{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,5,28]],"date-time":"2026-05-28T09:02:02Z","timestamp":1779958922906,"version":"3.53.1"},"reference-count":11,"publisher":"Springer Science and Business Media LLC","license":[{"start":{"date-parts":[[2026,5,28]],"date-time":"2026-05-28T00:00:00Z","timestamp":1779926400000},"content-version":"tdm","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0"},{"start":{"date-parts":[[2026,5,28]],"date-time":"2026-05-28T00:00:00Z","timestamp":1779926400000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0"}],"content-domain":{"domain":["link.springer.com"],"crossmark-restriction":false},"short-container-title":["Psychopharmacology"],"abstract":"<jats:title>Abstract<\/jats:title>\n                  <jats:sec>\n                    <jats:title>Background<\/jats:title>\n                    <jats:p>Psilocybin is among the serotonergic psychedelics closest to potential FDA approval, with growing evidence of therapeutic benefit across psychiatric conditions. As clinical trials expand, systematic characterization of adverse events (AEs) remains essential. While transient hypertensive responses are well documented, hypotensive events such as neurocardiogenic syncope (NCS) are rarely reported.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Case presentation<\/jats:title>\n                    <jats:p>We describe a healthy 35\u2011year\u2011old male enrolled in an open\u2011label study investigating psilocybin\u2011evoked changes in brain function during transcranial magnetic stimulation and electroencephalography (TMS\u2011EEG). Approximately 60 minutes after receiving 25\u202fmg oral psilocybin, and shortly after initiation of an eye\u2011open resting\u2011state EEG, he experienced prodromal lightheadedness followed by a brief loss of consciousness and postural tone. Immediate blood pressure was 93\/51\u202fmmHg with tachycardia and diaphoresis. Supportive measures, including leg elevation and oral hydration, led to rapid stabilization, and no further cardiovascular abnormalities occurred. The participant reported an emotionally intense experience, and contextual factors - including upright seated posture, restrictive EEG equipment, and anticipatory anxiety surrounding TMS - may have contributed to heightened autonomic arousal and susceptibility to NCS.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Conclusions<\/jats:title>\n                    <jats:p>This case highlights a rare hypotensive AE during psilocybin administration and underscores the importance of vigilant cardiovascular monitoring, particularly during procedures that may amplify emotional arousal. Given that fewer than one\u2011quarter of contemporary psychedelic trials report systematic AE assessment, transparent documentation of both hypertensive and hypotensive events is critical for defining psilocybin\u2019s safety profile as clinical applications expand.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Parent trial registration<\/jats:title>\n                    <jats:p>Open Label Psilocybin Brain Stimulation and Imaging Pilot Study; ClinicalTrials.gov: NCT06835699. Date registered: 02\/13\/2025. The parent\u2011study consent form explicitly permits publication of de\u2011identified participant data, and separate institutional approval for this case report was obtained (IRB00543773).<\/jats:p>\n                  <\/jats:sec>","DOI":"10.1007\/s00213-026-07079-8","type":"journal-article","created":{"date-parts":[[2026,5,28]],"date-time":"2026-05-28T08:04:28Z","timestamp":1779955468000},"update-policy":"https:\/\/doi.org\/10.1007\/springer_crossmark_policy","source":"Crossref","is-referenced-by-count":0,"title":["Psilocybin-induced neurocardiogenic syncope: a case report"],"prefix":"10.1007","author":[{"given":"Mazen A.","family":"Atiq","sequence":"first","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Eli","family":"Weisman","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Rodrigo B.","family":"Guerra","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Luis Luna","family":"Martinez","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"David B.","family":"Yaden","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Frederick