Sorcery, black magic, and supernatural harm are central to many Amazonian shamanic traditions, yet their role in contemporary Western psychedelic culture has received little systematic empirical attention. Ethnographic work suggests that Western participants in ayahuasca tourism often downplay indigenous sorcery frameworks in favour of psychological or therapeutic interpretations of difficult experiences. Yet, anecdotal reports indicate that some participants leave ceremonies convinced they have been subjected to shamanic attack or supernatural harm. No quantitative study has examined the prevalence of such beliefs and experiences, the conditions under which they arise, or their implications for participant welfare in ceremonial settings. This study addresses that gap through a cross-sectional, retrospective, anonymous online survey of adults with personal, professional, or cultural involvement in psychedelics. Participants were recruited through psychedelic community networks and harm reduction organisations, including ICEERS, Chacruna, the Challenging Psychedelic Experiences Project, and the Fireside Project. The final analytic sample comprised 895 participants with at least one lifetime psychedelic experience. We aim to estimate the prevalence of beliefs in supernatural harm among Western psychedelic users; examine whether psychedelic experiences and immersion in psychedelic culture are associated with shifts in such beliefs; characterise experiences interpreted as black magic or supernatural harm; assess whether facilitator authority and fear of magical retaliation inhibit criticism of ceremonial leaders; and compare these patterns between those who regularly participated in ayahuasca ceremonies and the rest of the sample. The findings aim to inform both research on psychedelic-induced belief change and harm reduction frameworks in ceremonial settings.

Background As interest in psychedelics grows, concerns remain about ethical use and the documentation of adverse psychological effects. Use is increasing, yet long-term challenges - particularly among adolescents and young adults - are under-researched. This group is especially vulnerable, highlighting the need to understand how psychedelic-related challenges are experienced in naturalistic contexts. Methods This qualitative study used reflexive thematic analysis to explore the experiences of ten individuals aged 15–25 following challenging psychedelic episodes with extended difficulties lasting longer than a day. In-depth semi-structured interviews were conducted to examine themes around psychedelic integration, emerging adulthood, support-seeking strategies and available education about harm reduction strategies. Results Participants reported a range of emotional, cognitive and relational difficulties, as well as diverse strategies for making sense of their experiences. Key themes included the importance of preparation, supportive relationships and developmentally appropriate integration. Conclusions Findings underscore the need for age-specific harm reduction and integration services. Improved safety protocols and psychoeducation could help reduce long-term distress and support more ethical use of psychedelics in clinical and informal settings.

Background . It is widely accepted that beyond the pharmacological predictors, individuals’ pre-drug mental disposition, including intentions , influences the psychedelic experience. However, is it not fully clear how intentions and outcomes relate. This study explores the intention qualities beyond classically assessed category and explicitness in association with outcomes. Methods . Assessed retrospective self-report data ( N = 296) based on participants’ most recent experience involving a high dose of long-acting classical serotonergic psychedelics included intention ritualisation, perceived purity, exogeny (external origin), endogeny (internal origin), and centrality (the role of intention within the psychedelic experience). Assessed outcomes included perceived realisation and significance, occurrence of mystical-type and challenging experiences, emotional breakthroughs, and connectedness. Results . Ritualisation, perceived purity and centrality appeared to be largely associated with what could be considered positive outcomes, both in terms of perceived realisation and significance and acute psychedelic outcomes. In comparison to these, endogenous versus exogenous origin of intention appeared to matter less except for intentions which were defined with the help of meaningful others predicting higher emotional breakthrough scores. Conclusions . Results support the idea that ritualisation, perceived purity and centrality of intentions are associated with positive outcomes. These results may be useful to consider within the preparation for psychedelic experiences across all settings.

As psychedelic use increases and integrates with mainstream medicine, understanding the prevalence and nature of postpsychedelic adverse outcomes is critical. We investigated extended difficulties after psychedelic use via the Global Psychedelic Survey (GPS) 2025, which is a multilingual online survey of people who have used psychedelics. Data on the prevalence, characteristics, and associations of retrospectively reported extended difficulties was gained from N = 6,476 participants. The most common difficulties reported were existential struggle (36.6%), depression (34%), and derealization (29.4%). Existential struggle was rated as the most severe difficulty, but also the one contributing most to healing. Overall, 48.3% of participants reported one or more difficulties lasting 24 hours or more, and 9.9% experienced difficulties for over a year. Clinically relevant disruptive difficulties (defined as leasting at least a month that caused disruption to daily life) were reported by 8% of the sample and were associated with younger age at the time of survey and at first psychedelic use, lower income, lack of family support, lower emotional stability/conscientiousness/agreeableness, higher pre-existing anxiety/depression, and using psychedelics to treat mental health conditions. The results underscore the necessity for evidence-based education on the potential risks and benefits of psychedelics, robust safety guidelines in clinical psychedelic interventions, and additional services for those experiencing post-psychedelic extended difficulties.

