031-66355-0. PMID 37955822. Retrieved 12 May 2025. 5.1 Duration of Trip for Psychedelics: Why Does This Matter? [...] There are profound differences in the duration of action of serotonin psychedelics. LSD and mescaline are long lasting with effects for up to a day and so; often requiring overnight stays in clinical studies. Oral Psilocybin lasts approximately 4–6 h. Other psychedelics, like DMT (i.v. or smoked/intranasal) or 5-MEO-DMT (i.v./im/intranasal) can produce very short altered experiences (just 5–10 min). A key question is: are each equally effective for depression? If short acting psychedelics such as DMT and 5-MEO-DMT prove just as effective for treating depression, this would offer a cost-benefit when compared to longer lasting psychedelics such as psilocybin or LSD. [...] An alternative approach, being considered by some companies, is utilising a 5-HT2A receptor antagonist such as ketanserin (Becker et al. 2023) which can terminate an LSD trip after a given time, so shortening the treatment period in the clinic. Going forward, if psychedelics are integrated into health services; cost-benefit analyses will be crucial in delivering them as a viable treatment option. Overall, a shortened experience with similar antidepressant effects will be favourable. {{cite book}}: |journal= ignored (help) <a href="978-3-031-66355-0" target="_blank">978-3-031-66355-0</a> <a href="#fnref:64" class="footnote-back-ref">↩</a></li>
<li id="fn:65">Nutt, D. J.; Peill, J. M.; Weiss, B.; Godfrey, K.; Carhart-Harris, R. L.; Erritzoe, D. (2023). "Psilocybin and Other Classic Psychedelics in Depression". Emerging Neurobiology of Antidepressant Treatments. Vol. 66. Cham: Springer International Publishing. pp. 149–174. doi:10.1007/7854_2023_451. ISBN 978-3-031-66355-0. PMID 37955822. Retrieved 12 May 2025. 5.1 Duration of Trip for Psychedelics: Why Does This Matter? [...] There are profound differences in the duration of action of serotonin psychedelics. LSD and mescaline are long lasting with effects for up to a day and so; often requiring overnight stays in clinical studies. Oral Psilocybin lasts approximately 4–6 h. Other psychedelics, like DMT (i.v. or smoked/intranasal) or 5-MEO-DMT (i.v./im/intranasal) can produce very short altered experiences (just 5–10 min). A key question is: are each equally effective for depression? If short acting psychedelics such as DMT and 5-MEO-DMT prove just as effective for treating depression, this would offer a cost-benefit when compared to longer lasting psychedelics such as psilocybin or LSD. [...] An alternative approach, being considered by some companies, is utilising a 5-HT2A receptor antagonist such as ketanserin (Becker et al. 2023) which can terminate an LSD trip after a given time, so shortening the treatment period in the clinic. Going forward, if psychedelics are integrated into health services; cost-benefit analyses will be crucial in delivering them as a viable treatment option. Overall, a shortened experience with similar antidepressant effects will be favourable. {{cite book}}: |journal= ignored (help) <a href="978-3-031-66355-0" target="_blank">978-3-031-66355-0</a> <a href="#fnref:65" class="footnote-back-ref">↩</a></li>
<li id="fn:66">Ramaekers JG, Reckweg JT, Mason NL (January 2025). "Benefits and Challenges of Ultra-Fast, Short-Acting Psychedelics in the Treatment of Depression". Am J Psychiatry. 182 (1): 33–46. doi:10.1176/appi.ajp.20230890. PMID 39741439. <a href="/wiki/Doi_(identifier)" target="_blank">/wiki/Doi_(identifier)</a> <a href="#fnref:66" class="footnote-back-ref">↩</a></li>
<li id="fn:67">Ramaekers JG (May 2025). "Less is more? Antidepressant effects of short-acting psychedelics". Neuropsychopharmacology. 50 (6): 875–876. doi:10.1038/s41386-025-02103-5. PMC 12032289. PMID 40258989. <a href="/wiki/Doi_(identifier)" target="_blank">/wiki/Doi_(identifier)</a> <a href="#fnref:67" class="footnote-back-ref">↩</a></li>
<li id="fn:68">Nutt, D. J.; Peill, J. M.; Weiss, B.; Godfrey, K.; Carhart-Harris, R. L.; Erritzoe, D. (2023). "Psilocybin and Other Classic Psychedelics in Depression". Emerging Neurobiology of Antidepressant Treatments. Vol. 66. Cham: Springer International Publishing. pp. 149–174. doi:10.1007/7854_2023_451. ISBN 978-3-031-66355-0. PMID 37955822. Retrieved 12 May 2025. 5.1 Duration of Trip for Psychedelics: Why Does This Matter? [...] There are profound differences in the duration of action of serotonin psychedelics. LSD and mescaline are long lasting with effects for up to a day and so; often requiring overnight stays in clinical studies. Oral Psilocybin lasts approximately 4–6 h. Other psychedelics, like DMT (i.v. or smoked/intranasal) or 5-MEO-DMT (i.v./im/intranasal) can produce very short altered experiences (just 5–10 min). A key question is: are each equally effective for depression? If short acting psychedelics such as DMT and 5-MEO-DMT prove just as effective for treating depression, this would offer a cost-benefit when compared to longer lasting psychedelics such as psilocybin or LSD. [...] An alternative approach, being considered by some companies, is utilising a 5-HT2A receptor antagonist such as ketanserin (Becker et al. 2023) which can terminate an LSD trip after a given time, so shortening the treatment period in the clinic. Going forward, if psychedelics are integrated into health services; cost-benefit analyses will be crucial in delivering them as a viable treatment option. Overall, a shortened experience with similar antidepressant effects will be favourable. {{cite book}}: |journal= ignored (help) <a href="978-3-031-66355-0" target="_blank">978-3-031-66355-0</a> <a href="#fnref:68" class="footnote-back-ref">↩</a></li>
<li id="fn:69">Ramaekers JG, Reckweg JT, Mason NL (January 2025). "Benefits and Challenges of Ultra-Fast, Short-Acting Psychedelics in the Treatment of Depression". Am J Psychiatry. 182 (1): 33–46. doi:10.1176/appi.ajp.20230890. PMID 39741439. <a href="/wiki/Doi_(identifier)" target="_blank">/wiki/Doi_(identifier)</a> <a href="#fnref:69" class="footnote-back-ref">↩</a></li>
<li id="fn:70">Ramaekers JG (May 2025). "Less is more? Antidepressant effects of short-acting psychedelics". Neuropsychopharmacology. 50 (6): 875–876. doi:10.1038/s41386-025-02103-5. PMC 12032289. PMID 40258989. <a href="/wiki/Doi_(identifier)" target="_blank">/wiki/Doi_(identifier)</a> <a href="#fnref:70" class="footnote-back-ref">↩</a></li>
<li id="fn:71">Peplow, Mark (22 June 2024). "Should Next-Generation Psychedelics Skip the Trip?". Scientific American. Archived from the original on 26 June 2024. Retrieved 20 February 2025. But the psychoactive effects of [psychedelics] pose some major challenges. [...] And patients typically need close supervision for many hours while under the influence of the drugs, making it burdensome, expensive and impractical for many patients. To avoid these problems, some companies are tweaking psychedelic drugs to induce shorter or milder 'trips' that will not require such intensive patient oversight from clinicians. [...] Gilgamesh is also working on GM-2505, a 5-HT2A agonist that is structurally related to psilocybin and DMT. GM-2505 completed a phase 1 trial late last year and should enter phase 2 for major depressive disorder this year. Its psychedelic effect lasts 60 to 90 minutes — long enough for patients to "explore the altered state of consciousness that might be needed for long-term durable efficacy," Krugel says, yet within a timeframe that is manageable for healthcare systems. [...] <a href="https://archive.today/20240626183623/https://www.scientificamerican.com/article/should-next-generation-psychedelics-skip-the-trip/" target="_blank">https://archive.today/20240626183623/https://www.scientificamerican.com/article/should-next-generation-psychedelics-skip-the-trip/</a> <a href="#fnref:71" class="footnote-back-ref">↩</a></li>
<li id="fn:72">Nutt, D. J.; Peill, J. M.; Weiss, B.; Godfrey, K.; Carhart-Harris, R. L.; Erritzoe, D. (2023). "Psilocybin and Other Classic Psychedelics in Depression". Emerging Neurobiology of Antidepressant Treatments. Vol. 66. Cham: Springer International Publishing. pp. 149–174. doi:10.1007/7854_2023_451. ISBN 978-3-031-66355-0. PMID 37955822. Retrieved 12 May 2025. 5.1 Duration of Trip for Psychedelics: Why Does This Matter? [...] There are profound differences in the duration of action of serotonin psychedelics. LSD and mescaline are long lasting with effects for up to a day and so; often requiring overnight stays in clinical studies. Oral Psilocybin lasts approximately 4–6 h. Other psychedelics, like DMT (i.v. or smoked/intranasal) or 5-MEO-DMT (i.v./im/intranasal) can produce very short altered experiences (just 5–10 min). A key question is: are each equally effective for depression? If short acting psychedelics such as DMT and 5-MEO-DMT prove just as effective for treating depression, this would offer a cost-benefit when compared to longer lasting psychedelics such as psilocybin or LSD. [...] An alternative approach, being considered by some companies, is utilising a 5-HT2A receptor antagonist such as ketanserin (Becker et al. 2023) which can terminate an LSD trip after a given time, so shortening the treatment period in the clinic. Going forward, if psychedelics are integrated into health services; cost-benefit analyses will be crucial in delivering them as a viable treatment option. Overall, a shortened experience with similar antidepressant effects will be favourable. {{cite book}}: |journal= ignored (help) <a href="978-3-031-66355-0" target="_blank">978-3-031-66355-0</a> <a href="#fnref:72" class="footnote-back-ref">↩</a></li>
