Psychedelic Drug List: The Risks and Benefits of These Mind-Altering Substances
Key takeaways:
Psychedelic drugs affect brain chemicals such as serotonin and dopamine. This leads to changes in mood, perception, and emotional processing.
Some psychedelics show promise for mental health conditions such as depression, post-traumatic stress disorder (PTSD), and anxiety. But they also come with risks, such as hallucinations, paranoia, and, in rare cases, psychosis.
Not all psychedelics are equally safe. Some, such as PCP and NBOMes, have dangerous side effects and are considered high risks. Others, such as ketamine and MDMA, have medical applications but still carry a risk for dependence and misuse.
Table of contents
Psychedelic drugs are substances that alter your perception, mood, and thoughts. Some are found in nature, while others are made in labs. Many have been used for centuries in spiritual and healing practices. More recently, they’ve gained popularity as potential treatments for mental health conditions. But these substances also come with risks, and it’s important to be aware of them.
Keep in mind that in most cases, psychedelics are considered illegal substances and have no FDA-approved use. They also have side effects and drug interactions. Before trying a psychedelic drug, it’s best to discuss the risks and benefits with a trained medical professional to protect your safety.
This psychedelic drug list reviews how each of these compounds works in the body, along with their risks and possible benefits.
1. Psilocybin (magic mushrooms)
Psilocybin is a natural chemical found in certain mushrooms, which are often referred to as “magic mushrooms.” When you eat these mushrooms, the body turns their psilocybin into psilocin, the active form of the chemical.
Psilocin is considered a “classic psychedelic” because it binds to serotonin receptors in the brain. It may also increase dopamine levels. Both of these chemicals affect your mood and perception. Psilocin may also reduce activity in the brain’s Default Mode Network, which is involved with daydreaming and recalling past events. This may allow you to be more open to new ways of seeing yourself and the world around you.
What it feels like: Typically, psilocybin takes about 40 minutes to start working when swallowed, and the effects last around 4-6 hours. The effects of psychedelics, including psilocybin, can vary from person to person. But people often describe seeing and hearing things that aren’t real (hallucinations). You may also lose your sense of time and space and feel more connected to the universe as whole. Many people describe taking psilocybin as a mystical or spiritual experience.
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Potential benefits:
May help with depression, anxiety, and post-traumatic stress disorder (PTSD) symptoms.
May reduce end-of-life anxiety in people with terminal conditions.
Might help with substance use disorders, including helping people quit smoking.
Could increase creativity and a sense of spiritual connection, as reported by some people.
Risks:
Common psilocybin side effects include headache, nausea, and dizziness. A temporary increase in blood pressure and heart rate are also possible.
Can cause unpleasant side effects, such as intense hallucinations and anxiety, fear, or paranoia.
In rare cases, psilocybin can trigger psychotic episodes in some people, especially those with a history of mental health conditions such as schizophrenia or bipolar disorder.
2. DMT (ayahuasca)
DMT (dimethyltryptamine) is naturally found in the human body, which makes it unique among the other psychedelics. It’s also found in plants and is the main active ingredient in ayahuasca, a ceremonial drink that’s native to South America. DMT can also be lab-made, instead of derived from natural sources.
Like psilocybin, DMT affects serotonin and other chemicals in the brain that control mood and perception. It also seems to be able to change how the brain functions, which is known as neuroplasticity.
What it feels like: DMT is known for its intense visual effects. In some cases, visions are so intense that users can’t tell whether their eyes are open or closed. As with psilocybin, you may also experience a change in how you perceive space and time. Near-death and out-of-body experiences are also often associated with DMT use.
On its own, DMT has a rapid effect and is quickly cleared by the body. But when it’s consumed in ayahuasca, another ingredient in the drink slows the breakdown of DMT, which helps its effects last longer.
Potential benefits:
Studies suggest DMT may help with depression, anxiety, and PTSD.
People report spiritual and emotional healing from ayahuasca ceremonies.
Risks:
Common DMT side effects include nausea, headache, and fatigue. Increased heart rate and blood pressure are also possible. Vomiting is common when consuming DMT in the form of ayahuasca.
The experience can be intense, overwhelming, or frightening for some people.
Flashbacks (re-experiencing DMT’s effects after the drug has worn off) can occur days to weeks after using DMT, which can be unsettling in some cases.
