Who should avoid microdosing psilocybin

• Active episode or history of psychosis, psychotic disorders (schizophrenia, schizoaffective, delusional), including substance-induced psychosis.
• Active episode or history of bipolar I.
• Any acute destabilisation in mood, perception, or behaviour.
• Strong family history of psychosis/bipolar disorders (first‑degree relative).
• Severe depression, uncontrolled anxiety, or PTSD with dissociation.
• Suicidal thoughts, plans, or impulses.
• Any period where your mental health feels unstable or is rapidly changing.
• Any other severe mental health crisis or acute psychiatric symptoms.

Exercise major caution and, if possible, microdose psilocybin under clinical supervision, if you have:

• Bipolar II.

• Cognitive difficulties or confusion — especially problems with planning, organisation, memory or tracking — whether due to dementia, post-traumatic brain injury, severe ADHD, or any other condition.
• OCD with poor impulse control or compulsive redosing behaviour.

Exercise major caution and, if possible, microdose psilocybin under clinical supervision, if you have:

• Autism with severe sensory overwhelm or rigidity.

• Cardiovascular risks: uncontrolled cardiovascular disease (e.g., uncontrolled hypertension, significant arrhythmia), or structural conditions (e.g., valvular disease, cardiomyopathy).
• Seizure disorders not well controlled.
• Eating disorders with electrolyte instability or severe malnutrition, especially active anorexia nervosa.
• Sleep-deprivation or untreated sleep apnoea severe enough to cause cognitive lapses.
• Any other acute medical risks.

Exercise major caution and, if possible, microdose psilocybin under clinical supervision, if you have:

• Severe gastrointestinal disease (such as Crohn’s, ulcerative colitis flares, chronic gastritis, etc.).
• Severe migraines, especially migraines with aura when using triptans.

• For a list of medications that may interact with psilocybin CHECK HERE
• Undergoing major medication changes (starting, stopping, or switching medications).
• Current use of serotonergic recreational drugs: MDMA, 2C-x compounds, NBOMes, methylone, and similar agents.
• Experiencing strong or persistent side-effects of microdosing psilocybin that don’t settle despite dosage adjustments or changing the species, type, ingestion form or preparation method.

• Safety-sensitive jobs.
• Being subject to, or at risk of being subjected to, drug testing.
• Immigration or visa vulnerability.
• Where or when possession or use of psilocybin carries the risk of criminal penalties.

• In an acute state due to substance misuse. Signs of liver strain, seizures, unmanaged withdrawal, or any issue where a clinician would say, “We need to see you now”.
• In a severe withdrawal risk. The current stage of one’s addiction requires medical supervision for discontinuation or reduction.
• During benzodiazepine dependence, particularly during withdrawal or unstable use.
• During stimulant-induced psychosis or its history.

• If immediate safety concerns are present such as for example violence, fits of rage, neglect, endangering dependants, or active thoughts of self-harm, etc.
• If a marked tendency towards risky behaviours is present: Placing oneself or others in dangerous situations in the context of addiction or while under the influence.
• If a pattern of excessive spending is present to finance addictive substance use or behavioural addiction.
• If a marked impulsivity or recklessness is present, especially an inability to abstain from taking a full dose of psilocybin when in possession of the substance.
• If an inability to follow recommendations and instructions is present.

• During detox, in closed-setting treatment, or in mandated treatment, unless your treating team is aware of and explicitly agrees to your microdosing in that context.
• In unfavourable circumstances, such as any life situation that would make preparing, storing, or accurately measuring psilocybin intake difficult.
• With unrealistic expectations, magical-rescue fantasies, or pressure for a rapid fix.
• If a pattern of compulsive herbal or supplement stacking is present.