<li id="fn:73">Aday, Jacob S.; Barnett, Brian S.; Grossman, Dan; Murnane, Kevin S.; Nichols, Charles D.; Hendricks, Peter S. (1 September 2023). "Psychedelic Commercialization: A Wide-Spanning Overview of the Emerging Psychedelic Industry". Psychedelic Medicine. 1 (3): 150–165. doi:10.1089/psymed.2023.0013. ISSN 2831-4425. PMC 11661494. PMID 40046566. Recent work supported by MindMed demonstrated that ketanserin is able to shorten the duration of LSD's mind-altering effects while preserving LSD-induced elevations of brain-derived neurotrophic factor, a marker of neuroplasticity, suggesting the possibility that LSDinduced therapeutic effects might be retained despite the psychedelic experience being prematurely aborted.84 [...] Many of the formulation and chemical strategies target shortening the duration of action of psychedelics to promote patient compliance, reduce clinical utilization costs, and enhance their fit to the payment system of our current model of care. [...] Further, at present, very little is known about best practices for psychedelic-assisted psychotherapy, including the quantity and types of therapeutic support needed to maximize safety and efficacy, and companies are forced to navigate the tension between providing adequate support to participants while minimizing costs. One of the greatest costs will undoubtedly be therapist/monitor time, leading some companies to invest in researching and/or developing short-acting psychedelic compounds that theoretically reduce the amount of therapist time needed, or leading them to minimize the support offered in their trials (e.g., MindMed's LSD for generalized anxiety disorder study87). <a href="https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11661494" target="_blank">https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11661494</a> <a href="#fnref:73" class="footnote-back-ref">↩</a></li>
<li id="fn:74">Becker AM, Klaiber A, Holze F, Istampoulouoglou I, Duthaler U, Varghese N, Eckert A, Liechti ME (February 2023). "Ketanserin Reverses the Acute Response to LSD in a Randomized, Double-Blind, Placebo-Controlled, Crossover Study in Healthy Participants". Int J Neuropsychopharmacol. 26 (2): 97–106. doi:10.1093/ijnp/pyac075. PMC 9926053. PMID 36342343. <a href="https://www.ncbi.nlm.nih.gov/pmc/articles/PMC9926053" target="_blank">https://www.ncbi.nlm.nih.gov/pmc/articles/PMC9926053</a> <a href="#fnref:74" class="footnote-back-ref">↩</a></li>
<li id="fn:75">Halman A, Kong G, Sarris J, Perkins D (January 2024). "Drug-drug interactions involving classic psychedelics: A systematic review". J Psychopharmacol. 38 (1): 3–18. doi:10.1177/02698811231211219. PMC 10851641. PMID 37982394. <a href="https://www.ncbi.nlm.nih.gov/pmc/articles/PMC10851641" target="_blank">https://www.ncbi.nlm.nih.gov/pmc/articles/PMC10851641</a> <a href="#fnref:75" class="footnote-back-ref">↩</a></li>
<li id="fn:76">Becker AM, Klaiber A, Holze F, Istampoulouoglou I, Duthaler U, Varghese N, Eckert A, Liechti ME (February 2023). "Ketanserin Reverses the Acute Response to LSD in a Randomized, Double-Blind, Placebo-Controlled, Crossover Study in Healthy Participants". Int J Neuropsychopharmacol. 26 (2): 97–106. doi:10.1093/ijnp/pyac075. PMC 9926053. PMID 36342343. <a href="https://www.ncbi.nlm.nih.gov/pmc/articles/PMC9926053" target="_blank">https://www.ncbi.nlm.nih.gov/pmc/articles/PMC9926053</a> <a href="#fnref:76" class="footnote-back-ref">↩</a></li>
<li id="fn:77">Halman A, Kong G, Sarris J, Perkins D (January 2024). "Drug-drug interactions involving classic psychedelics: A systematic review". J Psychopharmacol. 38 (1): 3–18. doi:10.1177/02698811231211219. PMC 10851641. PMID 37982394. <a href="https://www.ncbi.nlm.nih.gov/pmc/articles/PMC10851641" target="_blank">https://www.ncbi.nlm.nih.gov/pmc/articles/PMC10851641</a> <a href="#fnref:77" class="footnote-back-ref">↩</a></li>
<li id="fn:78">Becker AM, Klaiber A, Holze F, Istampoulouoglou I, Duthaler U, Varghese N, Eckert A, Liechti ME (February 2023). "Ketanserin Reverses the Acute Response to LSD in a Randomized, Double-Blind, Placebo-Controlled, Crossover Study in Healthy Participants". Int J Neuropsychopharmacol. 26 (2): 97–106. doi:10.1093/ijnp/pyac075. PMC 9926053. PMID 36342343. <a href="https://www.ncbi.nlm.nih.gov/pmc/articles/PMC9926053" target="_blank">https://www.ncbi.nlm.nih.gov/pmc/articles/PMC9926053</a> <a href="#fnref:78" class="footnote-back-ref">↩</a></li>
<li id="fn:79">Leikin, Jerrold B.; Krantz, Anne J.; Zell-Kanter, Michele; Barkin, Robert L.; Hryhorczuk, Daniel O. (1989). "Clinical Features and Management of Intoxication Due to Hallucinogenic Drugs". Medical Toxicology and Adverse Drug Experience. 4 (5). Springer Science and Business Media LLC: 324–350. doi:10.1007/bf03259916. ISSN 0113-5244. PMID 2682130. <a href="/wiki/Doi_(identifier)" target="_blank">/wiki/Doi_(identifier)</a> <a href="#fnref:79" class="footnote-back-ref">↩</a></li>
<li id="fn:80">Halpern, John H.; Suzuki, Joji; Huertas, Pedro E.; Passie, Torsten (2010). "Hallucinogens". Addiction Medicine. New York, NY: Springer New York. pp. 1083–1098. doi:10.1007/978-1-4419-0338-9_54. ISBN 978-1-4419-0337-2. <a href="978-1-4419-0337-2" target="_blank">978-1-4419-0337-2</a> <a href="#fnref:80" class="footnote-back-ref">↩</a></li>
<li id="fn:81">Holze F, Liechti ME, Müller F (July 2024). "Pharmacological Properties of Psychedelics with a Special Focus on Potential Harms". Current Topics in Behavioral Neurosciences. Curr Top Behav Neurosci. doi:10.1007/7854_2024_510. PMID 39080236. <a href="/wiki/Doi_(identifier)" target="_blank">/wiki/Doi_(identifier)</a> <a href="#fnref:81" class="footnote-back-ref">↩</a></li>
<li id="fn:82">Olsen RW (July 2018). "GABAA receptor: Positive and negative allosteric modulators". Neuropharmacology. 136 (Pt A): 10–22. doi:10.1016/j.neuropharm.2018.01.036. PMC 6027637. PMID 29407219. <a href="https://www.ncbi.nlm.nih.gov/pmc/articles/PMC6027637" target="_blank">https://www.ncbi.nlm.nih.gov/pmc/articles/PMC6027637</a> <a href="#fnref:82" class="footnote-back-ref">↩</a></li>
<li id="fn:83">Yates G, Melon E (January 2024). "Trip-killers: a concerning practice associated with psychedelic drug use" (PDF). Emerg Med J. 41 (2): 112–113. doi:10.1136/emermed-2023-213377. PMID 38123961. <a href="https://web.archive.org/web/20250511111827oe_/https://s3.amazonaws.com/crawl.prod.proquest.com/fpcache/71f445805bfb61341cbc438c8ae23bd3.pdf?X-Amz-Security-Token=IQoJb3JpZ2luX2VjEBMaCXVzLWVhc3QtMSJIMEYCIQDETX7YpaG5THA%2FNbKR0d92wr6h%2Bgg9preNcKjAsEqo%2BQIhAIlPGGWOeUc23LqhBzRYbxvSXB9aqSe2vVonl4nacAhhKp0CCLz%2F%2F%2F%2F%2F%2F%2F%2F%2F%2FwEQABoMNTE4MzQ2ODQ4MzQxIgy9ji58Qtbi%2BavuKeYq8QEDL1U5KZDQ0bXFyVapeqJgE%2FX6x8DcJfFU8DAXYZPSQEwrIdfPbZWcYsH340deru%2FUHnNaGGpuHFoVzui%2FMbqBz7MANcowj%2FL1%2BQZzQ5hXh5KM3BW8E6NRzrQyuPRmBy7kQUkx8%2BjTN%2BXSMgF%2FCAs6Dn9fScgBGz3ddkwRZXDkjasqMP65RCPKhagK68cyMbf3oX%2BKS8a4Kltc2rk3CnWEhOKrZU4mIxq07DikLAXQbl8YRZJIkeOhN5TgBaLWJqyn1td2VWCMymAaFsqtPWHwXnEfsolRlfDooe6QXfE2YwX5PxBVJU7GPXRgrAqPjwtJMOCHgsEGOpwBYif%2BaDMBdz3IEghuvCvorAS0mkHzdcOz%2Fi7AzuN9nch%2FIm8llhMsN41aAWHuSG25pnhhftauFsg7rbGsrW2nl2kq2upi9zP7y%2Fnqk93jcP0kr0jM8zU12bYoSTsToQJsshH4N%2BTQUMwlzRQfeVv8MXdq%2BgSTTzJrWNwT1yNzye3rSHjvOumbNl6sgBISw7QqRzhB6hZTuf8AcI%2B7&X-Amz-Algorithm=AWS4-HMAC-SHA256&X-Amz-Date=20250511T111826Z&X-Amz-SignedHeaders=host&X-Amz-Credential=ASIAXRL7BHBKRAKCQVVB%2F20250511%2Fus-east-1%2Fs3%2Faws4_request&X-Amz-Expires=3600&X-Amz-Signature=20bb1b90e4c8dbaa4115c954387617ebe2f55269bdd517692f1380193ed3f769" target="_blank">https://web.archive.org/web/20250511111827oe_/https://s3.amazonaws.com/crawl.prod.proquest.com/fpcache/71f445805bfb61341cbc438c8ae23bd3.pdf?X-Amz-Security-Token=IQoJb3JpZ2luX2VjEBMaCXVzLWVhc3QtMSJIMEYCIQDETX7YpaG5THA%2FNbKR0d92wr6h%2Bgg9preNcKjAsEqo%2BQIhAIlPGGWOeUc23LqhBzRYbxvSXB9aqSe2vVonl4nacAhhKp0CCLz%2F%2F%2F%2F%2F%2F%2F%2F%2F%2FwEQABoMNTE4MzQ2ODQ4MzQxIgy9ji58Qtbi%2BavuKeYq8QEDL1U5KZDQ0bXFyVapeqJgE%2FX6x8DcJfFU8DAXYZPSQEwrIdfPbZWcYsH340deru%2FUHnNaGGpuHFoVzui%2FMbqBz7MANcowj%2FL1%2BQZzQ5hXh5KM3BW8E6NRzrQyuPRmBy7kQUkx8%2BjTN%2BXSMgF%2FCAs6Dn9fScgBGz3ddkwRZXDkjasqMP65RCPKhagK68cyMbf3oX%2BKS8a4Kltc2rk3CnWEhOKrZU4mIxq07DikLAXQbl8YRZJIkeOhN5TgBaLWJqyn1td2VWCMymAaFsqtPWHwXnEfsolRlfDooe6QXfE2YwX5PxBVJU7GPXRgrAqPjwtJMOCHgsEGOpwBYif%2BaDMBdz3IEghuvCvorAS0mkHzdcOz%2Fi7AzuN9nch%2FIm8llhMsN41aAWHuSG25pnhhftauFsg7rbGsrW2nl2kq2upi9zP7y%2Fnqk93jcP0kr0jM8zU12bYoSTsToQJsshH4N%2BTQUMwlzRQfeVv8MXdq%2BgSTTzJrWNwT1yNzye3rSHjvOumbNl6sgBISw7QqRzhB6hZTuf8AcI%2B7&X-Amz-Algorithm=AWS4-HMAC-SHA256&X-Amz-Date=20250511T111826Z&X-Amz-SignedHeaders=host&X-Amz-Credential=ASIAXRL7BHBKRAKCQVVB%2F20250511%2Fus-east-1%2Fs3%2Faws4_request&X-Amz-Expires=3600&X-Amz-Signature=20bb1b90e4c8dbaa4115c954387617ebe2f55269bdd517692f1380193ed3f769</a> <a href="#fnref:83" class="footnote-back-ref">↩</a></li>
<li id="fn:84">Suran M (February 2024). "Study Finds Hundreds of Reddit Posts on "Trip-Killers" for Psychedelic Drugs". JAMA. 331 (8): 632–634. doi:10.1001/jama.2023.28257. PMID 38294772. <a href="/wiki/Doi_(identifier)" target="_blank">/wiki/Doi_(identifier)</a> <a href="#fnref:84" class="footnote-back-ref">↩</a></li>
<li id="fn:85">Halman A, Kong G, Sarris J, Perkins D (January 2024). "Drug-drug interactions involving classic psychedelics: A systematic review". J Psychopharmacol. 38 (1): 3–18. doi:10.1177/02698811231211219. PMC 10851641. PMID 37982394. <a href="https://www.ncbi.nlm.nih.gov/pmc/articles/PMC10851641" target="_blank">https://www.ncbi.nlm.nih.gov/pmc/articles/PMC10851641</a> <a href="#fnref:85" class="footnote-back-ref">↩</a></li>
<li id="fn:86">Fradet M, Kelly CM, Donnelly AJ, Suppes T (December 2024). "Psilocybin and hallucinogenic mushrooms". CNS Spectr. 29 (6): 611–632. doi:10.1017/S1092852924002487. PMID 39789676. <a href="https://doi.org/10.1017%2FS1092852924002487" target="_blank">https://doi.org/10.1017%2FS1092852924002487</a> <a href="#fnref:86" class="footnote-back-ref">↩</a></li>
<li id="fn:87">Halman A, Kong G, Sarris J, Perkins D (January 2024). "Drug-drug interactions involving classic psychedelics: A systematic review". J Psychopharmacol. 38 (1): 3–18. doi:10.1177/02698811231211219. PMC 10851641. PMID 37982394. <a href="https://www.ncbi.nlm.nih.gov/pmc/articles/PMC10851641" target="_blank">https://www.ncbi.nlm.nih.gov/pmc/articles/PMC10851641</a> <a href="#fnref:87" class="footnote-back-ref">↩</a></li>
<li id="fn:88">Fradet M, Kelly CM, Donnelly AJ, Suppes T (December 2024). "Psilocybin and hallucinogenic mushrooms". CNS Spectr. 29 (6): 611–632. doi:10.1017/S1092852924002487. PMID 39789676. <a href="https://doi.org/10.1017%2FS1092852924002487" target="_blank">https://doi.org/10.1017%2FS1092852924002487</a> <a href="#fnref:88" class="footnote-back-ref">↩</a></li>
<li id="fn:89">Halman A, Kong G, Sarris J, Perkins D (January 2024). "Drug-drug interactions involving classic psychedelics: A systematic review". J Psychopharmacol. 38 (1): 3–18. doi:10.1177/02698811231211219. PMC 10851641. PMID 37982394. <a href="https://www.ncbi.nlm.nih.gov/pmc/articles/PMC10851641" target="_blank">https://www.ncbi.nlm.nih.gov/pmc/articles/PMC10851641</a> <a href="#fnref:89" class="footnote-back-ref">↩</a></li>