Background Psychedelic consumption in naturalistic settings is rising, and a significant minority of users experience extended psychological difficulties. Yet, research exploring these challenges remains limited. Despite widespread endorsement of integration practices, little is known about how therapists approach integration for heterogeneous extended difficulties. Methods Nineteen therapists with experience supporting post-psychedelic extended difficulties participated in semi-structured interviews. Data was analysed using reflexive thematic analysis to identify core integration strategies and map symptom-specific adaptations. Results Nine themes of integration strategies were identified, organised into two therapeutic phases: stabilisation (grounding, psychoeducation, clinical safety) and processing (therapeutic alliance, client-led meaning-making, biographical contextualisation, symbolic framing and tolerance of uncertainty, pacing, and somatic anchoring). For each theme, symptom-specific adaptations were identified for six common post-psychedelic presentations. For ontological shock therapists emphasised somatic grounding to counter “philosophical spiralling” alongside client-led meaning-making. For anxiety, symptoms were framed as adaptive nervous-system responses requiring careful client-paced engagement. For dissociative symptoms, therapists prioritised safety planning to support daily functioning and approached traumatic content slowly and carefully. For self-perception disturbances, (ego inflation or deflation) therapists encouraged metaphorical exploration of psychedelic content. When resurfaced traumatic material, therapists highlighted memory fallibility and facilitated gradual exposure to reduce re-traumatisation. For disappointment and unmet expectations, therapists used retrospective psychoeducation and explored links to recurring patterns of unmet expectations. Conclusions Findings offer practice-informed insights into how therapists tailor integration across diverse presentations. These non-prescriptive findings represent a preliminary contribution to an emerging area of research. As psychedelic use expands outside of clinical trials, further development of clinical guidance, training, and service pathways is essential to support individuals experiencing post-psychedelic extended difficulties.

While profound psychedelic and other exceptional experiences are often reported as the most profound events in experiencers’ lives, these events can be difficult to process and transmute into positive outcomes such as improved wellbeing and prosocial behaviour. Existing models of how these experiences are processed tend to present a single, linear pathway. To update and expand existing models of psychological processing following psychedelic and other exceptional experiences, 17 semi-structured experiencer interviews were conducted and analysed using reflective thematic analysis and transpersonal methods. A pathway framework prototype was identified from the data, including four distinct processing patterns: Challenging, Deep Surrender, What Goes Up, and Slow Flow. Implications of this four-pathway framework are considered for experiencers and helping professionals, along with suggestions for future research. Key recommendations include more research into the nuances and predictors of processing pathways and taking a longer view of the time it takes to process and integrate psychedelic and other exceptional experiences.

Background Psychedelic substances are increasingly used outside clinical trials, yet individuals seeking support after challenging experiences often report that available services are inadequate or misaligned with their needs. While prior research documents both beneficial and adverse outcomes of naturalistic use, less is known about how such experiences are received and interpreted within routine psychotherapeutic care. Methods We conducted semi-structured interviews with 48 adults reporting significant psychological or functional difficulties following naturalistic psychedelic experiences, of whom 35 had subsequently engaged with professional psychotherapy and formed the analytic sample for the present study. Data were analyzed using reflexive thematic analysis, informed by a phenomenological epistemology, with attention to participants’ accounts of therapeutic encounters, meaning-making processes, and trajectories of distress and recovery. Results Four interrelated themes were identified. Participants described: (1) therapeutic encounters experienced as misaligned or invalidating, characterized by reductionist or pathologizing interpretations; (2) unmet needs for therapeutic knowledge and relational competency regarding altered states, ontological ambiguity, and non-linear change; (3) the development of self-directed or informal support strategies when professional care was perceived as unavailable or unsafe; and (4) temporal mismatches between participants’ recovery trajectories and clinicians’ expectations of symptom stabilization. Across accounts, these dynamics frequently co-occurred with concealment of distress and erosion of therapeutic trust; delayed help-seeking was described by a smaller subset of participants, primarily those who reported shame or anticipated incomprehension as barriers to accessing care. Conclusions Findings highlight structural and epistemic tensions between dominant mental health frameworks and the forms of distress reported after challenging psychedelic experiences. Rather than isolated clinical failures, participants' accounts suggest systemic mismatches across ontological, temporal, and relational dimensions. These findings contribute to the emerging concept of "psychedelic-informed therapy" — a clinical orientation that may help mental health professionals work with clients who have had psychedelic experiences outside clinical settings. The themes identified point toward competencies including ontological flexibility, temporal sensitivity, and attention to the relational dynamics of disclosure and concealment, though further research is needed to develop and evaluate these as formalized clinical practices.

