When Psychedelics Go Wrong: Inside Berlin's Specialized Clinic For Psychedelic Side Effects

In Berlin, a unique medical clinic has been quietly addressing the needs of a growing, underserved patient population: individuals experiencing lingering and disruptive effects from psychedelic substances. Known as the Ambulanz Psychedelische Substanzen (Outpatient Clinic for Psychedelic Substances) and based at Charité, one of Germany's most prestigious university hospitals, the clinic was founded by psychiatrist Dr. Tomislav Majić in 2018. As The Guardian reported, since its inception, the clinic has become a rare haven for people suffering from conditions like hallucinogen persisting perception disorder (HPPD), anxiety and derealization after using psychedelics.

The surge in public interest surrounding psychedelics has largely focused on their potential therapeutic benefits. From treating depression and PTSD to aiding end-of-life anxiety, substances like psilocybin, MDMA, and LSD are becoming part of a new frontier in mental health treatment. However, as more people experiment with these substances recreationally or as part of self-exploration, some are left grappling with unexpected and sometimes long-term side effects.

When The Psychedelic Experience Persists

One such patient is James (a pseudonym to protect his privacy), who experienced a profound and distressing shift in his vision after taking psychedelic mushrooms. "I couldn't read the text on my computer screen," James recalled to The Guardian, adding that his entire visual field was filled with static. After seeking help from doctors in London, he found little support. "I was told, ‘This is why we don't do drugs,'" James said. It was clear that traditional medical professionals were not equipped to handle his symptoms.

Like many, James turned to online forums and self-diagnosed himself with HPPD, a condition where visual disturbances persist long after the drug's effects should have faded. Eventually, he found his way to Dr. Majić's clinic in Berlin. There, James received an official diagnosis and, for the first time, felt heard and understood. "The approach was completely different—nonjudgmental and focused on finding solutions," he said, per the outlet.

The clinic treats a wide range of symptoms stemming from psychedelic use. Patients arrive with conditions such as HPPD, depersonalization, psychosis, or even recurring panic attacks triggered by their drug experiences. "There are a lot of patients who suffer from psychedelic-related problems," Dr. Majić said. "They don't have anywhere to go."

The Clinic's Approach

The Berlin clinic operates with a harm reduction philosophy. The staff does not advise patients to stop using psychedelics entirely but rather helps them understand what might have led to their difficulties. By diagnosing the specific issue and offering a combination of medication, psychotherapy and support, they provide critical assistance to those in need. Many patients come to the clinic in search of answers after struggling for months—or even years—with their symptoms. The clinic serves about 10 to 15 patients per month, and Majić has noted the high demand despite no formal advertising.

Psychedelics have different risk profiles than traditional drugs, and while they are not known to be physically addictive or prone to causing overdose, they can lead to challenging psychological experiences. For some, a single difficult trip spirals into lasting mental health issues that they find impossible to shake without proper intervention.

Global Context: Persistent Side Effects

The effects of psychedelics, particularly those that persist long after the trip, are only now gaining attention from researchers. A 2023 study by the Challenging Psychedelic Experiences Project surveyed 608 people about their long-term symptoms after psychedelic use. The findings were startling: about a third of respondents had been dealing with their symptoms for over a year. Emotional difficulties, including heightened anxiety and existential confusion, were common themes.

For some, the aftermath of a psychedelic experience leaves them grappling with existential questions that they struggle to integrate into their daily lives. Richard, another patient of the clinic, developed visual disturbances after using DMT. "I have sensitivity to light, which lingers in my vision like an afterglow," he shared with The Guardian. The anxiety that followed his trip evolved into what Dr. Majić referred to as ontological shock—an overwhelming confrontation with existential thoughts and the nature of reality.

"This type of experience is not a psychiatric disorder," explained Majić, "but it's disruptive, and people find it difficult to make sense of."

Expanding Support Beyond Berlin

While Berlin's psychedelic clinic is one of the few places offering specialized care for these conditions, other resources are emerging. Jules Evans, the director of the Challenging Psychedelic Experiences Project, runs an online peer support group for people dealing with similar issues. Other organizations, like the Fireside Project, offer peer support hotlines. Additionally, groups dedicated to psychedelic integration, which help users process and understand their psychedelic experiences, are growing, though they often lack standardization.

The rise of psychedelics in mainstream consciousness has outpaced the infrastructure needed to support people when things go wrong. Most conventional psychiatrists lack the training to address issues that are not directly related to substance abuse but are tied to a single traumatic drug experience. "People are often told to go to addiction clinics, but that's not the problem," said Majić. "They're struggling with the aftereffects, not continued use."

A Future For Psychedelic Medicine

Despite these challenges, Dr. Majić remains optimistic about the future of psychedelics in medicine. He is also involved in clinical trials studying the use of psilocybin for treatment-resistant depression and 5-MeO-DMT, a powerful psychedelic, for other mental health conditions. "They can be beneficial," he said. "But they're also harmful for some."

Cover image made with AI