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Psilocybin (4-phosphoryloxy-N,N-dimethyltryptamine) is the principal psychoactive alkaloid of the Psilocybe genus of mushrooms and one of the most clinically researched classic psychedelics. It is itself essentially inactive and functions as a prodrug: after ingestion it is rapidly dephosphorylated by alkaline phosphatase to psilocin, the tryptamine that actually crosses into the brain and drives the experience through agonism at serotonin 5-HT2A receptors. In controlled clinical trials, psilocybin combined with psychological support has shown rapid and sometimes durable antidepressant effects, including a head-to-head study against the antidepressant escitalopram, alongside signals in anxiety, substance use disorders, and end-of-life distress. Neuroimaging suggests its antidepressant action may involve a transient global increase in brain network integration that outlasts the acute drug effect. It is generally physiologically well tolerated, with nausea and headache the most common adverse effects.
- Rapid antidepressant response in supervised clinical trials
- Effects can outlast the acute experience by weeks in responders
- Generally well tolerated with low toxicity and low addiction risk
- Antidepressant response tracks a global increase in brain network integration
- Nausea and headache, usually transient
- Anxiety or distressing experiences without proper support
- Transient rises in heart rate and blood pressure
- Rare suicidal ideation reported, mainly in non-responders
Mechanism
Psilocybin is a with little intrinsic activity at receptors; its effects depend on rapid conversion to psilocin. Following oral ingestion, alkaline phosphatase (and to a lesser degree other enzymes) removes the 4-phosphoryloxy group to yield psilocin (4-hydroxy-N,N-dimethyltryptamine), which is enough to cross the and reach dose-dependent plasma and brain concentrations. Psilocin then acts as an or partial agonist at serotonin receptors, the shared molecular target of the classic psychedelics, with additional activity at 5-HT2C and receptors. Agonism at 5-HT2A receptors on cortical pyramidal neurons alters cortical excitability and large-scale network dynamics, and human arterial spin labeling studies show that psilocin reduces cerebral blood flow and constricts the internal carotid artery, effects blocked by the 5-HT2A ketanserin, confirming the receptor as central to its physiology.
Beyond the acute experience, psilocybin's therapeutic potential is linked to neuroplastic changes. Its active promotes markers of neuronal plasticity, and emerging work implicates additional targets beyond canonical cell-surface signaling, including biased agonism, intracellular 5-HT2A receptor pools accessible to psychedelics, and downstream engagement of neurotrophic pathways. Functional MRI in patients with depression has shown that antidepressant response to psilocybin correlates with decreased brain network modularity, that is, a global increase in network integration and flexibility among 5-HT2A-rich higher-order networks, a change not seen with escitalopram. Psilocin is metabolized through Phase I and Phase II routes, notably glucuronidation to psilocin-O-glucuronide, with an elimination of roughly two to three hours, which accounts for the four-to-six-hour duration of the psilocybin experience.
receptor fingerprint
Alkaline phosphatasesubstrate (dephosphorylation to psilocin)
receptoragonist (via psilocin)
5-HT2C receptoragonist (via psilocin)
receptoragonist (via psilocin)
Safetyrisks and cautions, not medical advice
Contemporary controlled research indicates that psilocybin is generally physiologically safe, with low toxicity and low addictive potential, and serious adverse events are largely avoidable in screened participants within supervised settings. The most common acute effects are transient nausea, headache, anxiety, and increases in blood pressure and heart rate, and challenging psychological experiences can occur that require preparation and support. As a serotonergic agonist it carries the theoretical cardiovascular cautions of the class and should be avoided by people with serious cardiac disease.
It is contraindicated for individuals with a personal or family history of psychotic disorders, and combining it with other serotonergic drugs or monoamine oxidase inhibitors is inadvisable; selective serotonin reuptake inhibitors can blunt its subjective effects. Notably, even in large trials rare cases of suicidal ideation have been recorded, chiefly among non-responders, underscoring that it is not a self-administered treatment. Psilocybin remains a controlled substance in most jurisdictions and is investigational for psychiatric use. Not medical advice.
Subjective profileweighing the evidence above
The best-evidenced classic psychedelic there is, with rapid antidepressant signals in supervised trials, low toxicity and low addiction risk. That evidence comes from screened participants with preparation and integration support, not from a night alone. Not for anyone with a psychosis history.
Resources
No suppliers are provided for compounds like this. This entry is here for reference.
Research
- 2017first citedMetabolism of psilocybin and psilocin: clinical and forensic toxicological relevance
- 2025most recentPharmacokinetics of Psilocybin, a Tryptamine Alkaloid in Magic Mushroom (Psilocybe cubensis): A…
- 1.Psychedelic Therapy: A Primer for Primary Care Clinicians-Psilocybin
- 2.Increased global integration in the brain after psilocybin therapy for depression
- 3.Acute psilocybin and ketanserin effects on cerebral blood flow: 5-HT2AR neuromodulation in healthy humans
- 4.Metabolism of psilocybin and psilocin: clinical and forensic toxicological relevance
- 5.Pharmacokinetics of Psilocybin, a Tryptamine Alkaloid in Magic Mushroom (Psilocybe cubensis): A Systematic Review.
- 6.Emerging mechanisms of psilocybin-induced neuroplasticity
- 7.Possible psychedelic therapeutic mechanism
- 8.Classic Psychedelics for the Treatment of Depression: Potential Benefits and Challenges
- 9.Psychedelics as Medicines: An Emerging New Paradigm
- 10.5-HT2A receptors: Pharmacology and functional selectivity
- 11.Cardiovascular safety of psychedelic medicine: current status and future directions
- 12.Rethinking Therapeutic Strategies for Anorexia Nervosa: Insights From Psychedelic Medicine and Animal Models
12 listed here; entry last updated August 2026
Reviews
My notesprivate to this device
FAQ
Why is psilocybin called a prodrug?
Psilocybin itself is largely inactive at brain receptors. After you ingest it, the enzyme alkaline phosphatase strips off a phosphate group to form psilocin, and it is psilocin that crosses into the brain and produces the psychedelic effects. So psilocybin is really a stable delivery form for psilocin.
How does psilocybin help depression?
In trials, psilocybin paired with psychological support produces rapid and sometimes lasting reductions in depression, and in one study it matched the SSRI escitalopram on the main outcome. Brain imaging suggests the benefit relates to a temporary increase in how flexibly and globally brain networks connect, a change not seen with the standard antidepressant.
How long does a psilocybin experience last?
Effects typically begin within twenty to forty minutes of an oral dose and last about four to six hours, consistent with psilocin's short half-life of roughly two to three hours. Onset is faster on an empty stomach.
Limitations of the evidence
- Effects blunted by concurrent SSRIs
Adverse effects
- Nausea and headache, usually transient
- Anxiety or distressing experiences without proper support
- Transient rises in heart rate and blood pressure
- Rare suicidal ideation reported, mainly in non-responders