<li id="fn:90">Brandt SD, Kavanagh PV, Twamley B, Westphal F, Elliott SP, Wallach J, Stratford A, Klein LM, McCorvy JD, Nichols DE, Halberstadt AL (February 2018). "Return of the lysergamides. Part IV: Analytical and pharmacological characterization of lysergic acid morpholide (LSM-775)". Drug Test Anal. 10 (2): 310–322. doi:10.1002/dta.2222. PMC 6230476. PMID 28585392. Additionally, pretreatment with the 5‐HT1A agonist buspirone (20 mg p.o.) markedly attenuates the visual effects of psilocybin in human volunteers.59 Although buspirone failed to completely block the hallucinogenic effects of psilocybin, the limited inhibition is not necessarily surprising because buspirone is a low efficacy 5‐HT1A partial agonist.60 The level of 5‐HT1A activation produced by buspirone may not be sufficient to completely counteract the stimulation of 5‐HT2A receptors by psilocin (the active metabolite of psilocybin). Another consideration is that psilocin acts as a 5‐HT1A agonist.30 If 5‐HT1A activation by psilocin buffers its hallucinogenic effects similar to DMT58 then competition between psilocin and a weaker partial agonist such as buspirone would limit attenuation of the hallucinogenic response. <a href="https://www.ncbi.nlm.nih.gov/pmc/articles/PMC6230476" target="_blank">https://www.ncbi.nlm.nih.gov/pmc/articles/PMC6230476</a> <a href="#fnref:90" class="footnote-back-ref">↩</a></li>
<li id="fn:91">Pokorny T, Preller KH, Kraehenmann R, Vollenweider FX (April 2016). "Modulatory effect of the 5-HT1A agonist buspirone and the mixed non-hallucinogenic 5-HT1A/2A agonist ergotamine on psilocybin-induced psychedelic experience". Eur Neuropsychopharmacol. 26 (4): 756–766. doi:10.1016/j.euroneuro.2016.01.005. PMID 26875114. <a href="/wiki/Doi_(identifier)" target="_blank">/wiki/Doi_(identifier)</a> <a href="#fnref:91" class="footnote-back-ref">↩</a></li>
<li id="fn:92">Halman A, Kong G, Sarris J, Perkins D (January 2024). "Drug-drug interactions involving classic psychedelics: A systematic review". J Psychopharmacol. 38 (1): 3–18. doi:10.1177/02698811231211219. PMC 10851641. PMID 37982394. <a href="https://www.ncbi.nlm.nih.gov/pmc/articles/PMC10851641" target="_blank">https://www.ncbi.nlm.nih.gov/pmc/articles/PMC10851641</a> <a href="#fnref:92" class="footnote-back-ref">↩</a></li>
<li id="fn:93">Fradet M, Kelly CM, Donnelly AJ, Suppes T (December 2024). "Psilocybin and hallucinogenic mushrooms". CNS Spectr. 29 (6): 611–632. doi:10.1017/S1092852924002487. PMID 39789676. <a href="https://doi.org/10.1017%2FS1092852924002487" target="_blank">https://doi.org/10.1017%2FS1092852924002487</a> <a href="#fnref:93" class="footnote-back-ref">↩</a></li>
<li id="fn:94">Fradet M, Kelly CM, Donnelly AJ, Suppes T (December 2024). "Psilocybin and hallucinogenic mushrooms". CNS Spectr. 29 (6): 611–632. doi:10.1017/S1092852924002487. PMID 39789676. <a href="https://doi.org/10.1017%2FS1092852924002487" target="_blank">https://doi.org/10.1017%2FS1092852924002487</a> <a href="#fnref:94" class="footnote-back-ref">↩</a></li>
<li id="fn:95">James E, Joel Z, Attwooll V, Benway T, Good M, Tziras G, Routledge C, Macek T (2024). "ACNP 63rd Annual Meeting: Poster Abstracts P1-P304: P160. SPL026 (DMT Fumarate) in Combination With Selective Serotonin Reuptake Inhibitors (SSRIs) for Patients With Major Depressive Disorder" (PDF). Neuropsychopharmacology. 49 (S1): 65–235 (155–156). doi:10.1038/s41386-024-02011-0. ISSN 0893-133X. PMC 11627186. PMID 39643633. Retrieved 31 January 2025. <a href="https://www.nature.com/articles/s41386-024-02011-0.pdf" target="_blank">https://www.nature.com/articles/s41386-024-02011-0.pdf</a> <a href="#fnref:95" class="footnote-back-ref">↩</a></li>
<li id="fn:96">James E, Joel Z, Attwooll V, Benway T, Good M, Tziras G, Routledge C, Macek T (2024). "ACNP 63rd Annual Meeting: Poster Abstracts P1-P304: P160. SPL026 (DMT Fumarate) in Combination With Selective Serotonin Reuptake Inhibitors (SSRIs) for Patients With Major Depressive Disorder" (PDF). Neuropsychopharmacology. 49 (S1): 65–235 (155–156). doi:10.1038/s41386-024-02011-0. ISSN 0893-133X. PMC 11627186. PMID 39643633. Retrieved 31 January 2025. <a href="https://www.nature.com/articles/s41386-024-02011-0.pdf" target="_blank">https://www.nature.com/articles/s41386-024-02011-0.pdf</a> <a href="#fnref:96" class="footnote-back-ref">↩</a></li>
<li id="fn:97">Halman A, Kong G, Sarris J, Perkins D (January 2024). "Drug-drug interactions involving classic psychedelics: A systematic review". J Psychopharmacol. 38 (1): 3–18. doi:10.1177/02698811231211219. PMC 10851641. PMID 37982394. <a href="https://www.ncbi.nlm.nih.gov/pmc/articles/PMC10851641" target="_blank">https://www.ncbi.nlm.nih.gov/pmc/articles/PMC10851641</a> <a href="#fnref:97" class="footnote-back-ref">↩</a></li>
<li id="fn:98">Egger, Klemens; Aicher, Helena D.; Cumming, Paul; Scheidegger, Milan (10 September 2024). "Neurobiological research on N,N-dimethyltryptamine (DMT) and its potentiation by monoamine oxidase (MAO) inhibition: from ayahuasca to synthetic combinations of DMT and MAO inhibitors". Cellular and Molecular Life Sciences. 81 (1). Springer Science and Business Media LLC: 395. doi:10.1007/s00018-024-05353-6. ISSN 1420-682X. PMC 11387584. PMID 39254764. <a href="https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11387584" target="_blank">https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11387584</a> <a href="#fnref:98" class="footnote-back-ref">↩</a></li>
<li id="fn:99">Dean BV, Stellpflug SJ, Burnett AM, Engebretsen KM (June 2013). "2C or not 2C: phenethylamine designer drug review". J Med Toxicol. 9 (2): 172–178. doi:10.1007/s13181-013-0295-x. PMC 3657019. PMID 23494844. <a href="https://www.ncbi.nlm.nih.gov/pmc/articles/PMC3657019" target="_blank">https://www.ncbi.nlm.nih.gov/pmc/articles/PMC3657019</a> <a href="#fnref:99" class="footnote-back-ref">↩</a></li>
<li id="fn:100">Theobald DS, Maurer HH (January 2007). "Identification of monoamine oxidase and cytochrome P450 isoenzymes involved in the deamination of phenethylamine-derived designer drugs (2C-series)". Biochem Pharmacol. 73 (2): 287–297. doi:10.1016/j.bcp.2006.09.022. PMID 17067556. <a href="/wiki/Doi_(identifier)" target="_blank">/wiki/Doi_(identifier)</a> <a href="#fnref:100" class="footnote-back-ref">↩</a></li>
<li id="fn:101">Halman A, Kong G, Sarris J, Perkins D (January 2024). "Drug-drug interactions involving classic psychedelics: A systematic review". J Psychopharmacol. 38 (1): 3–18. doi:10.1177/02698811231211219. PMC 10851641. PMID 37982394. <a href="https://www.ncbi.nlm.nih.gov/pmc/articles/PMC10851641" target="_blank">https://www.ncbi.nlm.nih.gov/pmc/articles/PMC10851641</a> <a href="#fnref:101" class="footnote-back-ref">↩</a></li>
<li id="fn:102">Murphree, Henry (1983). "The Pharmacology of Hallucinogens". Research Advances in Alcohol and Drug Problems. Boston, MA: Springer US. pp. 175–205. doi:10.1007/978-1-4613-3626-6_5. ISBN 978-1-4613-3628-0. In older work, various steroids (Bergen et al., 1960) including progesterone (Krus et al., 1961) were reported to be effective antagonists. This has not been replicated. In other early work, some compounds initially reported to be effective were not found to be so by other workers. These include azacyclonal (Fabing, 1955) and niacin (Agnew and Hoffer, 1955). <a href="978-1-4613-3628-0" target="_blank">978-1-4613-3628-0</a> <a href="#fnref:102" class="footnote-back-ref">↩</a></li>
<li id="fn:103">Agnew N, Hoffer A (January 1955). "Nicotinic acid modified lysergic acid diethylamide psychosis". J Ment Sci. 101 (422): 12–27. doi:10.1192/bjp.101.422.12. PMID 14368207. <a href="/wiki/Doi_(identifier)" target="_blank">/wiki/Doi_(identifier)</a> <a href="#fnref:103" class="footnote-back-ref">↩</a></li>
<li id="fn:104">Murphree, Henry (1983). "The Pharmacology of Hallucinogens". Research Advances in Alcohol and Drug Problems. Boston, MA: Springer US. pp. 175–205. doi:10.1007/978-1-4613-3626-6_5. ISBN 978-1-4613-3628-0. In older work, various steroids (Bergen et al., 1960) including progesterone (Krus et al., 1961) were reported to be effective antagonists. This has not been replicated. In other early work, some compounds initially reported to be effective were not found to be so by other workers. These include azacyclonal (Fabing, 1955) and niacin (Agnew and Hoffer, 1955). <a href="978-1-4613-3628-0" target="_blank">978-1-4613-3628-0</a> <a href="#fnref:104" class="footnote-back-ref">↩</a></li>
<li id="fn:105">Halman A, Kong G, Sarris J, Perkins D (January 2024). "Drug-drug interactions involving classic psychedelics: A systematic review". J Psychopharmacol. 38 (1): 3–18. doi:10.1177/02698811231211219. PMC 10851641. PMID 37982394. <a href="https://www.ncbi.nlm.nih.gov/pmc/articles/PMC10851641" target="_blank">https://www.ncbi.nlm.nih.gov/pmc/articles/PMC10851641</a> <a href="#fnref:105" class="footnote-back-ref">↩</a></li>
<li id="fn:106">Halberstadt AL (January 2015). "Recent advances in the neuropsychopharmacology of serotonergic hallucinogens". Behav Brain Res. 277: 99–120. doi:10.1016/j.bbr.2014.07.016. PMC 4642895. PMID 25036425. <a href="https://www.ncbi.nlm.nih.gov/pmc/articles/PMC4642895" target="_blank">https://www.ncbi.nlm.nih.gov/pmc/articles/PMC4642895</a> <a href="#fnref:106" class="footnote-back-ref">↩</a></li>
<li id="fn:107">Marek GJ, Schoepp DD (2021). "Cortical influences of serotonin and glutamate on layer V pyramidal neurons". 5-HT Interaction with Other Neurotransmitters: Experimental Evidence and Therapeutic Relevance - Part B. Progress in Brain Research. Vol. 261. pp. 341–378. doi:10.1016/bs.pbr.2020.11.002. ISBN 978-0-444-64258-5. PMID 33785135. {{cite book}}: |journal= ignored (help) <a href="978-0-444-64258-5" target="_blank">978-0-444-64258-5</a> <a href="#fnref:107" class="footnote-back-ref">↩</a></li>
<li id="fn:108">Marek GJ (August 2003). "Behavioral evidence for mu-opioid and 5-HT2A receptor interactions". Eur J Pharmacol. 474 (1): 77–83. doi:10.1016/s0014-2999(03)01971-x. PMID 12909198. <a href="/wiki/Doi_(identifier)" target="_blank">/wiki/Doi_(identifier)</a> <a href="#fnref:108" class="footnote-back-ref">↩</a></li>
<li id="fn:109">Halman A, Kong G, Sarris J, Perkins D (January 2024). "Drug-drug interactions involving classic psychedelics: A systematic review". J Psychopharmacol. 38 (1): 3–18. doi:10.1177/02698811231211219. PMC 10851641. PMID 37982394. <a href="https://www.ncbi.nlm.nih.gov/pmc/articles/PMC10851641" target="_blank">https://www.ncbi.nlm.nih.gov/pmc/articles/PMC10851641</a> <a href="#fnref:109" class="footnote-back-ref">↩</a></li>
<li id="fn:110">Pokorny T, Preller KH, Kraehenmann R, Vollenweider FX (April 2016). "Modulatory effect of the 5-HT1A agonist buspirone and the mixed non-hallucinogenic 5-HT1A/2A agonist ergotamine on psilocybin-induced psychedelic experience". Eur Neuropsychopharmacol. 26 (4): 756–766. doi:10.1016/j.euroneuro.2016.01.005. PMID 26875114. <a href="/wiki/Doi_(identifier)" target="_blank">/wiki/Doi_(identifier)</a> <a href="#fnref:110" class="footnote-back-ref">↩</a></li>
