Adolescents, Older Adults and Multiple Medicines

Urgent first

If a teenager or an older adult becomes unresponsive, has a seizure, chest pain or trouble breathing after taking any psychoactive product, call 911. For possible poisoning call US Poison Help, 1-800-222-1222. [1] See When to Seek Urgent Help. This page is education only: it does not say who should or should not use any substance and does not advise changing medicines. Evidence labels: established, promising but limited, insufficient evidence.

Adolescents

How common is use? NIDA reports that in the 2022 Monitoring the Future survey an estimated 1.2% of 8th graders, 2.1% of 10th graders and 4.4% of 12th graders reported using any hallucinogen in the past 12 months. [2] The survey's list includes LSD, MDMA, mescaline, peyote, psilocybin and PCP. [2]

What research exists? A 2026 review of all research on children and young people (from the 1950s to recent observational work) concluded that the limited available research suggests psychedelics appear to be safe overall, but that young people may be at more risk of anxiety, challenging experiences and ego dissolution. It called for more thorough clinical research. [3] That is insufficient evidence for any recommendation, and the review includes non-medical and historical reports that cannot show cause and effect.

Approved medicine. For esketamine (Spravato), the US label says safety and effectiveness in pediatric patients have not been established. [4] See Esketamine.

Edible products. The FDA warned that mushroom-labeled chocolate bars, cones and gummies may appeal to children and teenagers. [1] In the CDC's Arizona report, two adolescents became seriously ill within two hours of eating a chocolate bar, with decreased consciousness and respiratory depression, and needed breathing tubes. [5] See Unverified Mushroom Gummies.

Older adults

Trial participation is very low. A systematic review of 36 psychedelic-assisted therapy trials found only 19 of 1,400 participants (less than 1.4%) were aged 65 or older. [6] Detailed safety data existed for 10 of them; no serious adverse events occurred, and mild to moderate reactions included anxiety, stomach upset and high blood pressure during dosing sessions. [6] The authors say existing data in older adults is limited. [6] Ten people cannot show that the approach is safe for most older adults, and these were research participants who were screened. See Screening and Eligibility.

Heart. NIDA says psilocybin typically raises blood pressure and heart rate, which may be dangerous for people with heart conditions. [7] Heart conditions become more common with age, so this matters. See Cardiovascular Risks.

An approved comparison. In esketamine's clinical studies, 12% of patients exposed were 65 or older; the label reports no overall difference in safety, though blood levels of the drug were higher in older patients than in younger adults. [4]

Multiple medicines

Older adults, and some teens, often take several medicines. This is where interaction risk concentrates, but interactions are assessed one substance at a time and there is no universal chart. Examples from sources we read:

• NIDA says some researchers suspect psychedelics may interact with medicines that also raise serotonin, with rare reports of serotonin syndrome, which can occasionally be life-threatening. [2]
• The esketamine label says combining it with sedatives such as benzodiazepines, opioids or alcohol may increase sedation, and with stimulants may increase blood pressure. [4]

For other substances, see Psychedelic Drug Interactions and Toxicology and Serotonergic Medicines. General guides are at Older Adults and Children and Teens.

What to do with questions

Bring the full list of medicines, including over-the-counter products, to your prescriber or pharmacist and ask about any substance you are thinking about. Do not stop or change a prescribed medicine on your own.