Potential acute effects and pharmacology of orally administered MDMA and psilocybin
| MDMA30,31 | Psilocybin18,19,48 | |
|---|---|---|
| Potential acute psychological effects | Sense of well-being, relaxation, reduced anxiety, stimulation, euphoria, prosocial effects, heightened introspection, increased self-esteem, reduced fearfulness, increased empathy, altered sense of time, mystical experience | Elevated mood, stimulation, enhanced introspection, illusions, visual perceptual changes, hallucinations (auditory, olfactory, tactile, gustatory, and visual), synesthesia, alterations in sense of time, enhanced feelings of connectedness, anxiety, fatigue, affective lability, mystical experience |
| Potential acute physical effects28,29 | Mydriasis; diaphoresis; increases in blood pressure, temperature, and heart rate; slight impairment in psychomotor performance; dry mouth; jaw clenching; bruxism | Mydriasis, elevated or slowed heart rate, elevated or decreased blood pressure, nausea, increased or decreased tendon reflexes, tremor, dysmetria |
| Most common adverse effects | Anxiety, jaw clenching, muscle tightness, reduced appetite, nausea, dizziness, excessive sweating, restlessness, feeling jittery, blurred vision, pyrexia, irritability, panic attack | Headache, nausea, visual perceptual effects, dizziness, fatigue, euphoric mood and mood alteration, anxiety, and paresthesia |
| Time to peak effects | 1–2 hours | 1–2 hours |
| Elimination half-life | 8–9 hours | 2–3 hours |
| Duration of acute effects | 4–6 hours | 6 hours |
| Primary neurotransmitters affected | Serotonin, norepinephrine, dopamine | Serotonin |
| Metabolism | Primarily hepatic, via cytochrome P450 (mainly CYP2D6) | Rapidly undergoes hepatic first-pass metabolism and dephosphorylation into psilocin (psychoactive metabolite); psilocin then undergoes phase I and phase II (primary) metabolism in the small intestine and liver, with metabolites eventually excreted renally |
MDMA = 3,4-methylenedioxymethamphet amine