{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,8,17]],"date-time":"2026-08-17T09:24:55Z","timestamp":1786958695796,"version":"build-2736575974"},"reference-count":89,"publisher":"MDPI AG","issue":"8","license":[{"start":{"date-parts":[[2026,8,14]],"date-time":"2026-08-14T00:00:00Z","timestamp":1786665600000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":["Life"],"abstract":"<jats:p>Clinical trials and naturalistic studies describe psychedelics under markedly different exposure conditions. This narrative review searched PubMed\/MEDLINE, the Cochrane Library, ClinicalTrials.gov, and regulatory sources through 15 July 2026, and examined safety and outcomes across four dimensions of exposure: dose, frequency, person, and context. In screened adults receiving one to three supervised doses, transient headache, nausea, anxiety, and cardiovascular activation are common; serious reactions are uncommon but include persistent anxiety, suicidality signals, and a recent case of hallucinogen persisting perception disorder. Evidence supports MDMA (3,4-Methylenedioxymethamphetamine) -assisted therapy for post-traumatic stress disorder and psilocybin-based interventions for depression, although functional unblinding, selected samples, inconsistent comparators, and a recent negative primary trial constrain certainty. Naturalistic studies suggest that vulnerability and context modify outcomes, but frequency is inconsistently measured and rarely linked to cumulative exposure or long-term health. Short-term microdosing trials show limited benefit, whereas long-term cardiac and psychiatric safety remains unresolved. Exposure-defined cohorts, prospective registries, echocardiographic surveillance, and blinding-aware comparative trials are priorities.<\/jats:p>","DOI":"10.3390\/life16081338","type":"journal-article","created":{"date-parts":[[2026,8,17]],"date-time":"2026-08-17T08:05:41Z","timestamp":1786953941000},"page":"1338","update-policy":"https:\/\/doi.org\/10.3390\/mdpi_crossmark_policy","source":"Crossref","is-referenced-by-count":0,"title":["Psychedelic Safety and Clinical Outcomes Across Exposure Patterns: A Structured Narrative Review"],"prefix":"10.3390","volume":"16","author":[{"ORCID":"https:\/\/orcid.org\/0000-0001-7638-1741","authenticated-orcid":false,"given":"Szabolcs","family":"K\u00e9ri","sequence":"first","affiliation":[{"name":"Szt\u00e1rai Institute, Tokaj-Hegyalja University, 3950 S\u00e1rospatak, Hungary"},{"name":"Department of Physiology, Albert Szent-Gy\u00f6rgyi Medical School, University of Szeged, 6720 Szeged, Hungary"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"1968","published-online":{"date-parts":[[2026,8,14]]},"reference":[{"key":"ref_1","doi-asserted-by":"crossref","first-page":"264","DOI":"10.1124\/pr.115.011478","article-title":"Psychedelics","volume":"68","author":"Nichols","year":"2016","journal-title":"Pharmacol. 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