Positives

• A 2024 case report documents a 41-year-old woman with severe Long COVID symptoms (anxiety, depression, insomnia, joint pain, cognitive difficulties, headache) who saw 20% improvement after her first psilocybin session, marked improvement after the second (returning to PhD studies and work), and complete remission after a third session following a relapse Wiley.
  
  
• A different Long COVID patient described psilocybin-assisted therapy as moving her mood “from absolute misery to absolute happiness,” with heart rate dropping from severe spikes to mild ones and overwhelming exhaustion stopping TIME.
  
  
• A patient quoted in TIME said she felt “connected to humanity again, having emotions again, experiencing some joy again, and feeling normal,” with cognitive functioning improving dramatically and creativity returning TIME.
  
  

Negatives

• In community discussions across Long COVID forums, roughly 1 in 8 (11.8%) said their Long COVID symptoms got worse after dosing psilocybin, including flares of fatigue and cognitive symptoms PubMed.

Hurdles & Side Effects

• Psilocybin remains Schedule I in the US (with limited carve-outs in Oregon and Colorado for adult-supervised use); access typically requires either a research trial, travel to a legal jurisdiction, or use of underground providers without medical screening PsyPost.
  
  
• Treatment requires 6-8 hour supervised dosing sessions with two-therapist support and weeks of preparation and integration work; underground use carries risks of psychological destabilization, particularly for patients with personal or family history of psychotic-spectrum disorders Frontiers in Psychiatry.