Systematic review · 2026
Review of heart valve risks from repeated LSD and MDMA use
- Original title
- Cardiac Consequences Associated with Psychedelic Use: A Systematic Review of Lysergic Acid Diethylamide, 3,4-Methylenedioxymethamphetamine, and 5-Hydroxytryptamine 2B-Mediated Valvular Heart Disease.
- Authors
- Xu T, Wong S, Le GH, et al.
- Journal
- Pharmacopsychiatry, 2026
- Molecules
- LSD, MDMA, Psilocybin
- Conditions
- Other
- Evidence grade
- Low
- Source
- Read the original paper
The question
Could repeated or long-term use of LSD or MDMA damage heart valves by switching on a receptor called 5-HT2B, which is already known to cause valve disease with some other drugs?
What they did
Researchers searched Google Scholar, OVID and PubMed from the databases’ beginnings to June 1, 2025. They looked for studies linking psychedelics or MDMA to activity at the 5-HT2B receptor and to any molecular, cellular, structural or functional sign of heart valve disease. Seventeen studies met their criteria, including laboratory (test tube), animal and human work.
What they found
No studies were found for psilocybin, DMT or mescaline. Both LSD and MDMA bind to the 5-HT2B receptor — LSD with high affinity, MDMA with moderate affinity — and both triggered signalling in valve cells linked to tissue growth and scarring in laboratory work. Animal studies confirmed that serotonin-type signalling can cause valve disease, and long-term MDMA use has been associated with valve abnormalities in people. No clinical cases of LSD-related valve disease have been reported.
The fine print
Most of the evidence is mechanistic — from cells and animals — rather than from people, so it shows a plausible pathway, not proven harm in humans. The human MDMA findings are associations from a small body of work and cannot separate the drug from other factors. The review reports no pooled participant numbers or statistics, and does not address the single or occasional doses used in supervised trials. This summary is based on the abstract only.
What it means
The biology suggests that repeated, sustained exposure to LSD or MDMA could in theory stress heart valves, which is a reason for heart monitoring in psychedelic research rather than evidence that harm has occurred in trial participants.
Evidence grade: Low. A systematic review that pools mostly laboratory and animal studies with very limited human data, and reports no pooled numerical analysis.
This summary is based on the study’s published abstract.