Benzodiazepines and antipsychotics most often recommended, but few safety warnings on social media

The use of potentially harmful ‘trip-killers’ to cut short ‘bad drug trips’ after taking psychedelics, such as LSD or magic mushrooms, is an emerging concern, warn doctors in a research letter, published online in Emergency Medicine Journal.

Their analysis of relevant threads on the social media platform Reddit, shows that drugs such as benzodiazepines (sedatives) and antipsychotics are the options most frequently recommended, but warnings about their potential side effects are rarely included, they highlight.

The intensity of a psychedelic drug trip can cause distress, agitation, and even psychosis, point out the authors, citing recent research indicating that more than 8% of drug-related attendances at European emergency care departments involve psychedelic drugs.

And this proportion may very well increase as the clinical use of these agents expands, they suggest.

One of the ways to cut short, or lessen the intensity of, a bad trip and avoid potentially requiring hospital treatment, is to take additional mind altering drugs, dubbed ‘trip-killers’. 

Although not new, this option has gained much greater traction on social media in recent years, note the authors, who did a systematic keyword search of Reddit, looking for relevant threads in English to gain a better understanding of trip-killer use.

They found 128 threads created between 2015 and 2023, yielding a total of 709 posts.

Top of the league table, with 440 recommendations, amounting to nearly half (46%) of all the trip-killers mentioned in posts, were various benzodiazepines, followed by several different antipsychotics (171;18%).

One in 10 recommendations were for antidepressants, while 1 in 20 were for alcohol. Opioids, antihistamines, herbal remedies, such as camomile and valerian, and prescribed sleeping pills, attracted 3% each. Cannabis and cannabidiol each took 2% of the vote share.

Trip-killers were mostly discussed in reference to countering the effects of LSD (235 recommendations), magic mushrooms (143), and MDMA, popularly known as ecstasy (21).

Only 58 posts mentioned potentially harmful side effects.

“The popularity of benzodiazepines raises concerns,” write the authors. “Benzodiazepines are addictive and have been repeatedly implicated in overdose deaths. The doses described on Reddit risk over-sedation, hypotension [low blood pressure], and respiratory depression [stopping breathing or shallow breathing],” they point out.

Doses of one of the recommended antipsychotics, quetiapine, were also high (25 – 600 mg), they note, with only a few posts differentiating between fast and slower release formulations.

“Information on trip-killers isn’t available through drug advice services, despite the probable risks they pose,” highlight the authors.


Notes for editors
Research letter: Trip-killers: a concerning practice associated with psychedelic drug use doi: 10.1136/emermed-2023-213377
Journal: Emergency Medicine Journal

Funding: None declared

Link to Academy of Medical Sciences labelling system

Externally peer reviewed? Yes
Evidence type: Observational; data analysis
Subjects: People