<li id="fn:111">Strassman RJ (1996). "Human psychopharmacology of N,N-dimethyltryptamine". Behav Brain Res. 73 (1–2): 121–124. doi:10.1016/0166-4328(96)00081-2. PMID 8788488. <a href="/wiki/Doi_(identifier)" target="_blank">/wiki/Doi_(identifier)</a> <a href="#fnref:111" class="footnote-back-ref">↩</a></li>
<li id="fn:112">Fradet M, Kelly CM, Donnelly AJ, Suppes T (December 2024). "Psilocybin and hallucinogenic mushrooms". CNS Spectr. 29 (6): 611–632. doi:10.1017/S1092852924002487. PMID 39789676. <a href="https://doi.org/10.1017%2FS1092852924002487" target="_blank">https://doi.org/10.1017%2FS1092852924002487</a> <a href="#fnref:112" class="footnote-back-ref">↩</a></li>
<li id="fn:113">Holze F, Liechti ME, Müller F (July 2024). "Pharmacological Properties of Psychedelics with a Special Focus on Potential Harms". Current Topics in Behavioral Neurosciences. Curr Top Behav Neurosci. doi:10.1007/7854_2024_510. PMID 39080236. <a href="/wiki/Doi_(identifier)" target="_blank">/wiki/Doi_(identifier)</a> <a href="#fnref:113" class="footnote-back-ref">↩</a></li>
<li id="fn:114">Nayak SM, Gukasyan N, Barrett FS, Erowid E, Erowid F, Griffiths RR (September 2021). "Classic Psychedelic Coadministration with Lithium, but Not Lamotrigine, is Associated with Seizures: An Analysis of Online Psychedelic Experience Reports" (PDF). Pharmacopsychiatry. 54 (5): 240–245. doi:10.1055/a-1524-2794. PMID 34348413. <a href="https://www.thieme-connect.com/products/ejournals/pdf/10.1055/a-1524-2794.pdf" target="_blank">https://www.thieme-connect.com/products/ejournals/pdf/10.1055/a-1524-2794.pdf</a> <a href="#fnref:114" class="footnote-back-ref">↩</a></li>
<li id="fn:115">Yates G, Melon E (January 2024). "Trip-killers: a concerning practice associated with psychedelic drug use" (PDF). Emerg Med J. 41 (2): 112–113. doi:10.1136/emermed-2023-213377. PMID 38123961. <a href="https://web.archive.org/web/20250511111827oe_/https://s3.amazonaws.com/crawl.prod.proquest.com/fpcache/71f445805bfb61341cbc438c8ae23bd3.pdf?X-Amz-Security-Token=IQoJb3JpZ2luX2VjEBMaCXVzLWVhc3QtMSJIMEYCIQDETX7YpaG5THA%2FNbKR0d92wr6h%2Bgg9preNcKjAsEqo%2BQIhAIlPGGWOeUc23LqhBzRYbxvSXB9aqSe2vVonl4nacAhhKp0CCLz%2F%2F%2F%2F%2F%2F%2F%2F%2F%2FwEQABoMNTE4MzQ2ODQ4MzQxIgy9ji58Qtbi%2BavuKeYq8QEDL1U5KZDQ0bXFyVapeqJgE%2FX6x8DcJfFU8DAXYZPSQEwrIdfPbZWcYsH340deru%2FUHnNaGGpuHFoVzui%2FMbqBz7MANcowj%2FL1%2BQZzQ5hXh5KM3BW8E6NRzrQyuPRmBy7kQUkx8%2BjTN%2BXSMgF%2FCAs6Dn9fScgBGz3ddkwRZXDkjasqMP65RCPKhagK68cyMbf3oX%2BKS8a4Kltc2rk3CnWEhOKrZU4mIxq07DikLAXQbl8YRZJIkeOhN5TgBaLWJqyn1td2VWCMymAaFsqtPWHwXnEfsolRlfDooe6QXfE2YwX5PxBVJU7GPXRgrAqPjwtJMOCHgsEGOpwBYif%2BaDMBdz3IEghuvCvorAS0mkHzdcOz%2Fi7AzuN9nch%2FIm8llhMsN41aAWHuSG25pnhhftauFsg7rbGsrW2nl2kq2upi9zP7y%2Fnqk93jcP0kr0jM8zU12bYoSTsToQJsshH4N%2BTQUMwlzRQfeVv8MXdq%2BgSTTzJrWNwT1yNzye3rSHjvOumbNl6sgBISw7QqRzhB6hZTuf8AcI%2B7&X-Amz-Algorithm=AWS4-HMAC-SHA256&X-Amz-Date=20250511T111826Z&X-Amz-SignedHeaders=host&X-Amz-Credential=ASIAXRL7BHBKRAKCQVVB%2F20250511%2Fus-east-1%2Fs3%2Faws4_request&X-Amz-Expires=3600&X-Amz-Signature=20bb1b90e4c8dbaa4115c954387617ebe2f55269bdd517692f1380193ed3f769" target="_blank">https://web.archive.org/web/20250511111827oe_/https://s3.amazonaws.com/crawl.prod.proquest.com/fpcache/71f445805bfb61341cbc438c8ae23bd3.pdf?X-Amz-Security-Token=IQoJb3JpZ2luX2VjEBMaCXVzLWVhc3QtMSJIMEYCIQDETX7YpaG5THA%2FNbKR0d92wr6h%2Bgg9preNcKjAsEqo%2BQIhAIlPGGWOeUc23LqhBzRYbxvSXB9aqSe2vVonl4nacAhhKp0CCLz%2F%2F%2F%2F%2F%2F%2F%2F%2F%2FwEQABoMNTE4MzQ2ODQ4MzQxIgy9ji58Qtbi%2BavuKeYq8QEDL1U5KZDQ0bXFyVapeqJgE%2FX6x8DcJfFU8DAXYZPSQEwrIdfPbZWcYsH340deru%2FUHnNaGGpuHFoVzui%2FMbqBz7MANcowj%2FL1%2BQZzQ5hXh5KM3BW8E6NRzrQyuPRmBy7kQUkx8%2BjTN%2BXSMgF%2FCAs6Dn9fScgBGz3ddkwRZXDkjasqMP65RCPKhagK68cyMbf3oX%2BKS8a4Kltc2rk3CnWEhOKrZU4mIxq07DikLAXQbl8YRZJIkeOhN5TgBaLWJqyn1td2VWCMymAaFsqtPWHwXnEfsolRlfDooe6QXfE2YwX5PxBVJU7GPXRgrAqPjwtJMOCHgsEGOpwBYif%2BaDMBdz3IEghuvCvorAS0mkHzdcOz%2Fi7AzuN9nch%2FIm8llhMsN41aAWHuSG25pnhhftauFsg7rbGsrW2nl2kq2upi9zP7y%2Fnqk93jcP0kr0jM8zU12bYoSTsToQJsshH4N%2BTQUMwlzRQfeVv8MXdq%2BgSTTzJrWNwT1yNzye3rSHjvOumbNl6sgBISw7QqRzhB6hZTuf8AcI%2B7&X-Amz-Algorithm=AWS4-HMAC-SHA256&X-Amz-Date=20250511T111826Z&X-Amz-SignedHeaders=host&X-Amz-Credential=ASIAXRL7BHBKRAKCQVVB%2F20250511%2Fus-east-1%2Fs3%2Faws4_request&X-Amz-Expires=3600&X-Amz-Signature=20bb1b90e4c8dbaa4115c954387617ebe2f55269bdd517692f1380193ed3f769</a> <a href="#fnref:115" class="footnote-back-ref">↩</a></li>
<li id="fn:116">Bellanavidanalage Gothami Ayanthie Vis Jayasinha (8 February 2024). Towards Safer Trips: Exploring Harm Reduction Strategies for Recreational Psychedelic Use in Aotearoa New Zealand (Thesis). University of Otago. Retrieved 3 October 2024. Another form of mixing substances involves the use of trip killers; a pharmacological coping strategy aimed to reduce the negative effects of a psychedelic experience by consuming a different substance (Suran, 2024). While this is a new concept and an under researched area, there are reports of trip killers being effective in reducing the negative effects of a psychedelic experience (Suran, 2024). One study gathered research from reddit, an online social media platform, investigating the usage of trip killers during challenging psychedelic experiences (Suran, 2024). The most popular and effective trip killers used were prescription medication, with 47% reporting the use of benzodiazepines as they reduce anxiety, followed by the use of antipsychotic and antidepressant medication (Suran, 2024). However, there are risks in mixing substances with psychedelic drugs, and subjectivity in the effectiveness. As some individuals may experience positive effects, while for others it may lead to negative effects (Suran, 2024). Therefore, it is recommended that before using trip killers, individuals should try other non- pharmacological coping strategies to reduce the negative effects of the psychedelic drug (Gable, 2004; Van Amsterdam et al., 2011). These factors discussed above, demonstrate the effectiveness of protective behaviours and harm reduction practices, in promoting safe psychedelic use and reducing harm. <a href="https://ourarchive.otago.ac.nz/esploro/outputs/graduate/Towards-Safer-Trips-Exploring-Harm-Reduction/9926550679501891" target="_blank">https://ourarchive.otago.ac.nz/esploro/outputs/graduate/Towards-Safer-Trips-Exploring-Harm-Reduction/9926550679501891</a> <a href="#fnref:116" class="footnote-back-ref">↩</a></li>
<li id="fn:117">Yates G, Melon E (January 2024). "Trip-killers: a concerning practice associated with psychedelic drug use" (PDF). Emerg Med J. 41 (2): 112–113. doi:10.1136/emermed-2023-213377. PMID 38123961. <a href="https://web.archive.org/web/20250511111827oe_/https://s3.amazonaws.com/crawl.prod.proquest.com/fpcache/71f445805bfb61341cbc438c8ae23bd3.pdf?X-Amz-Security-Token=IQoJb3JpZ2luX2VjEBMaCXVzLWVhc3QtMSJIMEYCIQDETX7YpaG5THA%2FNbKR0d92wr6h%2Bgg9preNcKjAsEqo%2BQIhAIlPGGWOeUc23LqhBzRYbxvSXB9aqSe2vVonl4nacAhhKp0CCLz%2F%2F%2F%2F%2F%2F%2F%2F%2F%2FwEQABoMNTE4MzQ2ODQ4MzQxIgy9ji58Qtbi%2BavuKeYq8QEDL1U5KZDQ0bXFyVapeqJgE%2FX6x8DcJfFU8DAXYZPSQEwrIdfPbZWcYsH340deru%2FUHnNaGGpuHFoVzui%2FMbqBz7MANcowj%2FL1%2BQZzQ5hXh5KM3BW8E6NRzrQyuPRmBy7kQUkx8%2BjTN%2BXSMgF%2FCAs6Dn9fScgBGz3ddkwRZXDkjasqMP65RCPKhagK68cyMbf3oX%2BKS8a4Kltc2rk3CnWEhOKrZU4mIxq07DikLAXQbl8YRZJIkeOhN5TgBaLWJqyn1td2VWCMymAaFsqtPWHwXnEfsolRlfDooe6QXfE2YwX5PxBVJU7GPXRgrAqPjwtJMOCHgsEGOpwBYif%2BaDMBdz3IEghuvCvorAS0mkHzdcOz%2Fi7AzuN9nch%2FIm8llhMsN41aAWHuSG25pnhhftauFsg7rbGsrW2nl2kq2upi9zP7y%2Fnqk93jcP0kr0jM8zU12bYoSTsToQJsshH4N%2BTQUMwlzRQfeVv8MXdq%2BgSTTzJrWNwT1yNzye3rSHjvOumbNl6sgBISw7QqRzhB6hZTuf8AcI%2B7&X-Amz-Algorithm=AWS4-HMAC-SHA256&X-Amz-Date=20250511T111826Z&X-Amz-SignedHeaders=host&X-Amz-Credential=ASIAXRL7BHBKRAKCQVVB%2F20250511%2Fus-east-1%2Fs3%2Faws4_request&X-Amz-Expires=3600&X-Amz-Signature=20bb1b90e4c8dbaa4115c954387617ebe2f55269bdd517692f1380193ed3f769" target="_blank">https://web.archive.org/web/20250511111827oe_/https://s3.amazonaws.com/crawl.prod.proquest.com/fpcache/71f445805bfb61341cbc438c8ae23bd3.pdf?X-Amz-Security-Token=IQoJb3JpZ2luX2VjEBMaCXVzLWVhc3QtMSJIMEYCIQDETX7YpaG5THA%2FNbKR0d92wr6h%2Bgg9preNcKjAsEqo%2BQIhAIlPGGWOeUc23LqhBzRYbxvSXB9aqSe2vVonl4nacAhhKp0CCLz%2F%2F%2F%2F%2F%2F%2F%2F%2F%2FwEQABoMNTE4MzQ2ODQ4MzQxIgy9ji58Qtbi%2BavuKeYq8QEDL1U5KZDQ0bXFyVapeqJgE%2FX6x8DcJfFU8DAXYZPSQEwrIdfPbZWcYsH340deru%2FUHnNaGGpuHFoVzui%2FMbqBz7MANcowj%2FL1%2BQZzQ5hXh5KM3BW8E6NRzrQyuPRmBy7kQUkx8%2BjTN%2BXSMgF%2FCAs6Dn9fScgBGz3ddkwRZXDkjasqMP65RCPKhagK68cyMbf3oX%2BKS8a4Kltc2rk3CnWEhOKrZU4mIxq07DikLAXQbl8YRZJIkeOhN5TgBaLWJqyn1td2VWCMymAaFsqtPWHwXnEfsolRlfDooe6QXfE2YwX5PxBVJU7GPXRgrAqPjwtJMOCHgsEGOpwBYif%2BaDMBdz3IEghuvCvorAS0mkHzdcOz%2Fi7AzuN9nch%2FIm8llhMsN41aAWHuSG25pnhhftauFsg7rbGsrW2nl2kq2upi9zP7y%2Fnqk93jcP0kr0jM8zU12bYoSTsToQJsshH4N%2BTQUMwlzRQfeVv8MXdq%2BgSTTzJrWNwT1yNzye3rSHjvOumbNl6sgBISw7QqRzhB6hZTuf8AcI%2B7&X-Amz-Algorithm=AWS4-HMAC-SHA256&X-Amz-Date=20250511T111826Z&X-Amz-SignedHeaders=host&X-Amz-Credential=ASIAXRL7BHBKRAKCQVVB%2F20250511%2Fus-east-1%2Fs3%2Faws4_request&X-Amz-Expires=3600&X-Amz-Signature=20bb1b90e4c8dbaa4115c954387617ebe2f55269bdd517692f1380193ed3f769</a> <a href="#fnref:117" class="footnote-back-ref">↩</a></li>
<li id="fn:118">Suran M (February 2024). "Study Finds Hundreds of Reddit Posts on "Trip-Killers" for Psychedelic Drugs". JAMA. 331 (8): 632–634. doi:10.1001/jama.2023.28257. PMID 38294772. <a href="/wiki/Doi_(identifier)" target="_blank">/wiki/Doi_(identifier)</a> <a href="#fnref:118" class="footnote-back-ref">↩</a></li>