S.","family":"Barrett","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Sandeep","family":"Nayak","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Ceyda","family":"Sayali","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"297","published-online":{"date-parts":[[2026,5,28]]},"reference":[{"issue":"12","key":"7079_CR8","doi-asserted-by":"publisher","first-page":"1099","DOI":"10.1176\/appi.ajp.20250037","volume":"182","author":"AE Downey","year":"2025","unstructured":"Downey AE et al (2025) Sudden loss of consciousness following Psilocybin ingestion. Am J Psychiatry 182(12):1099\u20131100","journal-title":"Am J Psychiatry"},{"key":"7079_CR7","doi-asserted-by":"crossref","unstructured":"Griffiths RR et al (2006) Psilocybin can occasion mystical-type experiences having substantial and sustained personal meaning and spiritual significance. Psychopharmacology 187(3):268\u2009\u2013\u200983 discussion 284\u2009\u2013\u200992","DOI":"10.1007\/s00213-006-0457-5"},{"issue":"22","key":"7079_CR5","doi-asserted-by":"publisher","first-page":"2997","DOI":"10.1161\/CIRCULATIONAHA.104.482018","volume":"111","author":"BP Grubb","year":"2005","unstructured":"Grubb BP (2005) Neurocardiogenic syncope and related disorders of orthostatic intolerance. Circulation 111(22):2997\u20133006","journal-title":"Circulation"},{"issue":"12","key":"7079_CR11","doi-asserted-by":"publisher","first-page":"1225","DOI":"10.1001\/jamapsychiatry.2024.2546","volume":"81","author":"JT Hinkle","year":"2024","unstructured":"Hinkle JT et al (2024) Adverse events in studies of classic Psychedelics: a systematic review and meta-analysis. JAMA Psychiatry 81(12):1225\u20131235","journal-title":"JAMA Psychiatry"},{"key":"7079_CR9","unstructured":"Kabir Nath GG, Englebert L (2026) COMP360 Phase 3 Program topline results COMP005 & COMP006"},{"issue":"8","key":"7079_CR10","doi-asserted-by":"publisher","first-page":"965","DOI":"10.1177\/02698811221084063","volume":"36","author":"EI Kopra","year":"2022","unstructured":"Kopra EI et al (2022) Adverse experiences resulting in emergency medical treatment seeking following the use of magic mushrooms. J Psychopharmacol 36(8):965\u2013973","journal-title":"J Psychopharmacol"},{"issue":"23","key":"7079_CR6","doi-asserted-by":"publisher","first-page":"2898","DOI":"10.1161\/01.CIR.102.23.2898","volume":"102","author":"R Mosqueda-Garcia","year":"2000","unstructured":"Mosqueda-Garcia R et al (2000) The elusive pathophysiology of neurally mediated syncope. Circulation 102(23):2898\u20132906","journal-title":"Circulation"},{"key":"7079_CR1","doi-asserted-by":"publisher","first-page":"61","DOI":"10.1016\/j.euroneuro.2023.07.011","volume":"76","author":"N Perez","year":"2023","unstructured":"Perez N et al (2023) Psilocybin-assisted therapy for depression: a systematic review and dose-response meta-analysis of human studies. Eur Neuropsychopharmacol 76:61\u201376","journal-title":"Eur Neuropsychopharmacol"},{"issue":"1","key":"7079_CR4","doi-asserted-by":"publisher","first-page":"33","DOI":"10.1089\/psymed.2023.0046","volume":"2","author":"JC Strickland","year":"2024","unstructured":"Strickland JC, Garcia-Romeu A, Johnson MW (2024) The mystical experience questionnaire 4-item and challenging experience questionnaire 7-item. Psychedelic Med (New Rochelle) 2(1):33\u201343","journal-title":"Psychedelic Med (New Rochelle)"},{"key":"7079_CR3","unstructured":"University JH Psilocybin brain stimulation and imaging pilot study (OPTE). available from: https:\/\/clinicaltrials.gov\/study\/NCT06835699"},{"issue":"4","key":"7079_CR2","doi-asserted-by":"publisher","first-page":"e245960","DOI":"10.1001\/jamanetworkopen.2024.5960","volume":"7","author":"A Yerubandi","year":"2024","unstructured":"Yerubandi A et al (2024) Acute adverse effects of therapeutic doses of psilocybin: a systematic review and meta-analysis. 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The parent-study consent form explicitly permits publication of de-identified participant data, and separate institutional approval for this case report was obtained (IRB00543773).","order":3,"name":"Ethics","group":{"name":"EthicsHeading","label":"Consent to publish"}},{"value":"The authors have no conflicts of interest to disclose pertaining to this manuscript.","order":4,"name":"Ethics","group":{"name":"EthicsHeading","label":"Conflict of interest disclosure"}},{"value":"The authors declare no competing interests.","order":5,"name":"Ethics","group":{"name":"EthicsHeading","label":"Competing interests"}}]}}