Accumulating psychedelic research has demonstrated a potential for improving mental health and wellbeing, yet studies in the context of eating disorders (EDs) are limited. This study aims to explore the subjective effects of psychedelic experiences to gain insight into the benefits and risks for people with EDs. Semi-structured interviews were conducted with eight adults aged 25–54 (mean age = 36.9), reporting to have had experiences with EDs and psychedelics in both naturalistic and clinical settings. Participants had multiple diagnoses and suffered chronic EDs, (mean age of onset = 13), diagnosed (N = 7) and undiagnosed (N = 1). Reports of cessation or the reduction of ED symptoms were unanimous and long-lasting for seven, with two participants reporting recovery attributed to psychedelic use. Two participants reported relapsing, attributed to environmental factors in the months following. Thematic analysis resulted in two superordinate themes, each comprising three subordinate themes. The first superordinate theme, ‘Exploring’ via the ‘gateway to healing’, illustrates mental, emotional, and transcendental elements of psychedelic experiences. The second superordinate theme, ‘Transformation’ and being ‘able to do the work’, illustrates cognitive and behavioural outcomes, with retrospective safety perceptions. These findings may provide more in-depth information on what benefits and experiences people with EDs can obtain from the use of psychedelic drugs and may inform more robust investigations of psychedelic-assisted therapy for the treatment of EDs.

Objective This article outlines recommendations from 30 psychedelic researchers on how to create a better psychedelic safety net. Methods A survey of 30 psychedelic researchers asked them to identify key critical research gaps around psychedelic harm and safety. Results The critical research gaps identified by the authors included defining the main types of psychedelic harm, the predictors of those harms, and the most effective way to treat those harms. They also call for better support for those experiencing post‐psychedelic difficulties, including better online information, peer support groups, affordable therapy, and psychiatric consultation and medication. Finally, the authors call for better funding to create a psychedelic safety net, and suggest psychedelic philanthropists, investors and companies could commit 1% of their investment in psychedelics into supporting safety measures such as research and support services. Conclusions The authors identify several practical steps to create a better psychedelic safety net and call for more funding to psychedelic safety measures such as research and support services. Relevance to clinical practice The authors outline important gaps in our knowledge around the safety and risk profile of psychedelic medicines and identify practical steps forward for researchers and clinical practitioners to make this promising field safer.

Background and Aims This naturalistic mixed methods field study, aimed to assess the potential of a psilocybin induced experience, to help Emergency Medical Service Workers (EMSW) to address psychological and stress related symptoms stemming from a challenging working environment, known to contribute to occupational burnout (OB). Methods This exploration was conducted with an intentional sample of five participants, recruited through an online survey who self-administered a therapeutic dose of psilocybin mushrooms to manage psychological symptoms resulting from their work as EMSW, allowing the authors to assess the outcome. To measure the impact of the experience, changes in OB measures were assessed with psychometric instruments previously used in this population at three timepoints, before and after the session. The subjective impact of the psychedelic experience, through psychological insights and emotional breakthroughs, was also assessed, and two follow-up interviews were conducted to collect further data. Results The results showed that, two weeks after the session, a visible improvement was noticed in several measures of pre-existent OB, that remained stable after two months. Additionally, most participants reported a strong subjective impact, that they perceived as fundamental for the positive outcome. Conclusions After one therapeutic psylocibin session, several measures of OB showed an encouraging level of improvement and may constitute an important step towards finding alternative and innovative solutions to address high rates of psychological distress experienced by EMSWs, also benefiting the organization and the quality of patient care. The limitations and implications of the study and suggestions for future research are discussed.