<li id="fn:119">Yates G, Melon E (January 2024). "Trip-killers: a concerning practice associated with psychedelic drug use" (PDF). Emerg Med J. 41 (2): 112–113. doi:10.1136/emermed-2023-213377. PMID 38123961. <a href="https://web.archive.org/web/20250511111827oe_/https://s3.amazonaws.com/crawl.prod.proquest.com/fpcache/71f445805bfb61341cbc438c8ae23bd3.pdf?X-Amz-Security-Token=IQoJb3JpZ2luX2VjEBMaCXVzLWVhc3QtMSJIMEYCIQDETX7YpaG5THA%2FNbKR0d92wr6h%2Bgg9preNcKjAsEqo%2BQIhAIlPGGWOeUc23LqhBzRYbxvSXB9aqSe2vVonl4nacAhhKp0CCLz%2F%2F%2F%2F%2F%2F%2F%2F%2F%2FwEQABoMNTE4MzQ2ODQ4MzQxIgy9ji58Qtbi%2BavuKeYq8QEDL1U5KZDQ0bXFyVapeqJgE%2FX6x8DcJfFU8DAXYZPSQEwrIdfPbZWcYsH340deru%2FUHnNaGGpuHFoVzui%2FMbqBz7MANcowj%2FL1%2BQZzQ5hXh5KM3BW8E6NRzrQyuPRmBy7kQUkx8%2BjTN%2BXSMgF%2FCAs6Dn9fScgBGz3ddkwRZXDkjasqMP65RCPKhagK68cyMbf3oX%2BKS8a4Kltc2rk3CnWEhOKrZU4mIxq07DikLAXQbl8YRZJIkeOhN5TgBaLWJqyn1td2VWCMymAaFsqtPWHwXnEfsolRlfDooe6QXfE2YwX5PxBVJU7GPXRgrAqPjwtJMOCHgsEGOpwBYif%2BaDMBdz3IEghuvCvorAS0mkHzdcOz%2Fi7AzuN9nch%2FIm8llhMsN41aAWHuSG25pnhhftauFsg7rbGsrW2nl2kq2upi9zP7y%2Fnqk93jcP0kr0jM8zU12bYoSTsToQJsshH4N%2BTQUMwlzRQfeVv8MXdq%2BgSTTzJrWNwT1yNzye3rSHjvOumbNl6sgBISw7QqRzhB6hZTuf8AcI%2B7&X-Amz-Algorithm=AWS4-HMAC-SHA256&X-Amz-Date=20250511T111826Z&X-Amz-SignedHeaders=host&X-Amz-Credential=ASIAXRL7BHBKRAKCQVVB%2F20250511%2Fus-east-1%2Fs3%2Faws4_request&X-Amz-Expires=3600&X-Amz-Signature=20bb1b90e4c8dbaa4115c954387617ebe2f55269bdd517692f1380193ed3f769" target="_blank">https://web.archive.org/web/20250511111827oe_/https://s3.amazonaws.com/crawl.prod.proquest.com/fpcache/71f445805bfb61341cbc438c8ae23bd3.pdf?X-Amz-Security-Token=IQoJb3JpZ2luX2VjEBMaCXVzLWVhc3QtMSJIMEYCIQDETX7YpaG5THA%2FNbKR0d92wr6h%2Bgg9preNcKjAsEqo%2BQIhAIlPGGWOeUc23LqhBzRYbxvSXB9aqSe2vVonl4nacAhhKp0CCLz%2F%2F%2F%2F%2F%2F%2F%2F%2F%2FwEQABoMNTE4MzQ2ODQ4MzQxIgy9ji58Qtbi%2BavuKeYq8QEDL1U5KZDQ0bXFyVapeqJgE%2FX6x8DcJfFU8DAXYZPSQEwrIdfPbZWcYsH340deru%2FUHnNaGGpuHFoVzui%2FMbqBz7MANcowj%2FL1%2BQZzQ5hXh5KM3BW8E6NRzrQyuPRmBy7kQUkx8%2BjTN%2BXSMgF%2FCAs6Dn9fScgBGz3ddkwRZXDkjasqMP65RCPKhagK68cyMbf3oX%2BKS8a4Kltc2rk3CnWEhOKrZU4mIxq07DikLAXQbl8YRZJIkeOhN5TgBaLWJqyn1td2VWCMymAaFsqtPWHwXnEfsolRlfDooe6QXfE2YwX5PxBVJU7GPXRgrAqPjwtJMOCHgsEGOpwBYif%2BaDMBdz3IEghuvCvorAS0mkHzdcOz%2Fi7AzuN9nch%2FIm8llhMsN41aAWHuSG25pnhhftauFsg7rbGsrW2nl2kq2upi9zP7y%2Fnqk93jcP0kr0jM8zU12bYoSTsToQJsshH4N%2BTQUMwlzRQfeVv8MXdq%2BgSTTzJrWNwT1yNzye3rSHjvOumbNl6sgBISw7QqRzhB6hZTuf8AcI%2B7&X-Amz-Algorithm=AWS4-HMAC-SHA256&X-Amz-Date=20250511T111826Z&X-Amz-SignedHeaders=host&X-Amz-Credential=ASIAXRL7BHBKRAKCQVVB%2F20250511%2Fus-east-1%2Fs3%2Faws4_request&X-Amz-Expires=3600&X-Amz-Signature=20bb1b90e4c8dbaa4115c954387617ebe2f55269bdd517692f1380193ed3f769</a> <a href="#fnref:119" class="footnote-back-ref">↩</a></li>
<li id="fn:120">Suran M (February 2024). "Study Finds Hundreds of Reddit Posts on "Trip-Killers" for Psychedelic Drugs". JAMA. 331 (8): 632–634. doi:10.1001/jama.2023.28257. PMID 38294772. <a href="/wiki/Doi_(identifier)" target="_blank">/wiki/Doi_(identifier)</a> <a href="#fnref:120" class="footnote-back-ref">↩</a></li>
<li id="fn:121">Davidson, Colin (14 February 2024). "Using "trip killers" to cut short bad drug trips is potentially dangerous". The Conversation (UK Edition). SyndiGate Media Inc.: NA. Retrieved 3 October 2024. <a href="https://go.gale.com/ps/i.do?p=HRCA&sw=w&v=2.1&it=r&id=GALE%7CA782593467&sid=googleScholar&linkaccess=abs&userGroupName=anon~65c6fefa&aty=open-web-entry" target="_blank">https://go.gale.com/ps/i.do?p=HRCA&sw=w&v=2.1&it=r&id=GALE%7CA782593467&sid=googleScholar&linkaccess=abs&userGroupName=anon~65c6fefa&aty=open-web-entry</a> <a href="#fnref:121" class="footnote-back-ref">↩</a></li>
<li id="fn:122">Yates G, Melon E (January 2024). "Trip-killers: a concerning practice associated with psychedelic drug use" (PDF). Emerg Med J. 41 (2): 112–113. doi:10.1136/emermed-2023-213377. PMID 38123961. <a href="https://web.archive.org/web/20250511111827oe_/https://s3.amazonaws.com/crawl.prod.proquest.com/fpcache/71f445805bfb61341cbc438c8ae23bd3.pdf?X-Amz-Security-Token=IQoJb3JpZ2luX2VjEBMaCXVzLWVhc3QtMSJIMEYCIQDETX7YpaG5THA%2FNbKR0d92wr6h%2Bgg9preNcKjAsEqo%2BQIhAIlPGGWOeUc23LqhBzRYbxvSXB9aqSe2vVonl4nacAhhKp0CCLz%2F%2F%2F%2F%2F%2F%2F%2F%2F%2FwEQABoMNTE4MzQ2ODQ4MzQxIgy9ji58Qtbi%2BavuKeYq8QEDL1U5KZDQ0bXFyVapeqJgE%2FX6x8DcJfFU8DAXYZPSQEwrIdfPbZWcYsH340deru%2FUHnNaGGpuHFoVzui%2FMbqBz7MANcowj%2FL1%2BQZzQ5hXh5KM3BW8E6NRzrQyuPRmBy7kQUkx8%2BjTN%2BXSMgF%2FCAs6Dn9fScgBGz3ddkwRZXDkjasqMP65RCPKhagK68cyMbf3oX%2BKS8a4Kltc2rk3CnWEhOKrZU4mIxq07DikLAXQbl8YRZJIkeOhN5TgBaLWJqyn1td2VWCMymAaFsqtPWHwXnEfsolRlfDooe6QXfE2YwX5PxBVJU7GPXRgrAqPjwtJMOCHgsEGOpwBYif%2BaDMBdz3IEghuvCvorAS0mkHzdcOz%2Fi7AzuN9nch%2FIm8llhMsN41aAWHuSG25pnhhftauFsg7rbGsrW2nl2kq2upi9zP7y%2Fnqk93jcP0kr0jM8zU12bYoSTsToQJsshH4N%2BTQUMwlzRQfeVv8MXdq%2BgSTTzJrWNwT1yNzye3rSHjvOumbNl6sgBISw7QqRzhB6hZTuf8AcI%2B7&X-Amz-Algorithm=AWS4-HMAC-SHA256&X-Amz-Date=20250511T111826Z&X-Amz-SignedHeaders=host&X-Amz-Credential=ASIAXRL7BHBKRAKCQVVB%2F20250511%2Fus-east-1%2Fs3%2Faws4_request&X-Amz-Expires=3600&X-Amz-Signature=20bb1b90e4c8dbaa4115c954387617ebe2f55269bdd517692f1380193ed3f769" target="_blank">https://web.archive.org/web/20250511111827oe_/https://s3.amazonaws.com/crawl.prod.proquest.com/fpcache/71f445805bfb61341cbc438c8ae23bd3.pdf?X-Amz-Security-Token=IQoJb3JpZ2luX2VjEBMaCXVzLWVhc3QtMSJIMEYCIQDETX7YpaG5THA%2FNbKR0d92wr6h%2Bgg9preNcKjAsEqo%2BQIhAIlPGGWOeUc23LqhBzRYbxvSXB9aqSe2vVonl4nacAhhKp0CCLz%2F%2F%2F%2F%2F%2F%2F%2F%2F%2FwEQABoMNTE4MzQ2ODQ4MzQxIgy9ji58Qtbi%2BavuKeYq8QEDL1U5KZDQ0bXFyVapeqJgE%2FX6x8DcJfFU8DAXYZPSQEwrIdfPbZWcYsH340deru%2FUHnNaGGpuHFoVzui%2FMbqBz7MANcowj%2FL1%2BQZzQ5hXh5KM3BW8E6NRzrQyuPRmBy7kQUkx8%2BjTN%2BXSMgF%2FCAs6Dn9fScgBGz3ddkwRZXDkjasqMP65RCPKhagK68cyMbf3oX%2BKS8a4Kltc2rk3CnWEhOKrZU4mIxq07DikLAXQbl8YRZJIkeOhN5TgBaLWJqyn1td2VWCMymAaFsqtPWHwXnEfsolRlfDooe6QXfE2YwX5PxBVJU7GPXRgrAqPjwtJMOCHgsEGOpwBYif%2BaDMBdz3IEghuvCvorAS0mkHzdcOz%2Fi7AzuN9nch%2FIm8llhMsN41aAWHuSG25pnhhftauFsg7rbGsrW2nl2kq2upi9zP7y%2Fnqk93jcP0kr0jM8zU12bYoSTsToQJsshH4N%2BTQUMwlzRQfeVv8MXdq%2BgSTTzJrWNwT1yNzye3rSHjvOumbNl6sgBISw7QqRzhB6hZTuf8AcI%2B7&X-Amz-Algorithm=AWS4-HMAC-SHA256&X-Amz-Date=20250511T111826Z&X-Amz-SignedHeaders=host&X-Amz-Credential=ASIAXRL7BHBKRAKCQVVB%2F20250511%2Fus-east-1%2Fs3%2Faws4_request&X-Amz-Expires=3600&X-Amz-Signature=20bb1b90e4c8dbaa4115c954387617ebe2f55269bdd517692f1380193ed3f769</a> <a href="#fnref:122" class="footnote-back-ref">↩</a></li>
<li id="fn:123">Suran M (February 2024). "Study Finds Hundreds of Reddit Posts on "Trip-Killers" for Psychedelic Drugs". JAMA. 331 (8): 632–634. doi:10.1001/jama.2023.28257. PMID 38294772. <a href="/wiki/Doi_(identifier)" target="_blank">/wiki/Doi_(identifier)</a> <a href="#fnref:123" class="footnote-back-ref">↩</a></li>
<li id="fn:124">Muir OS, Shinozuka K, Beutler BD, Arenas A, Cherian K, Evans VD, Fasano C, Tabaac BJ (2024). "Psychedelic Therapy: A Primer for Primary Care Clinicians-The Strengths, Weaknesses, Opportunities, and Threats of Psychedelic Therapeutics". Am J Ther. 31 (2): e178 – e182. doi:10.1097/MJT.0000000000001720. PMID 38518273. When psychedelics are used in recreational contexts without adequate supervision, they can lead to tragic outcomes.20 There are rare reports of serious adverse effects, including psychosis and even suicide, arising from recreational use.21 Methods for subduing socalled "bad trips" in recreational settings include potentially dangerous habits, such as taking benzodiazepines, which are known to be "trip killers."22 <a href="https://www.researchgate.net/publication/379188134" target="_blank">https://www.researchgate.net/publication/379188134</a> <a href="#fnref:124" class="footnote-back-ref">↩</a></li>
<li id="fn:125">Yates G, Melon E (January 2024). "Trip-killers: a concerning practice associated with psychedelic drug use" (PDF). Emerg Med J. 41 (2): 112–113. doi:10.1136/emermed-2023-213377. PMID 38123961. <a href="https://web.archive.org/web/20250511111827oe_/https://s3.amazonaws.com/crawl.prod.proquest.com/fpcache/71f445805bfb61341cbc438c8ae23bd3.pdf?X-Amz-Security-Token=IQoJb3JpZ2luX2VjEBMaCXVzLWVhc3QtMSJIMEYCIQDETX7YpaG5THA%2FNbKR0d92wr6h%2Bgg9preNcKjAsEqo%2BQIhAIlPGGWOeUc23LqhBzRYbxvSXB9aqSe2vVonl4nacAhhKp0CCLz%2F%2F%2F%2F%2F%2F%2F%2F%2F%2FwEQABoMNTE4MzQ2ODQ4MzQxIgy9ji58Qtbi%2BavuKeYq8QEDL1U5KZDQ0bXFyVapeqJgE%2FX6x8DcJfFU8DAXYZPSQEwrIdfPbZWcYsH340deru%2FUHnNaGGpuHFoVzui%2FMbqBz7MANcowj%2FL1%2BQZzQ5hXh5KM3BW8E6NRzrQyuPRmBy7kQUkx8%2BjTN%2BXSMgF%2FCAs6Dn9fScgBGz3ddkwRZXDkjasqMP65RCPKhagK68cyMbf3oX%2BKS8a4Kltc2rk3CnWEhOKrZU4mIxq07DikLAXQbl8YRZJIkeOhN5TgBaLWJqyn1td2VWCMymAaFsqtPWHwXnEfsolRlfDooe6QXfE2YwX5PxBVJU7GPXRgrAqPjwtJMOCHgsEGOpwBYif%2BaDMBdz3IEghuvCvorAS0mkHzdcOz%2Fi7AzuN9nch%2FIm8llhMsN41aAWHuSG25pnhhftauFsg7rbGsrW2nl2kq2upi9zP7y%2Fnqk93jcP0kr0jM8zU12bYoSTsToQJsshH4N%2BTQUMwlzRQfeVv8MXdq%2BgSTTzJrWNwT1yNzye3rSHjvOumbNl6sgBISw7QqRzhB6hZTuf8AcI%2B7&X-Amz-Algorithm=AWS4-HMAC-SHA256&X-Amz-Date=20250511T111826Z&X-Amz-SignedHeaders=host&X-Amz-Credential=ASIAXRL7BHBKRAKCQVVB%2F20250511%2Fus-east-1%2Fs3%2Faws4_request&X-Amz-Expires=3600&X-Amz-Signature=20bb1b90e4c8dbaa4115c954387617ebe2f55269bdd517692f1380193ed3f769" target="_blank">https://web.archive.org/web/20250511111827oe_/https://s3.amazonaws.com/crawl.prod.proquest.com/fpcache/71f445805bfb61341cbc438c8ae23bd3.pdf?X-Amz-Security-Token=IQoJb3JpZ2luX2VjEBMaCXVzLWVhc3QtMSJIMEYCIQDETX7YpaG5THA%2FNbKR0d92wr6h%2Bgg9preNcKjAsEqo%2BQIhAIlPGGWOeUc23LqhBzRYbxvSXB9aqSe2vVonl4nacAhhKp0CCLz%2F%2F%2F%2F%2F%2F%2F%2F%2F%2FwEQABoMNTE4MzQ2ODQ4MzQxIgy9ji58Qtbi%2BavuKeYq8QEDL1U5KZDQ0bXFyVapeqJgE%2FX6x8DcJfFU8DAXYZPSQEwrIdfPbZWcYsH340deru%2FUHnNaGGpuHFoVzui%2FMbqBz7MANcowj%2FL1%2BQZzQ5hXh5KM3BW8E6NRzrQyuPRmBy7kQUkx8%2BjTN%2BXSMgF%2FCAs6Dn9fScgBGz3ddkwRZXDkjasqMP65RCPKhagK68cyMbf3oX%2BKS8a4Kltc2rk3CnWEhOKrZU4mIxq07DikLAXQbl8YRZJIkeOhN5TgBaLWJqyn1td2VWCMymAaFsqtPWHwXnEfsolRlfDooe6QXfE2YwX5PxBVJU7GPXRgrAqPjwtJMOCHgsEGOpwBYif%2BaDMBdz3IEghuvCvorAS0mkHzdcOz%2Fi7AzuN9nch%2FIm8llhMsN41aAWHuSG25pnhhftauFsg7rbGsrW2nl2kq2upi9zP7y%2Fnqk93jcP0kr0jM8zU12bYoSTsToQJsshH4N%2BTQUMwlzRQfeVv8MXdq%2BgSTTzJrWNwT1yNzye3rSHjvOumbNl6sgBISw7QqRzhB6hZTuf8AcI%2B7&X-Amz-Algorithm=AWS4-HMAC-SHA256&X-Amz-Date=20250511T111826Z&X-Amz-SignedHeaders=host&X-Amz-Credential=ASIAXRL7BHBKRAKCQVVB%2F20250511%2Fus-east-1%2Fs3%2Faws4_request&X-Amz-Expires=3600&X-Amz-Signature=20bb1b90e4c8dbaa4115c954387617ebe2f55269bdd517692f1380193ed3f769</a> <a href="#fnref:125" class="footnote-back-ref">↩</a></li>
<li id="fn:126">Suran M (February 2024). "Study Finds Hundreds of Reddit Posts on "Trip-Killers" for Psychedelic Drugs". JAMA. 331 (8): 632–634. doi:10.1001/jama.2023.28257. PMID 38294772. <a href="/wiki/Doi_(identifier)" target="_blank">/wiki/Doi_(identifier)</a> <a href="#fnref:126" class="footnote-back-ref">↩</a></li>
<li id="fn:127">Davidson, Colin (14 February 2024). "Using "trip killers" to cut short bad drug trips is potentially dangerous". The Conversation (UK Edition). SyndiGate Media Inc.: NA. Retrieved 3 October 2024. <a href="https://go.gale.com/ps/i.do?p=HRCA&sw=w&v=2.1&it=r&id=GALE%7CA782593467&sid=googleScholar&linkaccess=abs&userGroupName=anon~65c6fefa&aty=open-web-entry" target="_blank">https://go.gale.com/ps/i.do?p=HRCA&sw=w&v=2.1&it=r&id=GALE%7CA782593467&sid=googleScholar&linkaccess=abs&userGroupName=anon~65c6fefa&aty=open-web-entry</a> <a href="#fnref:127" class="footnote-back-ref">↩</a></li>
