People’s Pharmacy | Could the hallucinogen psilocybin prevent cluster headaches?
Q. A doctor prescribed high-dose verapamil daily to prevent horrible cluster headaches. I’ve been taking it for the last eight years with great success but some undesirable side effects. Another option would be very welcome.
Several years ago, one of my sisters sent me an article you wrote suggesting that psilocybin might reduce cluster headaches. Is there any more research about this use? Any information will be helpful.
A. Cluster headaches consist of intense, usually one-sided pain that is excruciating. Worse, they repeat in cycles. As a result, anticipation of pain starting up again poisons even the time between headache episodes. Verapamil is used off label as a preventive measure, but it takes two or three weeks to kick in (Headache, Sep. 2025).
Danish researchers conducted a small study (11 volunteers) to test whether psilocybin could improve sleep in people with chronic cluster headache (Journal of Psychopharmacology, May 29, 2026). Such individuals don’t sleep well. They slept better after taking psilocybin once a week for three weeks, but we don’t know whether psilocybin actually improved their cluster headaches.
A separate review of the research concluded that low doses might be helpful: “While available studies on psychedelics suggest potential benefit in cluster headache and migraine, access remains complex due to legal considerations, and additional studies are needed to confirm their effectiveness and to ensure safety before they can be recommended for use.” (Current Neurology and Neuroscience Reports, Aug. 9, 2025).
Q. I am concerned about lead in psyllium products. How much is present, and how much can be tolerated?
A. Psyllium is a fiber product derived from the plant Plantago. People often take it to promote regularity (think Metamucil) or to lower cholesterol. You have identified one important drawback, however. Many psyllium supplements contain some lead, a toxic heavy metal. No known level is safe, although the FDA recommends limiting intake to 8.8 micrograms/day for women of childbearing age.
When ConsumerLab.com analyzed psyllium products, four out of nine had excess lead. They found that Organic India Psyllium Whole Husk Fiber had very little lead. To review the rest of the results, you need a subscription.
Q. I cannot sleep without a high dose of Ambien (zolpidem), which I’ve been taking for years. I don’t nap during the day. When Ambien stops working, as it occasionally has, I sometimes stay awake for six or seven days straight.
I now take zolpidem and trazodone at bedtime along with NyQuil Severe Cold & Flu. This combination works most nights, and I do not wake for six or eight hours. I remain exhausted most days but at least I am sleeping.
A. We’re not surprised that you feel exhausted during the day. The combination of sedating medications you are taking is worrisome.
Trazodone is a sedating antidepressant. It has never been approved for insomnia, but we suspect that many doctors prescribe it for sleeping problems.
The NyQuil formulation you take contains the antihistamine doxylamine. It has sedating properties. That makes three medications that can cause drowsiness. That could account for your next-day exhaustion.
You might want to consider alternatives to help you sleep. We discuss several options in our eGuide to Getting a Good Night’s Sleep. This online resource may be found under the Health eGuides tab at www.PeoplesPharmacy.com. Some suggestions include guided meditation, a hot shower before bed and natural approaches such as magnesium, tart cherries, acupressure or herbal remedies.
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In their column, Joe and Teresa Graedon answer letters from readers. Write to them in care of this newspaper or e-mail them via their Web site: www.peoplespharmacy.com. Their newest book is Top Screwups Doctors Make and How to Avoid Them (Crown).