IntroductionClassical near-death experiences (NDEs) refer to states of disconnected consciousness characterised by a range of features occurring in the context of being close to death. Various psychedelic substances, such as N,N-dimethyltryptamine (DMT), consistently replicate NDE features and may be considered ‘near-death-like experiences.’ However, a systematic qualitative analysis comparing the specifics of content with the broader themes of both psychedelic and NDEs has yet to be conducted.MethodsWe report the third thematic and content analysis of the DMT experience from a naturalistic field study, focusing on themes related to death and dying. Based on 36 semi-structured interviews, this analysis is then directly compared, qualitatively and in terms of content frequency, with a novel extension of a previous thematic analysis of 34 written NDE narratives.ResultsThe ‘canonical NDE themes’ identified across the DMT experiences included Translocation, Bright Light(s), Sense of Dying, The Void, Disembodiment, Tunnel-like Structures, Light Being-esque Entities, Deceased Family, Life Review-like, and Hyper-empathic Experiences. A total of 95% of participants reported at least one of these. Twelve ‘less typical NDE motifs’ were also noted. Five classical NDE features were entirely absent from DMT, while DMT exhibited an even broader array of experience features that were absent from NDEs. DMT clearly shares a more basic phenomenological structure with NDEs but shows differences in the prevalence of certain features. Furthermore, DMT did not present any immediately recognisable linear sequencing of themes. Overall, DMT is distinctly unique in its qualitative content, characterised by its more prodigious and stereotypical nature, which includes kaleidoscopic, extraterrestrial, transcultural, fluctuating, and overwhelming elements.DiscussionWhen examining the comparability between DMT and NDEs at a fundamentally more nuanced level of qualitative content (as opposed to broad themes or questionnaire items), the two experiences clearly diverge. However, a minority of NDEs, which are themselves unique, do share significant content with DMT. Taken together, DMT could be considered an ‘NDE-mimetic.’ The weaker comparability is likely due not only to differences in context but also to the complex neural processes occurring near death, in which endogenous DMT may only play a small role. In light of this level of parallelism with NDEs, some potential clinical applications of DMT are also discussed.

Psychedelics are undergoing a clinical research renaissance, with compounds such as psilocybin advancing to Phase 3 trials for treatment-resistant depression and receiving fast-track or breakthrough designations from regulatory agencies. Despite this progress, the field lacks standardized terminology to guide clinical development, dosing, safety monitoring, and regulatory classification. Here, we present a comprehensive framework for psychedelic nomenclature based on pharmacology, subjective effects, dosing, and therapeutic use. A pharmacological classification system is described, encompassing serotonergic, glutamatergic, kappaergic, GABAergic, and atypical psychedelics. Dose-dependent categories—microdose, minidose, mididose, and macrodose—are introduced to standardize the description of dosing levels and intended subjective effects. We also standardize vague terms like “short-acting” or “long-acting” with specific pharmacokinetic parameters, including route, onset, and duration of action. Safety considerations are also explored, particularly cardiovascular and psychological effects, and we discuss the need for risk mitigation protocols in higher-risk compounds like ibogaine. The evolving role of psychotherapy in psychedelic treatment is also examined, proposing terminology to distinguish between “psychedelic therapy” and varying levels of psychological support. A three-phase treatment model—preparation, dosing, and integration—is recommended as a minimum standard for safe and effective care. The lack of comparative research on psychotherapy modalities in psychedelic therapy is identified as a critical gap. Ultimately, a standardized lexicon and clinical framework will support clearer communication, improved trial design, and more equitable access as psychedelic therapies move toward widespread clinical use.

Psychedelic induced mystical experiences have been largely assumed to drive the therapeutic effects of these substances, which may in part be mediated by changes in metaphysical beliefs. However, there is growing evidence that psychedelic experiences can also trigger long lasting distress. Studies of persisting difficulties suggest a high prevalence of ontological challenges (related to the way people understand reality and existence). We conducted semi-structured interviews with 26 people who reported experiencing existential distress following psychedelic experiences. We explored the phenomenology of participants' difficulties and the ways they navigated them, including what they found helpful and unhelpful in their process. Thematic analysis revealed that participants experienced persistent existential struggle, marked by confusion about their existence and purpose and preoccupation with meaning-making. Along with cognitive difficulties stemming from the ungrounding of their prior frameworks for understanding, participants' ontologically challenging experiences also had significant emotional, social, bodily and other functional impact. Participants managed to alleviate their distress primarily through 'grounding': practices of embodiment and the social and cognitive normalisation of their experience. Our findings suggest that psychedelic experiences act as pivotal mental states that can facilitate transformative learning processes, challenging and expanding the ways individuals make meaning. This research contributes to the growing field of psychedelic integration by exploring the complex pathways through which people reestablish coherence and grow following ontologically challenging psychedelic experiences.

