Psychedelic Medicine Podcast with Dr. Lynn Marie Morski · Lynn Marie Morski, MD, JD

Is Psilocybin Safe for Me? with Seth Mehr, MD

July 9, 2025·53 min·5 clips

A client's suicide plan with an insulin pump shows the hidden dangers of psilocybin for diabetics.

Dr. Lynn Marie Morski hosts Dr. Seth Mayer, an emergency medicine physician turned psychedelic medicine specialist and psilocybin facilitator. This episode focuses on evaluating personal safety and mitigating risks for individuals considering psilocybin therapy. Dr. Mayer co-authored a course on medical risk management for the Psychedelic Medicine Association. He outlines three primary risk categories: medical conditions, medication interactions, and mental health history. Specific medical concerns include cardiac issues like aneurysms or uncontrolled hypertension, neurological conditions such as seizures, and insulin-dependent diabetes. Medication risks involve serotonergic drugs, stimulants, lithium, and GLP-1 agonists like Ozempic. Mental health considerations cover psychotic disorders, bipolar disorder, spiritual emergency, substance use disorders, and suicidality. Psilocybin can increase heart rate and blood pressure significantly, posing risks for those with cardiovascular vulnerabilities. For someone with insulin-dependent diabetes and a history of suicide attempts using their insulin pump, a session could present a unique hazard. GLP-1 agonists may cause severely delayed and prolonged psilocybin experiences, leading Dr. Mayer to recommend a three-week pause before a session. A single SSRI may blunt the experience but combining multiple serotonergic medications raises the risk of serotonin toxicity. The concept of "spiritual emergency" describes a spectrum from a spiritual awakening to potentially dangerous grandiosity and invincibility. For substance use disorders, the main risks are presenting intoxicated or entering withdrawal during a session, which could synergize dangerously with psilocybin's effects. Assessing suicidality involves gauging where a person falls on a spectrum from passive ideation to having an active plan, as psilocybin can cause destabilization. Family history of psychosis or bipolar disorder in a first-degree relative is a risk factor, but age and personal psychedelic history also inform the assessment. Dr. Mayer emphasizes safety planning over simple gatekeeping, creating alternatives, delaying timing, or making contingency plans. He shares an example of a client with bipolar II disorder who, after a session, used a pre-arranged prescription for Seroquel to manage emerging hypomanic symptoms. For a client with paroxysmal atrial fibrillation, a contingency plan included having beta-blockers on hand and considering the logistics of emergency medical care. Building a support team might involve connecting a client with PTSD to a trauma-informed therapist before a session. The tone is educational and conversational, grounded in clinical experience and presented with humility about the unknowns in this emerging field. This episode is ideal for clinicians, prospective psilocybin clients, or anyone seeking a detailed, nuanced understanding of risk assessment. Listeners seeking only broad advocacy or definitive yes/no answers might find the detailed medical discussions less engaging.

As heard by us

A careful, clinician-minded look at psilocybin safety and screening.

The episode centers on psilocybin safety, with Dr. Lynn Marie Morski pressing on where screening matters most and how clinicians can think about risk. Dr.

Read the full review in PlayNext →

Why you'd press play

When you want a sober read on how to know if psilocybin is safe for you.

Read the full recommendation in PlayNext →

Listen to the show on

Apple Podcasts Spotify

Play clips from this episode More from Psychedelic Medicine Podcast with Dr. Lynn Marie Morski