Medical screening and medication review

The manuals converge on the need for careful pre-treatment screening before psychedelic administration, with attention to both medical and psychiatric suitability. Across the extracts, this includes reviewing medical history, current and recent medications, baseline physical or laboratory assessment, and identifying contraindications or conditions that make treatment unsafe or unsuitable. Several sources also emphasise coordination around medication changes, including washout or tapering, and review of concomitant medicines to reduce interaction risk. They also agree that psychiatric risk matters in screening, but the emphasis varies by manual. The LSD and 5-methoxy-N,N-dimethyltryptamine extracts focus on excluding psychotic and bipolar disorders, assessing family history, and considering suicidality or other comorbidities that increase risk. The LSD psychotherapy and MDMA-assisted therapy sources place particular weight on medication transitions, including antidepressants, anxiolytics, and prior SSRI exposure, while the ibogaine guidance broadens the history-taking to substance use, overdose and withdrawal history, and a wider set of organ-system risks. Sources differ most in how specific and how broad their screening scope is. Some manuals are tightly protocol-based, such as the LSD-assisted psychotherapy trial, which names ECG, metabolic profile, thyroid status, liver function, and medication washout timing. Others are more general, such as the 1964 LSD text, which mainly frames candidate selection around non-psychotic functional psychiatric disorders.