The authors would like to make the following corrections to this published paper [...]

IntroductionA growing body of literature is investigating the difficulties that some individuals encounter after psychedelic experiences. Existing research has explored the nature and predictors of these difficulties; however, a research gap exists in understanding how individuals endeavour to cope with such difficulties.MethodsThe current study collected data from an international cohort of 608 participants who reported experiencing difficulties that persisted for at least one day after a psychedelic experience. They provided written data on how they used coping strategies to alleviate these difficulties. The qualitative analysis of the written data on coping was conducted using Structured Tabular Thematic Analysis.ResultsA wide range of individual and social coping strategies were employed that were found helpful. The most common individual strategies were meditation and prayer, followed by self-educational activities such as reading and journaling. The most prevalent forms of social coping involved seeking support from friends or family members, followed by obtaining assistance from a therapist or coach. Features of social coping that were reported to be helpful included feeling heard/accepted, a non-judgemental attitude and sharing similar experiences.DiscussionOur findings hold potential for informing the design of therapeutic interventions and educational resources aimed at enhancing positive outcomes for those experiencing extended difficulties after psychedelic use.

Psychedelic drugs show promising therapeutic potential; however, some users experience extended difficulties following their use. This study investigated the prevalence, severity, duration, and associated coping strategies of post-psychedelic difficulties. We conducted an online survey of 159 participants, all of whom reported experiencing difficulties lasting more than one day after psychedelic use within the past 2-10 years. Participants rated the severity and duration of 11 types of difficulties and indicated effective coping strategies. Results revealed that social disconnection (72%), anxiety and panic attacks (68%), and existential struggle (65%) were the most prevalent difficulties. Anxiety and panic attacks were rated as most severe, while existential struggle and diminished self-esteem persisted the longest, with mean durations exceeding 15 months. Derealization and depersonalization, despite being common, were consistently rated as less severe than other difficulties. Self-education emerged as the predominant coping strategy for multiple difficulties, including social disconnection and existential struggle. Professional therapy was most effective for depression and diminished self-esteem, while peer and family support were particularly beneficial for managing anxiety and panic attacks. These findings highlight the diverse nature of post-psychedelic difficulties and the varying effectiveness of different coping strategies. Our results contribute to the development of more nuanced, effective approaches to harm reduction and integration in psychedelic use, emphasizing the importance of multifaceted support systems that include professional, educational, and community-based resources.

Recent theoretical work embedded within the predictive processing framework has proposed that the neurocognitive and therapeutic effects of psychedelics are driven by the modulation of priors (Carhart-Harris & Friston, 2019). We conducted pre-registered re-analyses of previous research (Yanakieva et al., 2019) to examine whether microdoses of lysergic acid diethylamide (LSD) alleviate the temporal reproduction bias introduced by priors, as predicted by this theoretical framework. In a between-groups design, participants were randomly assigned to one of four groups receiving LSD (5, 10, or 20 μg) or placebo (0 μg) and completed a visual temporal reproduction task spanning subsecond to suprasecond intervals (0.8 to 4 sec). Using mixed-effects modelling, we evaluated the impact of the treatment group, and of the overall history of stimulus intervals ( global priors) and the local stimulus history ( local priors), weighted by their respective precision weights (inverse of variance), on temporal reproduction. Our principal finding was that the precision-weighted local priors and their precision weights reduced the under-reproduction bias observed under LSD in the original research. Furthermore, controlling for the precision- weighted local prior eliminated the reduced temporal reproduction bias under LSD, indicating that LSD microdosing mitigated the temporal under-reproduction by reducing the relative weighting of priors. These results suggest that LSD microdosing alters human time perception by decreasing the influence of local temporal priors.

Long-term adverse experiences following psychedelic use can persist for weeks, months, or even years, and are relatively unexplored in psychedelic research. Our convergent mixed-method study gained quantitative and qualitative data from 608 participants who reported extended difficulties following psychedelic experiences. Data was gathered on the context of use, the nature and duration of the challenges they experienced (including a written description of these), plus a range of possible risk factors and perceived causes. The most common forms of extended difficulty were feelings of anxiety and fear, existential struggle, social disconnection, depersonalization and derealization. For approximately one-third of the participants, problems persisted for over a year, and for a sixth, they endured for more than three years. It was found that a shorter duration of difficulties was predicted by knowledge of dose, drug type and lower levels of difficulty reported during the psychoactive experience, while a narrower range of difficulties was predicted by taking the drug in a guided setting. Implications for psychedelic harm reduction are discussed.

