However therapeutic DMT may be, it is still a highly potent psychedelic that does cause a range of psychological and physiological changes.

The most common physiological side effects include elevated blood pressure and heart rate, dizziness, lack of coordination, nausea (if DMT is taken as part of ayahuasca), shivering, and potential loss of consciousness. This means that anyone with a heart condition should take high precautions if smoking DMT. Other risks involved here concern the logistics of ingestion: DMT is best enjoyed in a comfortable environment where there is little risk of injury.

As for the psychological effects, DMT can cause intense open-eyed hallucinations, which can completely alter one’s perception of the environment. This can result in heavy confusion, which may escalate into anxiety or panic. The closed-eyed visualizations can also be overwhelming and may cause a feeling of discomfort, fear, or, at the extreme, psychological trauma. In some users, DMT induces a feeling of separation between the mind/soul and the body. Losing this connection can catalyze an incredibly powerful and profound shift in consciousness, but it can also produce symptoms of depersonalization.

Moreover, the same study that found decreased anxiety- and depression-like symptoms in rats that received microdoses of DMT also found increased neuro atrophy, which is not observed in periodic administration of higher doses. More studies are required to determine the risks and benefits of microdosing DMT.

Lastly, the cases where it really might be potentially harmful is when there is interaction with other drugs or substances. Refer to the Pharmacology section of this guide for more information on what to avoid.

To ensure your safety, it’s to always have a sober sitter present. We can’t stress the importance of this enough.