Who should not use psilocybin mushrooms?

Psilocybin is not recommended for people with a personal or family history of psychosis, schizophrenia, or bipolar disorder type I; those taking lithium or MAOIs; individuals under 25; pregnant people; and those with serious cardiovascular or neurological conditions.

What factors does a psychedelic risk assessment evaluate?

A thorough risk assessment covers mental health history, family psychiatric history, current medications, physical health conditions, age, prior psychedelic experiences, current emotional state, and situational factors such as setting and the presence of a trip sitter.

Does psilocybin increase the risk of psychosis?

For most people without a predisposition, the risk of lasting psychosis from psilocybin is low. However, for individuals with a personal or family history of schizophrenia or bipolar I disorder, the risk is significantly elevated and psilocybin should be avoided.

Is psilocybin safe for people with a family history of schizophrenia?

No. A family history of schizophrenia is a strong contraindication because genetic vulnerability can be triggered by psilocybin's serotonergic action, potentially precipitating a psychotic episode even in someone with no previous symptoms.

Can psilocybin cause HPPD?

HPPD (Hallucinogen Persisting Perception Disorder) is a rare condition involving lasting visual disturbances after psychedelic use. Risk is highest among frequent users, those using high doses, and individuals with pre-existing anxiety or perceptual sensitivity.

Psychedelic Risk Assessment Tool

🏥 Medical Risk Factors

Current Medical Conditions:

Check all that apply:

Heart disease, cardiovascular problems, high blood pressure (uncontrolled)
Critical risk: Psychedelics increase heart rate and blood pressure Severe liver or kidney disease
Critical risk: Impaired metabolism/elimination of substances Epilepsy or seizure disorder
High risk: May lower seizure threshold Diabetes (Type 1 or 2)
Moderate risk: May affect blood sugar; monitoring needed Asthma or respiratory issues
Low-moderate risk: Anxiety can trigger; have inhaler ready Migraines or severe headaches
Low risk: May be triggered; some report improvement None of the above

Current Medications:

Check all that apply:

MAO Inhibitors (MAOIs) - antidepressants, Ayahuasca
CRITICAL: Life-threatening interaction with many substances Lithium (mood stabilizer)
CRITICAL: Dangerous interaction with psychedelics (seizure risk) SSRIs or SNRIs (antidepressants like Prozac, Zoloft, Lexapro)
High risk: Reduces psychedelic effects; rare serotonin syndrome risk Antipsychotics (e.g., Risperdal, Abilify, Zyprexa)
High risk: Blocks psychedelic effects; contraindicated Benzodiazepines (Xanax, Valium, Ativan, Klonopin)
Moderate risk: Reduces psychedelic effects; withdrawal can be dangerous Stimulants (Adderall, Ritalin, Vyvanse)
Moderate risk: Cardiovascular strain when combined Blood pressure medications
Low-moderate risk: Interaction possible; medical supervision advised None of the above

Pregnancy & Age:

Currently pregnant or breastfeeding
CRITICAL: Do not use psychedelics Under 18 years old
High risk: Brain still developing; wait until 25+ Over 65 years old
Moderate risk: Health screening important; start lower doses

🧠 Psychological Risk Factors

🌍 Situational & Environmental Factors

📚 Experience & Knowledge Level

📖 Understanding Risk Levels

Risk Level	Description	Recommendation
CRITICAL	Absolute or near-absolute contraindications present	DO NOT PROCEED. Medical dangers or high probability of severe adverse reaction.
HIGH	Significant risk factors present	Strongly advise against use unless in clinical/therapeutic setting with expert supervision.
MODERATE	Some risk factors present; extra precautions needed	Proceed with caution. Reduce dose, ensure excellent set/setting, have experienced sitter, prepare thoroughly.
LOW	Few or no significant risk factors	Relatively safer profile, but no psychedelic use is risk-free. Follow all harm reduction practices.

ℹ️ Important Considerations

Limitations of This Assessment:

Not comprehensive: Cannot account for every individual factor
Self-reported: Accuracy depends on honest self-assessment
Not medical advice: Consult healthcare provider for medical questions
Cannot predict outcomes: Even low-risk individuals can have difficult experiences
Dynamic risk: Your risk profile changes over time

Beyond This Assessment:

Medical consultation: If you have health conditions, get professional clearance
Psychological screening: Consider working with therapist for mental health assessment
Harm reduction: Always follow best practices (test substances, start low, sitter present, etc.)
Legal considerations: Understand laws in your jurisdiction
Continuous learning: Keep educating yourself on safety

⚠️ Psychedelic Risk Assessment Tool

🚨 Critical Disclaimer

📋 About This Assessment

🏥 Medical Risk Factors

Current Medical Conditions:

Current Medications:

Pregnancy & Age:

🧠 Psychological Risk Factors

Personal Mental Health History:

Family History (Blood relatives):

Current Mental State:

🌍 Situational & Environmental Factors

Set & Setting Preparation:

Support & Resources:

📚 Experience & Knowledge Level

Prior Experience:

Preparation & Knowledge:

Substance Use Patterns:

🎯 Your Risk Assessment Results

📞 Crisis Resources (Always Available):

📖 Understanding Risk Levels

ℹ️ Important Considerations

Limitations of This Assessment:

Beyond This Assessment:

📚 Further Resources

Safety Guides:

Preparation:

Mental Health: