A laboratory-made compound acting on serotonin receptors, producing a roughly eight-to-twelve-hour change in perception, emotion, and sense of self. Strongest evidence: lasting reduction in long-standing anxiety after one or two supervised full-strength sessions, and reduced heavy drinking after a single session. Very small scheduled amounts repeatedly fail to beat dummy treatment. Illegality and unverified supply remain practical limits. (Full Review)
| Marker | Target | Why |
|---|---|---|
| Blood pressure | 110–125 / 65–80 mmHg | Determines tolerance of a several-hour pressor load |
| Resting heart rate | 50–70 bpm | Baseline for the 10–20 bpm acute rise; a high resting rate narrows the reserve |
| 12-lead electrocardiogram (ECG) | Normal sinus rhythm; corrected QT interval under 440 ms in men and 460 ms in women | Detects arrhythmia and conduction abnormality that the acute autonomic load could unmask |
| Transthoracic echocardiogram | No more than trace mitral or aortic regurgitation; no leaflet thickening | The only test that could detect valve change from sustained 5-HT2B receptor activation |
| Alanine aminotransferase (ALT) | 10–26 U/L | Confirms hepatic capacity for a compound cleared entirely by the liver |
| Estimated glomerular filtration rate (eGFR) | Above 90 mL/min/1.73 m² | Establishes clearance capacity for metabolites and general physiological reserve |
| Thyroid-stimulating hormone (TSH) | 0.5–2.0 mIU/L | Thyroid dysfunction mimics both anxiety and depression and must be excluded before attributing symptoms or improvement to the intervention |
| High-sensitivity C-reactive protein (hs-CRP) | Below 1.0 mg/L | Baseline for the speculative anti-inflammatory hypothesis and a general cardiovascular risk marker |
| Prolactin | 4–15 ng/mL in men; 4–23 ng/mL in non-pregnant women | The compound acutely raises prolactin; a baseline distinguishes drug effect from a pre-existing pituitary abnormality |
| CYP2D6 genotype | Normal (extensive) metabolizer status | Poor metabolizer status predicts a longer, stronger exposure from a standard dose |
Cadence: Full baseline panel 1 to 4 weeks before a first session. Full-dose model: blood pressure and heart rate at baseline, hourly during the session, and at the end; clinical review at 1 week and 4 weeks; metabolic and hepatic panel repeated at 3 months if more than one session is undertaken. Repeated low-dose regimen: blood pressure weekly at home, clinical panel at 3 months, echocardiogram at 12 months and then every 12 to 24 months for as long as dosing continues.