Trip killers: Addressing a critical knowledge gap in psychedelic research

“Trip killers” are widely used but poorly studied, and their actual effectiveness and optimal use remain uncertain, highlighting an urgent need for research and standardised guidance.

In this paper, the authors examined the use of so-called “trip killers” (medications used to stop or reduce psychedelic experiences) and found that there is very little systematic scientific evidence supporting their effectiveness or best use.

They highlight that drugs such as benzodiazepines and antipsychotics are commonly used in clinical and recreational settings to manage difficult psychedelic experiences, but guidance is largely based on anecdote, clinical tradition, and limited data rather than controlled trials.

The paper also emphasises that these medications may dampen anxiety or agitation, but it is unclear whether they truly “terminate” the psychedelic experience or simply reduce distress while the drug continues to act.

“Psychedelic drugs are increasingly under investigation as potential therapeutic agents for mental health conditions and are being increasingly used recreationally. Psychedelic use may result in an episode of intense psychological distress, commonly referred to as a “bad trip.” Bad trips represent a potentially volatile, erratic, and dangerous situation, which may, in extreme cases, require presentation to accident and emergency departments and psychiatric hospital admission.

Managing such cases requires careful consideration, with priority given to non-pharmacological strategies. When these measures prove insufficient, an alternative approach may be necessary, one that can effectively attenuate or terminate the psychedelic state and restore psychological stability. Despite clinical relevance, there is no systematic evaluation of pharmacological interventions to terminate such experiences.

This review identifies and critically appraises candidate medications with potential utility as abortive agents, including serotonin antagonists, drugs for psychosis, and select drugs for anxiety and depression. We review these agents, their mechanisms of action, pharmacokinetics, safety profiles, and applicability in acute care settings. Binding strength at the molecular level, potency to functionally block receptor-mediated effects, and lack of side effects are key considerations.

We conclude by proposing a provisional framework for the pharmacologic management of adverse psychedelic experiences and highlight key priorities for future research.”

O’Mahony B, Harrington C, Harkin A, Lally N. Trip killers: Addressing a critical knowledge gap in psychedelic research. Journal of Psychopharmacology. 2026;0(0). Read Paper

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