What is known,
and what is not.

Adverse effects
are common.

“No serious adverse events” does not mean no side effects.

In the 2026 randomised trial of a manufactured formulation, adverse events were reported in 29 of 40 participants who received the active treatment. Nausea was common. None were classified as severe or serious during the controlled period, but that period was short.

An earlier phase 1 study of an intranasal formulation reported nasal discomfort, nausea, headache and vomiting. Its participants were selected healthy adults, screened to exclude seizure history, serious psychiatric concerns, pregnancy and MAOI use.

Those exclusions describe who was studied. They are not a clearance list, and a small screened sample cannot rule out rare harms. Bodily discomfort and psychological distress are also not evidence of progress, and should not be reinterpreted as such.

One combination
has killed people.

Monoamine oxidase inhibitors are the clearest known danger.

A published case describes severe poisoning after 5-MeO-DMT was combined with harmaline, an MAOI. Harm-reduction bodies report that combining 5-MeO-DMT or bufotenin with orally ingested beta-carbolines — the class found in some plant preparations — carries serious risk including hyperthermia, and that deaths have been reported. A case establishes that an outcome is possible, not how often it happens.

Beyond that, do not stop, taper or substitute prescribed medication on the basis of a website. A clinician needs your full medication and supplement list, your history, and the exact product involved. Broad reassurance about psychiatric medication is not adequate clinical guidance, and an absence of data about a combination is not evidence that it is safe.

A conversation,
not a form.

Some things rule out a session here. The list below is not complete, and is not meant to be used alone.

• MAOIs
• SSRIs
• Amphetamines
• Heart conditions

These are asked about directly before any date is set. They are a starting point for that conversation rather than the whole of it: health history, other medication and current circumstances are discussed too, and either of us can decide against going ahead. Nothing on this page replaces that conversation, and nothing in that conversation replaces a doctor who knows you.

It does not always
end when it ends.

Aspects of an experience can return after the acute effects have passed.

An exploratory analysis of 513 survey responses found that recurrences — sometimes called reactivations — were reported at different rates in two naturalistic samples. Most reported events were neutral or positive. Some were not. Selection and recall make that data unsuitable for predicting what will happen to any particular person.

Persistent insomnia, panic, disconnection or difficulty functioning deserves qualified mental-health assessment rather than reinterpretation. A favourable group average does not make anyone’s distress unimportant.

Do not wait
to see.

Suspected poisoning, unresponsiveness, severe difficulty breathing or a seizure needs immediate medical help.

Contact local emergency services and follow the dispatcher’s instructions. Do not induce vomiting. In the Netherlands the emergency number is 112.