Special-interest adverse event vigilance

The manuals converge on active vigilance for psychedelic-related adverse events during and after treatment, with repeated emphasis on hallucinations, psychotic symptoms, dissociation, mood alteration, cognitive disturbance, and other acute psychological or perceptual changes. Several sources also stress that adverse events are not limited to the dosing session, because lingering or delayed effects can emerge later and require follow-up monitoring and documentation. They also agree that safety events need prompt escalation and structured reporting. Across the extracts, the manuals recommend documenting onset, duration, dose, severity, and outcome, and they differ mainly in the level of specificity attached to reporting. Some protocols name immediate sponsor notification within 24 hours and follow-up until resolved or stable, while others describe broader clinical escalation, team communication, or referral to a study psychiatrist. The main differences are in the kinds of special-interest events each manual highlights. The psilocybin protocols focus most explicitly on neuropsychiatric reactions and persisting perceptual symptoms, the MDMA protocol adds cardiac, suicidality, and abuse-related concerns, and the BPL-003 report highlights delayed psychiatric sequelae such as HPPD and PTSD symptoms. The ayahuasca, LSD, and ibogaine sources are less specific, but still converge on close observation, acute distress monitoring, and readiness to respond to instability or adverse reactions.