<li id="fn:128">Yates G, Melon E (January 2024). "Trip-killers: a concerning practice associated with psychedelic drug use" (PDF). Emerg Med J. 41 (2): 112–113. doi:10.1136/emermed-2023-213377. PMID 38123961. <a href="https://web.archive.org/web/20250511111827oe_/https://s3.amazonaws.com/crawl.prod.proquest.com/fpcache/71f445805bfb61341cbc438c8ae23bd3.pdf?X-Amz-Security-Token=IQoJb3JpZ2luX2VjEBMaCXVzLWVhc3QtMSJIMEYCIQDETX7YpaG5THA%2FNbKR0d92wr6h%2Bgg9preNcKjAsEqo%2BQIhAIlPGGWOeUc23LqhBzRYbxvSXB9aqSe2vVonl4nacAhhKp0CCLz%2F%2F%2F%2F%2F%2F%2F%2F%2F%2FwEQABoMNTE4MzQ2ODQ4MzQxIgy9ji58Qtbi%2BavuKeYq8QEDL1U5KZDQ0bXFyVapeqJgE%2FX6x8DcJfFU8DAXYZPSQEwrIdfPbZWcYsH340deru%2FUHnNaGGpuHFoVzui%2FMbqBz7MANcowj%2FL1%2BQZzQ5hXh5KM3BW8E6NRzrQyuPRmBy7kQUkx8%2BjTN%2BXSMgF%2FCAs6Dn9fScgBGz3ddkwRZXDkjasqMP65RCPKhagK68cyMbf3oX%2BKS8a4Kltc2rk3CnWEhOKrZU4mIxq07DikLAXQbl8YRZJIkeOhN5TgBaLWJqyn1td2VWCMymAaFsqtPWHwXnEfsolRlfDooe6QXfE2YwX5PxBVJU7GPXRgrAqPjwtJMOCHgsEGOpwBYif%2BaDMBdz3IEghuvCvorAS0mkHzdcOz%2Fi7AzuN9nch%2FIm8llhMsN41aAWHuSG25pnhhftauFsg7rbGsrW2nl2kq2upi9zP7y%2Fnqk93jcP0kr0jM8zU12bYoSTsToQJsshH4N%2BTQUMwlzRQfeVv8MXdq%2BgSTTzJrWNwT1yNzye3rSHjvOumbNl6sgBISw7QqRzhB6hZTuf8AcI%2B7&X-Amz-Algorithm=AWS4-HMAC-SHA256&X-Amz-Date=20250511T111826Z&X-Amz-SignedHeaders=host&X-Amz-Credential=ASIAXRL7BHBKRAKCQVVB%2F20250511%2Fus-east-1%2Fs3%2Faws4_request&X-Amz-Expires=3600&X-Amz-Signature=20bb1b90e4c8dbaa4115c954387617ebe2f55269bdd517692f1380193ed3f769" target="_blank">https://web.archive.org/web/20250511111827oe_/https://s3.amazonaws.com/crawl.prod.proquest.com/fpcache/71f445805bfb61341cbc438c8ae23bd3.pdf?X-Amz-Security-Token=IQoJb3JpZ2luX2VjEBMaCXVzLWVhc3QtMSJIMEYCIQDETX7YpaG5THA%2FNbKR0d92wr6h%2Bgg9preNcKjAsEqo%2BQIhAIlPGGWOeUc23LqhBzRYbxvSXB9aqSe2vVonl4nacAhhKp0CCLz%2F%2F%2F%2F%2F%2F%2F%2F%2F%2FwEQABoMNTE4MzQ2ODQ4MzQxIgy9ji58Qtbi%2BavuKeYq8QEDL1U5KZDQ0bXFyVapeqJgE%2FX6x8DcJfFU8DAXYZPSQEwrIdfPbZWcYsH340deru%2FUHnNaGGpuHFoVzui%2FMbqBz7MANcowj%2FL1%2BQZzQ5hXh5KM3BW8E6NRzrQyuPRmBy7kQUkx8%2BjTN%2BXSMgF%2FCAs6Dn9fScgBGz3ddkwRZXDkjasqMP65RCPKhagK68cyMbf3oX%2BKS8a4Kltc2rk3CnWEhOKrZU4mIxq07DikLAXQbl8YRZJIkeOhN5TgBaLWJqyn1td2VWCMymAaFsqtPWHwXnEfsolRlfDooe6QXfE2YwX5PxBVJU7GPXRgrAqPjwtJMOCHgsEGOpwBYif%2BaDMBdz3IEghuvCvorAS0mkHzdcOz%2Fi7AzuN9nch%2FIm8llhMsN41aAWHuSG25pnhhftauFsg7rbGsrW2nl2kq2upi9zP7y%2Fnqk93jcP0kr0jM8zU12bYoSTsToQJsshH4N%2BTQUMwlzRQfeVv8MXdq%2BgSTTzJrWNwT1yNzye3rSHjvOumbNl6sgBISw7QqRzhB6hZTuf8AcI%2B7&X-Amz-Algorithm=AWS4-HMAC-SHA256&X-Amz-Date=20250511T111826Z&X-Amz-SignedHeaders=host&X-Amz-Credential=ASIAXRL7BHBKRAKCQVVB%2F20250511%2Fus-east-1%2Fs3%2Faws4_request&X-Amz-Expires=3600&X-Amz-Signature=20bb1b90e4c8dbaa4115c954387617ebe2f55269bdd517692f1380193ed3f769</a> <a href="#fnref:128" class="footnote-back-ref">↩</a></li>
<li id="fn:129">Suran M (February 2024). "Study Finds Hundreds of Reddit Posts on "Trip-Killers" for Psychedelic Drugs". JAMA. 331 (8): 632–634. doi:10.1001/jama.2023.28257. PMID 38294772. <a href="/wiki/Doi_(identifier)" target="_blank">/wiki/Doi_(identifier)</a> <a href="#fnref:129" class="footnote-back-ref">↩</a></li>
<li id="fn:130">Skolnick P, Crystal R (February 2020). "Cannabinoid1 (CB-1) receptor antagonists: a molecular approach to treating acute cannabinoid overdose". J Neural Transm (Vienna). 127 (2): 279–286. doi:10.1007/s00702-019-02132-7. PMC 7035232. PMID 31893308. <a href="https://www.ncbi.nlm.nih.gov/pmc/articles/PMC7035232" target="_blank">https://www.ncbi.nlm.nih.gov/pmc/articles/PMC7035232</a> <a href="#fnref:130" class="footnote-back-ref">↩</a></li>
<li id="fn:131">Bosquez-Berger, Taryn; Szanda, Gergő; Straiker, Alex (30 August 2023). "Requiem for Rimonabant: Therapeutic Potential for Cannabinoid CB1 Receptor Antagonists after the Fall". Drugs and Drug Candidates. 2 (3): 689–707. doi:10.3390/ddc2030035. ISSN 2813-2998. <a href="https://doi.org/10.3390%2Fddc2030035" target="_blank">https://doi.org/10.3390%2Fddc2030035</a> <a href="#fnref:131" class="footnote-back-ref">↩</a></li>
<li id="fn:132">Gorbenko AA, Heuberger JA, Juachon M, Klaassen E, Tagen M, Lawler JF, Schneeberger D, Cundy KC, Klumpers LE, Groeneveld GJ (February 2025). "CB1 Receptor Antagonist Selonabant (ANEB-001) Blocks Acute THC Effects in Healthy Volunteers: A Phase II Randomized Controlled Trial". Clin Pharmacol Ther. 117 (5): 1427–1436. doi:10.1002/cpt.3581. PMC 11993283. PMID 39898464. <a href="https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11993283" target="_blank">https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11993283</a> <a href="#fnref:132" class="footnote-back-ref">↩</a></li>
<li id="fn:133">Clark SD, Abi-Dargham A (October 2019). "The Role of Dynorphin and the Kappa Opioid Receptor in the Symptomatology of Schizophrenia: A Review of the Evidence". Biol Psychiatry. 86 (7): 502–511. doi:10.1016/j.biopsych.2019.05.012. PMID 31376930. Finally, in a double-blind study of 24 healthy volunteers, Maqueda et al. (27) found that salvinorin A produced both visual and auditory changes that could be blocked by the kappa, mu, and delta receptor antagonist naltrexone (Table 2). <a href="https://doi.org/10.1016%2Fj.biopsych.2019.05.012" target="_blank">https://doi.org/10.1016%2Fj.biopsych.2019.05.012</a> <a href="#fnref:133" class="footnote-back-ref">↩</a></li>
<li id="fn:134">Maqueda AE, Valle M, Addy PH, Antonijoan RM, Puntes M, Coimbra J, Ballester MR, Garrido M, González M, Claramunt J, Barker S, Lomnicka I, Waguespack M, Johnson MW, Griffiths RR, Riba J (July 2016). "Naltrexone but Not Ketanserin Antagonizes the Subjective, Cardiovascular, and Neuroendocrine Effects of Salvinorin-A in Humans". Int J Neuropsychopharmacol. 19 (7): pyw016. doi:10.1093/ijnp/pyw016. PMC 4966277. PMID 26874330. <a href="https://www.ncbi.nlm.nih.gov/pmc/articles/PMC4966277" target="_blank">https://www.ncbi.nlm.nih.gov/pmc/articles/PMC4966277</a> <a href="#fnref:134" class="footnote-back-ref">↩</a></li>
<li id="fn:135">Walsh SL, Chausmer AE, Strain EC, Bigelow GE (January 2008). "Evaluation of the mu and kappa opioid actions of butorphanol in humans through differential naltrexone blockade". Psychopharmacology (Berl). 196 (1): 143–155. doi:10.1007/s00213-007-0948-z. PMC 2766188. PMID 17909753. <a href="https://www.ncbi.nlm.nih.gov/pmc/articles/PMC2766188" target="_blank">https://www.ncbi.nlm.nih.gov/pmc/articles/PMC2766188</a> <a href="#fnref:135" class="footnote-back-ref">↩</a></li>
<li id="fn:136">Preston KL, Bigelow GE (February 1993). "Differential naltrexone antagonism of hydromorphone and pentazocine effects in human volunteers". J Pharmacol Exp Ther. 264 (2): 813–823. doi:10.1016/S0022-3565(25)10212-7. PMID 7679737. <a href="/wiki/Doi_(identifier)" target="_blank">/wiki/Doi_(identifier)</a> <a href="#fnref:136" class="footnote-back-ref">↩</a></li>
<li id="fn:137">Shim KH, Kang MJ, Sharma N, An SS (September 2022). "Beauty of the beast: anticholinergic tropane alkaloids in therapeutics". Nat Prod Bioprospect. 12 (1): 33. doi:10.1007/s13659-022-00357-w. PMC 9478010. PMID 36109439. The treatment of TA poisoning including gastric emptying, use of activated charcoal (0.5 to 1 g/kg in children or 25 to 100 g in adults) to absorb the drug and benzodiazepines for managing agitation [157, 158]. Physostigmine (an AChE inhibitor) is recommended in the case when both PNS and CNS are afected by anticholinergic poisoning [159, 160]. In such cases, intravenous dose of physostigmine (0.02 mg/kg for children and 0.5 to 2 mg/ kg for adults) is recommended [159]. Physostigmine is helpful in restoring the level of consciousness to its baseline [157] which is different from sedative action of benzodiazepines. <a href="https://www.ncbi.nlm.nih.gov/pmc/articles/PMC9478010" target="_blank">https://www.ncbi.nlm.nih.gov/pmc/articles/PMC9478010</a> <a href="#fnref:137" class="footnote-back-ref">↩</a></li>
<li id="fn:138">Bulut NS, Arpacıoğlu ZB (September 2022). "Acute onset psychosis with complex neurobehavioural symptomatology following the intramuscular injection of hyoscine butylbromide: a case report with an overview of the literature". Eur J Hosp Pharm. 29 (5): 294–297. doi:10.1136/ejhpharm-2020-002583. PMC 9660700. PMID 33376193. The most crucial intervention in the treatment of anticholinergic intoxication is without doubt the discontinuation of the suspected agent. Hospitalisation may be necessary for the close monitoring of severe cases. While physostigmine is commonly used as a specific antidote for anticholinergic toxicity, benzodiazepines and antipsychotics can prove to be useful in managing agitation, hallucinations, and aggressive and self-mutilative behaviours as in our case.2 <a href="https://www.ncbi.nlm.nih.gov/pmc/articles/PMC9660700" target="_blank">https://www.ncbi.nlm.nih.gov/pmc/articles/PMC9660700</a> <a href="#fnref:138" class="footnote-back-ref">↩</a></li>
<li id="fn:139">Shim KH, Kang MJ, Sharma N, An SS (September 2022). "Beauty of the beast: anticholinergic tropane alkaloids in therapeutics". Nat Prod Bioprospect. 12 (1): 33. doi:10.1007/s13659-022-00357-w. PMC 9478010. PMID 36109439. The treatment of TA poisoning including gastric emptying, use of activated charcoal (0.5 to 1 g/kg in children or 25 to 100 g in adults) to absorb the drug and benzodiazepines for managing agitation [157, 158]. Physostigmine (an AChE inhibitor) is recommended in the case when both PNS and CNS are afected by anticholinergic poisoning [159, 160]. In such cases, intravenous dose of physostigmine (0.02 mg/kg for children and 0.5 to 2 mg/ kg for adults) is recommended [159]. Physostigmine is helpful in restoring the level of consciousness to its baseline [157] which is different from sedative action of benzodiazepines. <a href="https://www.ncbi.nlm.nih.gov/pmc/articles/PMC9478010" target="_blank">https://www.ncbi.nlm.nih.gov/pmc/articles/PMC9478010</a> <a href="#fnref:139" class="footnote-back-ref">↩</a></li>
<li id="fn:140">Bulut NS, Arpacıoğlu ZB (September 2022). "Acute onset psychosis with complex neurobehavioural symptomatology following the intramuscular injection of hyoscine butylbromide: a case report with an overview of the literature". Eur J Hosp Pharm. 29 (5): 294–297. doi:10.1136/ejhpharm-2020-002583. PMC 9660700. PMID 33376193. The most crucial intervention in the treatment of anticholinergic intoxication is without doubt the discontinuation of the suspected agent. Hospitalisation may be necessary for the close monitoring of severe cases. While physostigmine is commonly used as a specific antidote for anticholinergic toxicity, benzodiazepines and antipsychotics can prove to be useful in managing agitation, hallucinations, and aggressive and self-mutilative behaviours as in our case.2 <a href="https://www.ncbi.nlm.nih.gov/pmc/articles/PMC9660700" target="_blank">https://www.ncbi.nlm.nih.gov/pmc/articles/PMC9660700</a> <a href="#fnref:140" class="footnote-back-ref">↩</a></li>
