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Review
. 2024 Mar;38(3):217-224.
doi: 10.1177/02698811231225609. Epub 2024 Jan 12.

Microdosing psychedelics and the risk of cardiac fibrosis and valvulopathy: Comparison to known cardiotoxins

Antonin Rouaud  1 , Abigail E Calder  1 , Gregor Hasler  1   2
Affiliations
Review

Microdosing psychedelics and the risk of cardiac fibrosis and valvulopathy: Comparison to known cardiotoxins

Antonin Rouaud et al. J Psychopharmacol. 2024 Mar.

Abstract

Though microdosing psychedelics has become increasingly popular, its long-term effects on cardiac health remain unknown. Microdosing most commonly involves ingesting sub-threshold doses of lysergic acid diethylamide (LSD), psilocybin, or other psychedelic drugs 2-4 times a week for at least several weeks, but potentially months or years. Concerningly, both LSD and psilocybin share structural similarities with medications which raise the risk of cardiac fibrosis and valvulopathy when taken regularly, including methysergide, pergolide, and fenfluramine. 3,4-Methylenedioxymethamphetamine, which is also reportedly used for microdosing, is likewise associated with heart valve damage when taken chronically. In this review, we evaluate the evidence that microdosing LSD, psilocybin, and other psychedelics for several months or more could raise the risk of cardiac fibrosis. We discuss the relationship between drug-induced cardiac fibrosis and the 5-HT2B receptor, and we make recommendations for evaluating the safety of microdosing psychedelics in future studies.

Keywords: Psychedelics; cardiology; psilocybin; serotonin.

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Conflict of interest statement

Declaration of conflicting interestsThe author(s) declared no potential conflicts of interest with respect to the research, authorship, and/or publication of this article.

Figures

Figure 1.
Figure 1.
Affinity at the 5-HT2BR and plasma concentrations of typical doses for drugs which have been investigated for links to fibrosis and VHD, as well as for LSD, psilocin, and psilocybin, for which the risk of VHD has not yet been investigated in controlled studies.
See this image and copyright information in PMC

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