IntroductionN,N-Dimethyltryptamine (DMT) is an endogenous serotonergic psychedelic capable of producing radical shifts in an experience that have significant implications for consciousness and its neural correlates, especially given the “disconnected consciousness” suggested by the “breakthrough” DMT state. Its increasing usage and clinical trial indicate the growing importance of a thorough elucidation of the experience's qualitative content, over and above the phenomenological structure. This is particularly in light of the intensely pervasive effects of DMT occasions in all dimensions of the self, which are often ontologically challenging yet potentially transformative.MethodsThis is the second report on the first naturalistic field study of DMT use exploring its qualitative analysis. Screened, healthy, anonymized, and experienced DMT users were observed during their non-clinical use of the drug at home (40–75-mg inhaled). In-depth semi-structured interviews, inspired by the micro-phenomenological technique, were employed immediately after their experience. This study reports on the thematic and content analysis of one major domain of the breakthrough experiences elicited, the “self”; where analyses of the “other” were previously reported. A total of 36 post-DMT experience interviews with mostly Caucasian (83%) men (eight women) of a mean of 37 years were predominantly inductively coded.ResultsInvariably, profound and highly intense experiences occurred. The first overarching category comprised the onset of effects, encompassing super-ordinate themes including sensory, emotion and body, and space-time shifts; the second category comprised bodily effects, encompassing themes including pleasurable, neutral/both, and uncomfortable; the third category comprised the sensorial effects, encompassing open-eye, visual, and cross-modal and other; the fourth comprised the psychological effects, encompassing memory and language, awareness and sense of self, and time distortions; and the fifth comprised the emotional effects, encompassing positive, neither/both, and challenging experiences. Many further subthemes also illuminate the rich content of the DMT experience.DiscussionThe present study provides a systematic and nuanced analysis of the content of the breakthrough DMT state pertaining to one's personal and self-referential experiences of the body, senses, psychology, and emotions. The resonances both with previous DMT studies and other types of extraordinary experiences, such as the alien abduction, shamanic and near-death experiences, are also elaborated upon. Putative neural mechanisms and their promise as a psychotherapeutic agent, especially owing to deep emotional impact, are discussed.

Introduction:Much research has focused on the modeling of the near-death experience (NDE) by classical and atypical psychedelics; however, to date, no study has reported on the relationship between the NDE and the experience induced by the highly potent, endogenous psychedelic drug 5-Methoxy-DMT (5MeO-DMT). This article presents a case study of an individual who is popularly documented to have had a profound near-death experience while in a coma caused by bacterial meningoencephalitis. Additionally, the individual also subsequently underwent an experience with 5MeO-DMT.Methods:A semi-structured interview was conducted with the subject concerning his experiences with both the NDE and 5MeO-DMT. A basic thematic analysis was performed on both the original text describing the NDE as well as the interview itself, which mainly focused on the subject's experience with 5MeO-DMT. This analysis was organized to identify both the similar and different emergent themes between the two states, with a particular emphasis on the subject's perceptions of the similarities and differences between the experiences.Results:There is a very high level of comparability between the original NDE and psychedelic experiences in general, including shared characteristics such as entering other worlds, meeting menacing or benevolent entities, experiencing synesthesia, perinatal regression, and lucid dreamlike properties. Much comparability was also identified with the 5MeO-DMT experience, in particular the major mystical experiential domains, such as ego dissolution, but especially transcendence of time and space. However, there were also a few unique themes (life review, the deceased, and the threshold) that emerged in the NDE that were not present in the 5MeO-DMT experience or other psychedelic experience studies, suggesting that these themes may be more unique to the NDE.Discussion:Despite such similarities, the participant asserted that his NDE and psychedelic experiences were not similar enough to be attributed to endogenous psychedelics. In this study, we discussed several mechanisms that could potentially account for the NDE, including lucid dreams and perinatal regression. However, the study also explored the possibility that the unique etiology of the participant's NDE, bacterial meningoencephalitis affecting the neocortex, may have triggered similar downstream neural activity as that initiated by psychedelic agents through pyramidal neuronal activation. This hypothesis is presented with appropriate caveats and acknowledged as speculative.