In rare cases, DMT may trigger psychosis. The risk seems to be higher for those with a history of psychosis-related conditions or when DMT is combined with other substances, such as cannabis.
3. Mescaline (peyote)
Mescaline is a naturally occurring psychedelic found in cacti — the peyote cactus in particular. Like other classic psychedelics, it affects serotonin receptors. Mescaline also affects other brain chemicals, including noradrenaline and dopamine. Mescaline’s effects are considered milder than those of most other psychedelic substances.
Despite being one of the oldest known psychedelics, there’s less research on mescaline than other substances. This may be due to its lower potency and long-lasting effects.
What it feels like: When swallowed, mescaline takes up to 3 hours to start working, and the effects can last for 12 hours or longer. People describe a distorted sense of reality while under the effects of mescaline. Synesthesia — a mixing of the senses, such as seeing colors in response to sounds — can also occur. Overall, the effects are described as pleasant and euphoric.
Potential benefits:
It’s traditionally used in Native American spiritual ceremonies for self-discovery.
Some research suggests mescaline may help with depression, anxiety, and substance use disorders.
Risks:
Mescaline side effects can include dilated pupils and increased body temperature, heart rate, and blood pressure. Nausea and vomiting are also common when mescaline is consumed in the form of peyote.
Long, intense experiences may be overwhelming.
There’s a risk of anxiety, paranoia, and delusions, especially with high doses. Psychosis can also occur in rare cases.
4. LSD (acid)
LSD (lysergic acid diethylamide) is a lab-made psychedelic. It’s one of the most potent psychedelics, considered 100 times stronger than psilocybin and 4,000 times stronger than mescaline.
LSD is another classic psychedelic that targets serotonin receptors. Serotonin receptors seem to hold on to LSD once it attaches, which may be why its effects last longer than those of other psychedelics. LSD may also increase dopamine levels.
What it feels like: LSD is typically taken orally, reaching peak effects within an hour and lasting for 6 to 12 hours or more. For many people, it leads to a blissful state with a positive disconnection from self and reality. People describe an increased feeling of well-being, happiness, and trust. Hallucinations, especially synesthesia associated with sight and sound, are also common.
Potential benefits:
Some studies suggest LSD-assisted therapy may help with mental health conditions such as depression and anxiety.
LSD also shows promise as a treatment for alcohol use disorder.
Risks:
Common LSD side effects include headache, dizziness, and dry mouth. Increased heart rate and blood pressure are also common.
High doses of LSD can lead to seizures, overheating, and heart problems.
A reduced sense of fear can lead to risky or dangerous behavior in some people.
Unpredictable effects can lead to distress, confusion, or paranoia.
Its effects can be long-lasting (12 hours or more).
LSD seems more likely than other psychedelics to cause flashbacks, referred to as hallucinogen persisting perception disorder. These can occur days, weeks, or even months after use.
5. MDMA (ecstasy, molly)
MDMA (3,4-methylenedioxymethamphetamine) is a lab-made chemical. It’s considered an enactogen, rather than a classic psychedelic drug. The term enactogen refers to MDMA’s effects, which differ from the effects of the classic psychedelic substances discussed earlier.
MDMA is chemically similar to both amphetamines and mescaline. It works by increasing the levels of several chemicals in the brain, including serotonin, norepinephrine, and dopamine. It also increases oxytocin levels, which can enhance feelings of love, connection, and trust.
What it feels like: When taken orally, MDMA reaches its peak effect after about 2 hours and can last for up to 2 days. Unlike other psychedelics, MDMA doesn’t typically have significant hallucinatory effects. It can increase energy, and people describe enhanced feelings of empathy, positivity, and social connection. An increased sensitivity to touch is also a common experience.
Potential benefits:
It’s FDA-designated as a "breakthrough therapy" for PTSD treatment.
MDMA may make talk therapy more effective, especially when dealing with traumatic or challenging topics. This is referred to as MDMA-assisted therapy.
Research shows that MDMA may also help with end-of-life anxiety, autism-related social anxiety, and substance misuse.
Risks:
Common MDMA side effects include jaw, back, and leg pain, headache, and nausea.
Serious side effects include dehydration, overheating, and electrolyte imbalances. Liver damage and dangerously high blood pressure and heart rate can also occur.
