Follow-Up and Ongoing Care

Urgent first

If you are having thoughts of harming yourself, call or text 988 in the United States, or call 911 in an emergency. Do not wait for a scheduled appointment. See also acute psychological distress and when to seek urgent help.

What follow-up means

After a treatment session, care does not end. Follow-up can mean check-ins to track mood and safety, support in making sense of the experience (often called integration), and a plan for what happens if symptoms return. This page is information only. It cannot say what any one person should do, and it does not replace advice from your own clinician. Evidence labels: mixed (findings point in different directions) and insufficient evidence (too little research to say).

What regulators and labels say

• FDA's guidance for psychedelic drug trials says sponsors should follow participants beyond the 12-week point to look for symptom recurrence or a need for repeat treatment. [1] It describes blinded long-term follow-up, typically 12 months, as the most informative design. [1]
• The prescribing information for the approved esketamine nasal spray requires patients to be monitored for at least 2 hours at each treatment session. [2] It tells patients not to drive or operate machinery until the next day after restful sleep and to arrange transportation home. [2]

What long-term studies report

Small studies, with limits.

In the placebo-controlled trial, the group difference was no longer significant at one year, while the first study reports durable effects in some patients. Both are single, small trials, and neither says what would happen for you. Label: mixed.

Integration and ongoing support

Integration usually means talking through the experience and its effects with a trained person. Beyond the description in what integration means, research on how best to do it is thin.

• A 2026 systematic review of 9 trials involving 283 patients found that therapy approaches combined with psychedelic substances varied widely in timing and content. [6] Insufficient evidence on which approach works best.
• In the Global Ayahuasca Survey, 55.9% reported adverse mental health effects in the weeks or months after, and around 88% saw them as part of a positive process of growth or integration, though around 12% sought professional support. [7] This is self-report from people who chose to take part, not a measure of benefit.

Questions to ask a service about aftercare

These are questions, not a promise of safety.

1. Who can I contact after the session, and how quickly will they answer?
2. What is the plan if distress, panic or strange perceptions continue?
3. Who coordinates with my regular prescriber or therapist?
4. How long will you check in, and what do you track?
5. What happens if I decide to stop?

Medicine changes, such as stopping or starting a psychiatric drug, are decisions for your prescriber: talking with a health professional. For what comes before treatment, see preparation in clinical settings. Reporting a medical product problem in the US can be done through FDA MedWatch, its program for health professionals, patients and consumers. [8] Oregon's psilocybin program also lists 988 for crisis support. [9]

What is not known

We did not find studies that tell us how long follow-up should last in routine care, or which integration approach works best. Proper evidence not found in the sources read for those questions.