A plant brew: one ingredient alters perception and thought, a second keeps it from being broken down in the gut. Its clearest effect is a rapid mood lift in hard-to-treat depression, though a later comparison suggests that shrinks once expectation is accounted for. Vomiting and raised blood pressure are near-universal; serious harm concentrates where screening is absent. (Full Review)
| Marker | Target | Why |
|---|---|---|
| Blood pressure | < 120/80 mmHg | Determines whether the acute 10–25 mmHg systolic rise is safe |
| Resting heart rate | 50–70 bpm | Baseline for the acute heart-rate rise; flags autonomic strain |
| Electrocardiogram, QTc interval | < 440 ms men, < 460 ms women | Excludes the electrical-recovery abnormality behind adrenaline-driven arrhythmia |
| hs-CRP | < 0.5 mg/L | Baseline inflammation; the marker that tracked antidepressant response |
| Serum potassium | 4.0–4.5 mmol/L | Vomiting-driven loss is the main arrhythmia and seizure-threshold risk |
| Serum magnesium (RBC) | 5.0–6.5 mg/dL | Same rationale; red-cell magnesium reflects stores better than serum |
| ALT and AST | < 25 U/L both | Hepatic capacity to clear β-carbolines; screens for occult liver disease |
| eGFR | > 90 mL/min/1.73m² | Fluid and electrolyte handling under vomiting-driven loss |
| Fasting glucose and HbA1c | < 90 mg/dL; < 5.3% | Metabolic baseline; pre-ceremony fasting is poorly tolerated with unstable blood sugar control |
| TSH | 0.5–2.0 mIU/L | Untreated thyroid dysfunction mimics and amplifies anxiety and cardiovascular response |
| CYP2D6 genotype | Normal metaboliser status | Identifies poor metabolisers reaching far higher harmine exposure from the same cup |
| PHQ-9 and GAD-7 questionnaire scores | PHQ-9 < 5; GAD-7 < 5 | The only measures verifying a mood or anxiety benefit |
Cadence: Blood pressure and resting heart rate on session morning and at 24 h; potassium and magnesium at 48 h after prolonged vomiting or a multi-night format; PHQ-9 and GAD-7 at 1 week, 4 weeks, and 3 months; hs-CRP at 4 weeks; liver enzymes, kidney function, and the full panel at 6 to 12 months for anyone drinking more than twice a year.