Depression, anxiety, and trouble concentrating are common in the days after using MDMA.
MDMA has the potential to cause neurotoxicity (brain damage) and decreased serotonin levels with high doses or frequent use.
MDMA is associated with long-term problems with memory, problem-solving, and self-control. Panic attacks, severe depression, and psychotic symptoms have also been reported.
There is a risk of contamination with harmful substances in nonmedical settings. This risk seems to be higher with recreational MDMA than with other psychedelic substances.
6. Ketamine
Ketamine isn’t a classic psychedelic. Instead, it’s considered a dissociative drug. Ketamine is actually an FDA-approved medication (Ketalar) that’s used for anesthesia. It also has psychedelic effects at lower doses and is used off-label to treat pain and depression.
Spravato (esketamine) is a prescription nasal spray that’s similar to ketamine and approved for certain types of depression. But you can only use Spravato in a healthcare setting with medical supervision.
Ketamine and Spravato affect several parts of the brain. They seem to increase neuroplasticity and reduce activity in the Default Mode Network. They also affect a brain chemical called glutamate, which influences mood, emotions, and thoughts.
What it feels like: Ketamine is described as having happy, dreamlike effects. It can change the way you perceive sights and sounds. You may also feel disconnected from your body and reality. Recreational ketamine is typically taken by mouth, starts working within 30 minutes or so, and lasts about an hour.
In a clinical setting, ketamine is typically given as an injection or infusion into a vein. It starts working quickly, and the psychedelic effects wear off over about an hour once the treatment is finished. But the clinical effects (such as improved mood) can be long-lasting after a single dose.
Spravato starts working soon after using it, and the psychedelic effects typically peak after 20 to 40 minutes, then wear off over the next few hours. The antidepressant effect can take up to 24 hours to become noticeable.
Proven benefits:
Spravato and ketamine work quickly to treat depression and reduce suicidal thoughts.
Ketamine is also considered an effective treatment for certain types of pain.
Possible benefits:
Ketamine shows potential in treating other mental health conditions, such as PTSD, anxiety, and substance misuse.
Risks:
Ketamine can cause unpleasant side effects, such as dissociation, confusion, and memory issues. Extreme detachment from reality can occur, which is referred to as being in a “k-hole.”
Serious side effects include heart problems and breathing troubles, especially with high doses.
There’s a risk of developing ketamine use disorder, especially with frequent use.
High doses and long-term use can lead to stomach problems and bladder damage ("ketamine bladder syndrome").
7. High-risk psychedelics
Some psychedelic substances — such as PCP (phencyclidine), ibogaine, and NBOMes — are riskier than the others listed here. They can cause dangerous side effects, including severe hallucinations, heart problems, and high-risk behaviors. These compounds can also be deadly in some cases.
The risks of these psychedelics outweigh any possible benefit, based on current research. If you’re interested in psychedelic drugs for a health condition, it’s best to talk to a healthcare professional about safer treatment options for your needs.
Are psychedelics addictive?
Most classic psychedelics don’t cause dependence or compulsive drug-seeking behavior the way that substances such as opioids or nicotine do. In fact, most psychedelics produce tolerance quickly. This means that they actually become less effective, or ineffective, with repeated use.
Other types of psychedelics — such as ketamine, MDMA, and PCP — seem more likely to lead to substance use issues. And all psychedelics have a potential to be misused. Keep in mind that while psychedelics may not cause physical dependence, there are other risks to consider, including mental distress or unsafe behavior while under their influence.
The bottom line
Psychedelic drugs can significantly alter perception and mood. Some, such as psilocybin and ketamine, show potential for treating mental health conditions such as depression and PTSD. But psychedelics also come with risks, including physical side effects or psychological distress.
Most classic psychedelics aren’t considered addictive. But others, such as ketamine and MDMA, have a higher potential for dependence and misuse. For high-risk psychedelics, such as PCP and NBOMes, the dangers outweigh any potential benefits.
Safe, guided use in clinical settings appears to be the most promising approach for many of these substances. But keep in mind that most psychedelics are illegal substances in the U.S. If you're considering using psychedelics for medical reasons, talking to a healthcare professional is the best first step.
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Keep in mind that psilocybin is legal in some states for personal and/or medicinal use, but not in others. Psilocybin is still illegal under federal law.