<li id="fn:141">Schep LJ, Slaughter RJ, Watts M, Mackenzie E, Gee P (June 2023). "The clinical toxicology of ketamine". Clin Toxicol (Phila). 61 (6): 415–428. doi:10.1080/15563650.2023.2212125. PMID 37267048. <a href="/wiki/Doi_(identifier)" target="_blank">/wiki/Doi_(identifier)</a> <a href="#fnref:141" class="footnote-back-ref">↩</a></li>
<li id="fn:142">Leikin, Jerrold B.; Krantz, Anne J.; Zell-Kanter, Michele; Barkin, Robert L.; Hryhorczuk, Daniel O. (1989). "Clinical Features and Management of Intoxication Due to Hallucinogenic Drugs". Medical Toxicology and Adverse Drug Experience. 4 (5). Springer Science and Business Media LLC: 324–350. doi:10.1007/bf03259916. ISSN 0113-5244. PMID 2682130. <a href="/wiki/Doi_(identifier)" target="_blank">/wiki/Doi_(identifier)</a> <a href="#fnref:142" class="footnote-back-ref">↩</a></li>
<li id="fn:143">Jenkins, Amanda J.; Gates, Madeleine J. (2020). "Hallucinogens and Psychedelics". Principles of Forensic Toxicology. Cham: Springer International Publishing. pp. 467–489. doi:10.1007/978-3-030-42917-1_26. ISBN 978-3-030-42916-4. <a href="978-3-030-42916-4" target="_blank">978-3-030-42916-4</a> <a href="#fnref:143" class="footnote-back-ref">↩</a></li>
<li id="fn:144">Gonda X (2012). "Basic pharmacology of NMDA receptors". Curr Pharm Des. 18 (12): 1558–1567. doi:10.2174/138161212799958521. PMID 22280436. <a href="/wiki/Doi_(identifier)" target="_blank">/wiki/Doi_(identifier)</a> <a href="#fnref:144" class="footnote-back-ref">↩</a></li>
<li id="fn:145">Rana V, Ghosh S, Bhatt A, Bisht D, Joshi G, Purohit P (2024). "N-Methyl-D-Aspartate (NMDA) Receptor Antagonists and their Pharmacological Implication: A Medicinal Chemistry-oriented Perspective Outline". Curr Med Chem. 31 (29): 4725–4744. doi:10.2174/0109298673288031240405061759. PMID 38638036. <a href="/wiki/Doi_(identifier)" target="_blank">/wiki/Doi_(identifier)</a> <a href="#fnref:145" class="footnote-back-ref">↩</a></li>
<li id="fn:146">Rothman, Steven M.; Olney, John W. (1987). "Excitotoxity and the NMDA receptor". Trends in Neurosciences. 10 (7). Elsevier BV: 299–302. doi:10.1016/0166-2236(87)90177-9. ISSN 0166-2236. <a href="/wiki/Doi_(identifier)" target="_blank">/wiki/Doi_(identifier)</a> <a href="#fnref:146" class="footnote-back-ref">↩</a></li>
<li id="fn:147">Suran M (February 2024). "Study Finds Hundreds of Reddit Posts on "Trip-Killers" for Psychedelic Drugs". JAMA. 331 (8): 632–634. doi:10.1001/jama.2023.28257. PMID 38294772. <a href="/wiki/Doi_(identifier)" target="_blank">/wiki/Doi_(identifier)</a> <a href="#fnref:147" class="footnote-back-ref">↩</a></li>
<li id="fn:148">Bey T, Patel A (February 2007). "Phencyclidine intoxication and adverse effects: a clinical and pharmacological review of an illicit drug". Cal J Emerg Med. 8 (1): 9–14. PMC 2859735. PMID 20440387. <a href="https://www.ncbi.nlm.nih.gov/pmc/articles/PMC2859735" target="_blank">https://www.ncbi.nlm.nih.gov/pmc/articles/PMC2859735</a> <a href="#fnref:148" class="footnote-back-ref">↩</a></li>
<li id="fn:149">Schep LJ, Slaughter RJ, Watts M, Mackenzie E, Gee P (June 2023). "The clinical toxicology of ketamine". Clin Toxicol (Phila). 61 (6): 415–428. doi:10.1080/15563650.2023.2212125. PMID 37267048. <a href="/wiki/Doi_(identifier)" target="_blank">/wiki/Doi_(identifier)</a> <a href="#fnref:149" class="footnote-back-ref">↩</a></li>
<li id="fn:150">Mitchel DH (1980). "Amanita mushroom poisoning". Annu Rev Med. 31: 51–57. doi:10.1146/annurev.me.31.020180.000411. PMID 6772091. <a href="/wiki/Doi_(identifier)" target="_blank">/wiki/Doi_(identifier)</a> <a href="#fnref:150" class="footnote-back-ref">↩</a></li>
<li id="fn:151">Rampolli FI, Kamler P, Carnevale Carlino C, Bedussi F (2021). "The Deceptive Mushroom: Accidental Amanita muscaria Poisoning". Eur J Case Rep Intern Med. 8 (3): 002212. doi:10.12890/2021_002212. PMC 7977045. PMID 33768066. <a href="https://www.ncbi.nlm.nih.gov/pmc/articles/PMC7977045" target="_blank">https://www.ncbi.nlm.nih.gov/pmc/articles/PMC7977045</a> <a href="#fnref:151" class="footnote-back-ref">↩</a></li>
<li id="fn:152">Yates G, Melon E (January 2024). "Trip-killers: a concerning practice associated with psychedelic drug use" (PDF). Emerg Med J. 41 (2): 112–113. doi:10.1136/emermed-2023-213377. PMID 38123961. <a href="https://web.archive.org/web/20250511111827oe_/https://s3.amazonaws.com/crawl.prod.proquest.com/fpcache/71f445805bfb61341cbc438c8ae23bd3.pdf?X-Amz-Security-Token=IQoJb3JpZ2luX2VjEBMaCXVzLWVhc3QtMSJIMEYCIQDETX7YpaG5THA%2FNbKR0d92wr6h%2Bgg9preNcKjAsEqo%2BQIhAIlPGGWOeUc23LqhBzRYbxvSXB9aqSe2vVonl4nacAhhKp0CCLz%2F%2F%2F%2F%2F%2F%2F%2F%2F%2FwEQABoMNTE4MzQ2ODQ4MzQxIgy9ji58Qtbi%2BavuKeYq8QEDL1U5KZDQ0bXFyVapeqJgE%2FX6x8DcJfFU8DAXYZPSQEwrIdfPbZWcYsH340deru%2FUHnNaGGpuHFoVzui%2FMbqBz7MANcowj%2FL1%2BQZzQ5hXh5KM3BW8E6NRzrQyuPRmBy7kQUkx8%2BjTN%2BXSMgF%2FCAs6Dn9fScgBGz3ddkwRZXDkjasqMP65RCPKhagK68cyMbf3oX%2BKS8a4Kltc2rk3CnWEhOKrZU4mIxq07DikLAXQbl8YRZJIkeOhN5TgBaLWJqyn1td2VWCMymAaFsqtPWHwXnEfsolRlfDooe6QXfE2YwX5PxBVJU7GPXRgrAqPjwtJMOCHgsEGOpwBYif%2BaDMBdz3IEghuvCvorAS0mkHzdcOz%2Fi7AzuN9nch%2FIm8llhMsN41aAWHuSG25pnhhftauFsg7rbGsrW2nl2kq2upi9zP7y%2Fnqk93jcP0kr0jM8zU12bYoSTsToQJsshH4N%2BTQUMwlzRQfeVv8MXdq%2BgSTTzJrWNwT1yNzye3rSHjvOumbNl6sgBISw7QqRzhB6hZTuf8AcI%2B7&X-Amz-Algorithm=AWS4-HMAC-SHA256&X-Amz-Date=20250511T111826Z&X-Amz-SignedHeaders=host&X-Amz-Credential=ASIAXRL7BHBKRAKCQVVB%2F20250511%2Fus-east-1%2Fs3%2Faws4_request&X-Amz-Expires=3600&X-Amz-Signature=20bb1b90e4c8dbaa4115c954387617ebe2f55269bdd517692f1380193ed3f769" target="_blank">https://web.archive.org/web/20250511111827oe_/https://s3.amazonaws.com/crawl.prod.proquest.com/fpcache/71f445805bfb61341cbc438c8ae23bd3.pdf?X-Amz-Security-Token=IQoJb3JpZ2luX2VjEBMaCXVzLWVhc3QtMSJIMEYCIQDETX7YpaG5THA%2FNbKR0d92wr6h%2Bgg9preNcKjAsEqo%2BQIhAIlPGGWOeUc23LqhBzRYbxvSXB9aqSe2vVonl4nacAhhKp0CCLz%2F%2F%2F%2F%2F%2F%2F%2F%2F%2FwEQABoMNTE4MzQ2ODQ4MzQxIgy9ji58Qtbi%2BavuKeYq8QEDL1U5KZDQ0bXFyVapeqJgE%2FX6x8DcJfFU8DAXYZPSQEwrIdfPbZWcYsH340deru%2FUHnNaGGpuHFoVzui%2FMbqBz7MANcowj%2FL1%2BQZzQ5hXh5KM3BW8E6NRzrQyuPRmBy7kQUkx8%2BjTN%2BXSMgF%2FCAs6Dn9fScgBGz3ddkwRZXDkjasqMP65RCPKhagK68cyMbf3oX%2BKS8a4Kltc2rk3CnWEhOKrZU4mIxq07DikLAXQbl8YRZJIkeOhN5TgBaLWJqyn1td2VWCMymAaFsqtPWHwXnEfsolRlfDooe6QXfE2YwX5PxBVJU7GPXRgrAqPjwtJMOCHgsEGOpwBYif%2BaDMBdz3IEghuvCvorAS0mkHzdcOz%2Fi7AzuN9nch%2FIm8llhMsN41aAWHuSG25pnhhftauFsg7rbGsrW2nl2kq2upi9zP7y%2Fnqk93jcP0kr0jM8zU12bYoSTsToQJsshH4N%2BTQUMwlzRQfeVv8MXdq%2BgSTTzJrWNwT1yNzye3rSHjvOumbNl6sgBISw7QqRzhB6hZTuf8AcI%2B7&X-Amz-Algorithm=AWS4-HMAC-SHA256&X-Amz-Date=20250511T111826Z&X-Amz-SignedHeaders=host&X-Amz-Credential=ASIAXRL7BHBKRAKCQVVB%2F20250511%2Fus-east-1%2Fs3%2Faws4_request&X-Amz-Expires=3600&X-Amz-Signature=20bb1b90e4c8dbaa4115c954387617ebe2f55269bdd517692f1380193ed3f769</a> <a href="#fnref:152" class="footnote-back-ref">↩</a></li>
<li id="fn:153">Halberstadt AL, Nichols DE (2020). "Serotonin and serotonin receptors in hallucinogen action". Handbook of the Behavioral Neurobiology of Serotonin. Handbook of Behavioral Neuroscience. Vol. 31. pp. 843–863. doi:10.1016/B978-0-444-64125-0.00043-8. ISBN 9780444641250. ISSN 1569-7339. S2CID 241134396. Pretreatment with the selective 5-HT reuptake inhibitors citalopram, fluoxetine, and paroxetine significantly attenuated most of the subjective effects of MDMA, consistent with the proposed involvement of carriermediated 5-HT release in the effects of MDMA (Farre et al., 2007; Liechti, Baumann, et al., 2000; Tancer & Johanson, 2007). Citalopram also inhibits the effect of MDMA on PPI (Liechti, Geyer, Hell, & Vollenweider, 2001). According to another report (Hysek, Simmler et al., 2012), the mixed SERT/NET inhibitor duloxetine robustly blocked most of the subjective response to MDMA, raising the possibility that NE release contributes to its effects. In a follow-up study, the selective NET inhibitor reboxetine significantly reduced the emotional excitation and feelings of stimulation produced by MDMA but did not alter its entactogenic or mood-elevating effects (Hysek et al., 2011). Therefore, although NE release contributes to the stimulant effects produced by MDMA, 5-HT release appears to be principally responsible for the unique entactogenic effects of the drug. [...] Several studies have examined the contribution of 5-HT and DA receptors to the effects of MDMA. Pretreatment with ketanserin produced some attenuation of the subjective effects of MDMA (Liechti, Saur, et al., 2000). However, the most significant reduction of MDMA effects by ketanserin occurred in the VR dimension of the APZ, indicating that 5-HT2A receptors are responsible for the effects of MDMA on perception. Ketanserin also blocked MDMA-induced impairment of performance on a verbal memory task (van Wel et al., 2011), but had no effect on the ability of MDMA to induce depersonalization and derealization (Puxty et al., 2017). <a href="9780444641250" target="_blank">9780444641250</a> <a href="#fnref:153" class="footnote-back-ref">↩</a></li>
<li id="fn:154">Price CM, Feduccia AA, DeBonis K (2022). "Effects of Selective Serotonin Reuptake Inhibitor Use on 3,4-Methylenedioxymethamphetamine-Assisted Therapy for Posttraumatic Stress Disorder: A Review of the Evidence, Neurobiological Plausibility, and Clinical Significance". J Clin Psychopharmacol. 42 (5): 464–469. doi:10.1097/JCP.0000000000001595. PMID 36018231. Anecdotal reports for decades have suggested that current SSRI use can significantly dampen or abolish the subjective effects of MDMA and serotonergic hallucinogens,16–22 although this was not always observed.23 Controlled studies beginning in the 2000s began to shed further light on this phenomenon by examining the impact of SSRI and MDMA coadministration in healthy controls. The SSRIs citalopram, paroxetine, and fluoxetine were all shown to reduce most of the psychological effects of MDMA when given as pretreatment, either orally for 3 to 5 days24–26 or intravenously for 90 minutes27,28 before MDMA oral dosing. The psychological effects of MDMA that were attenuated by SSRIs included positive mood/euphoria, alterations in thought process and content, extraversion/self-confidence, and dissociative phenomena. Not all psychological effects of MDMA were attenuated by SSRIs, however; effects on emotional excitability, sensitivity, and anxiety remained even with SSRI pretreatment.25,29 Selective serotonin reuptake inhibitors also reduced the effects of MDMA on various physiological parameters, including increases in blood pressure, heart rate, temperature, and pupil diameter.24–29 [...] 9 Studies in animal models support the idea that such attenuation of MDMA's effects via acute SSRI pretreatment occurs primarily through blockage of the serotonin reuptake transporter (SERT). Serotonin reuptake transporter–knockout animals have a marked reduction in MDMA-mediated serotonin release and subsequent depletion and neurotoxicity.30,31 Pretreatment of rats with SSRIs similarly attenuated MDMA-mediated increases in extracellular serotonin and led to preservation of serotonin metabolite concentrations and SERT binding that is normally depleted by MDMA after 1 week.32–35 <a href="https://escholarship.org/uc/item/0rw3v152" target="_blank">https://escholarship.org/uc/item/0rw3v152</a> <a href="#fnref:154" class="footnote-back-ref">↩</a></li>
<li id="fn:155">Halberstadt AL, Nichols DE (2020). "Serotonin and serotonin receptors in hallucinogen action". Handbook of the Behavioral Neurobiology of Serotonin. Handbook of Behavioral Neuroscience. Vol. 31. pp. 843–863. doi:10.1016/B978-0-444-64125-0.00043-8. ISBN 9780444641250. ISSN 1569-7339. S2CID 241134396. Pretreatment with the selective 5-HT reuptake inhibitors citalopram, fluoxetine, and paroxetine significantly attenuated most of the subjective effects of MDMA, consistent with the proposed involvement of carriermediated 5-HT release in the effects of MDMA (Farre et al., 2007; Liechti, Baumann, et al., 2000; Tancer & Johanson, 2007). Citalopram also inhibits the effect of MDMA on PPI (Liechti, Geyer, Hell, & Vollenweider, 2001). According to another report (Hysek, Simmler et al., 2012), the mixed SERT/NET inhibitor duloxetine robustly blocked most of the subjective response to MDMA, raising the possibility that NE release contributes to its effects. In a follow-up study, the selective NET inhibitor reboxetine significantly reduced the emotional excitation and feelings of stimulation produced by MDMA but did not alter its entactogenic or mood-elevating effects (Hysek et al., 2011). Therefore, although NE release contributes to the stimulant effects produced by MDMA, 5-HT release appears to be principally responsible for the unique entactogenic effects of the drug. [...] Several studies have examined the contribution of 5-HT and DA receptors to the effects of MDMA. Pretreatment with ketanserin produced some attenuation of the subjective effects of MDMA (Liechti, Saur, et al., 2000). However, the most significant reduction of MDMA effects by ketanserin occurred in the VR dimension of the APZ, indicating that 5-HT2A receptors are responsible for the effects of MDMA on perception. Ketanserin also blocked MDMA-induced impairment of performance on a verbal memory task (van Wel et al., 2011), but had no effect on the ability of MDMA to induce depersonalization and derealization (Puxty et al., 2017). <a href="9780444641250" target="_blank">9780444641250</a> <a href="#fnref:155" class="footnote-back-ref">↩</a></li>
<li id="fn:156">Price CM, Feduccia AA, DeBonis K (2022). "Effects of Selective Serotonin Reuptake Inhibitor Use on 3,4-Methylenedioxymethamphetamine-Assisted Therapy for Posttraumatic Stress Disorder: A Review of the Evidence, Neurobiological Plausibility, and Clinical Significance". J Clin Psychopharmacol. 42 (5): 464–469. doi:10.1097/JCP.0000000000001595. PMID 36018231. Anecdotal reports for decades have suggested that current SSRI use can significantly dampen or abolish the subjective effects of MDMA and serotonergic hallucinogens,16–22 although this was not always observed.23 Controlled studies beginning in the 2000s began to shed further light on this phenomenon by examining the impact of SSRI and MDMA coadministration in healthy controls. The SSRIs citalopram, paroxetine, and fluoxetine were all shown to reduce most of the psychological effects of MDMA when given as pretreatment, either orally for 3 to 5 days24–26 or intravenously for 90 minutes27,28 before MDMA oral dosing. The psychological effects of MDMA that were attenuated by SSRIs included positive mood/euphoria, alterations in thought process and content, extraversion/self-confidence, and dissociative phenomena. Not all psychological effects of MDMA were attenuated by SSRIs, however; effects on emotional excitability, sensitivity, and anxiety remained even with SSRI pretreatment.25,29 Selective serotonin reuptake inhibitors also reduced the effects of MDMA on various physiological parameters, including increases in blood pressure, heart rate, temperature, and pupil diameter.24–29 [...] 9 Studies in animal models support the idea that such attenuation of MDMA's effects via acute SSRI pretreatment occurs primarily through blockage of the serotonin reuptake transporter (SERT). Serotonin reuptake transporter–knockout animals have a marked reduction in MDMA-mediated serotonin release and subsequent depletion and neurotoxicity.30,31 Pretreatment of rats with SSRIs similarly attenuated MDMA-mediated increases in extracellular serotonin and led to preservation of serotonin metabolite concentrations and SERT binding that is normally depleted by MDMA after 1 week.32–35 <a href="https://escholarship.org/uc/item/0rw3v152" target="_blank">https://escholarship.org/uc/item/0rw3v152</a> <a href="#fnref:156" class="footnote-back-ref">↩</a></li>
<li id="fn:157">Liechti ME, Vollenweider FX (December 2001). "Which neuroreceptors mediate the subjective effects of MDMA in humans? A summary of mechanistic studies". Hum Psychopharmacol. 16 (8): 589–598. doi:10.1002/hup.348. PMID 12404538. <a href="/wiki/Doi_(identifier)" target="_blank">/wiki/Doi_(identifier)</a> <a href="#fnref:157" class="footnote-back-ref">↩</a></li>
<li id="fn:158">Halberstadt AL, Nichols DE (2020). "Serotonin and serotonin receptors in hallucinogen action". Handbook of the Behavioral Neurobiology of Serotonin. Handbook of Behavioral Neuroscience. Vol. 31. pp. 843–863. doi:10.1016/B978-0-444-64125-0.00043-8. ISBN 9780444641250. ISSN 1569-7339. S2CID 241134396. Pretreatment with the selective 5-HT reuptake inhibitors citalopram, fluoxetine, and paroxetine significantly attenuated most of the subjective effects of MDMA, consistent with the proposed involvement of carriermediated 5-HT release in the effects of MDMA (Farre et al., 2007; Liechti, Baumann, et al., 2000; Tancer & Johanson, 2007). Citalopram also inhibits the effect of MDMA on PPI (Liechti, Geyer, Hell, & Vollenweider, 2001). According to another report (Hysek, Simmler et al., 2012), the mixed SERT/NET inhibitor duloxetine robustly blocked most of the subjective response to MDMA, raising the possibility that NE release contributes to its effects. In a follow-up study, the selective NET inhibitor reboxetine significantly reduced the emotional excitation and feelings of stimulation produced by MDMA but did not alter its entactogenic or mood-elevating effects (Hysek et al., 2011). Therefore, although NE release contributes to the stimulant effects produced by MDMA, 5-HT release appears to be principally responsible for the unique entactogenic effects of the drug. [...] Several studies have examined the contribution of 5-HT and DA receptors to the effects of MDMA. Pretreatment with ketanserin produced some attenuation of the subjective effects of MDMA (Liechti, Saur, et al., 2000). However, the most significant reduction of MDMA effects by ketanserin occurred in the VR dimension of the APZ, indicating that 5-HT2A receptors are responsible for the effects of MDMA on perception. Ketanserin also blocked MDMA-induced impairment of performance on a verbal memory task (van Wel et al., 2011), but had no effect on the ability of MDMA to induce depersonalization and derealization (Puxty et al., 2017). <a href="9780444641250" target="_blank">9780444641250</a> <a href="#fnref:158" class="footnote-back-ref">↩</a></li>
<li id="fn:159">Liechti ME, Saur MR, Gamma A, Hell D, Vollenweider FX (October 2000). "Psychological and physiological effects of MDMA ("Ecstasy") after pretreatment with the 5-HT(2) antagonist ketanserin in healthy humans". Neuropsychopharmacology. 23 (4): 396–404. doi:10.1016/S0893-133X(00)00126-3. PMID 10989266. <a href="/wiki/Doi_(identifier)" target="_blank">/wiki/Doi_(identifier)</a> <a href="#fnref:159" class="footnote-back-ref">↩</a></li>
<li id="fn:160">Liechti ME, Vollenweider FX (December 2001). "Which neuroreceptors mediate the subjective effects of MDMA in humans? A summary of mechanistic studies". Hum Psychopharmacol. 16 (8): 589–598. doi:10.1002/hup.348. PMID 12404538. <a href="/wiki/Doi_(identifier)" target="_blank">/wiki/Doi_(identifier)</a> <a href="#fnref:160" class="footnote-back-ref">↩</a></li>
<li id="fn:161">van Wel JH, Kuypers KP, Theunissen EL, Bosker WM, Bakker K, Ramaekers JG (2012). "Effects of acute MDMA intoxication on mood and impulsivity: role of the 5-HT2 and 5-HT1 receptors". PLOS ONE. 7 (7): e40187. Bibcode:2012PLoSO...740187V. doi:10.1371/journal.pone.0040187. PMC 3393729. PMID 22808116. <a href="https://www.ncbi.nlm.nih.gov/pmc/articles/PMC3393729" target="_blank">https://www.ncbi.nlm.nih.gov/pmc/articles/PMC3393729</a> <a href="#fnref:161" class="footnote-back-ref">↩</a></li>
<li id="fn:162">Rusyniak DE, Sprague JE (November 2005). "Toxin-induced hyperthermic syndromes". Med Clin North Am. 89 (6): 1277–1296. doi:10.1016/j.mcna.2005.06.002. PMID 16227063. <a href="/wiki/Doi_(identifier)" target="_blank">/wiki/Doi_(identifier)</a> <a href="#fnref:162" class="footnote-back-ref">↩</a></li>
<li id="fn:163">Doyle AJ, Meyer J, Breen K, Hunt BJ (July 2020). "N-Methyl-3,4-methylendioxymethamphetamine (MDMA)-related coagulopathy and rhabdomyolysis: A case series and literature review". Res Pract Thromb Haemost. 4 (5): 829–834. doi:10.1002/rth2.12360. PMC 7354411. PMID 32685891. <a href="https://www.ncbi.nlm.nih.gov/pmc/articles/PMC7354411" target="_blank">https://www.ncbi.nlm.nih.gov/pmc/articles/PMC7354411</a> <a href="#fnref:163" class="footnote-back-ref">↩</a></li>
<li id="fn:164">Krolikowski, Allana M.; Koyfman, Alex (2014). "Methamphetamine and MDMA: 'Safe' drugs of abuse". African Journal of Emergency Medicine. 4 (1): 34–38. doi:10.1016/j.afjem.2013.01.005. <a href="https://doi.org/10.1016%2Fj.afjem.2013.01.005" target="_blank">https://doi.org/10.1016%2Fj.afjem.2013.01.005</a> <a href="#fnref:164" class="footnote-back-ref">↩</a></li>
</ol>

Trip killer open-in-new

Trip killer