Laboratory and ECG safety review

The manuals converge on routine review of ECG and laboratory data as part of safety monitoring, with attention to clinically meaningful abnormalities that may affect continued participation. Across the extracts, the shared emphasis is on identifying occult medical risk or treatment-emergent changes, then using those findings to inform whether monitoring or participation can continue. They also agree that abnormal findings may need escalation beyond routine review. One source describes repeating abnormal screening tests when permitted and referring clinically significant ECG abnormalities to cardiology, while another describes using cardiologist review to guide continued monitoring decisions when QTc remains prolonged or unstable. The 5-MeO-DMT study similarly frames ECG and laboratory review as part of broader safety assessment alongside symptoms and vital signs. The manuals differ in how specific they are about the data reviewed and the escalation pathway. The esketamine manual names fasting chemistry, hematology, urinalysis, pregnancy testing, and marked abnormalities such as liver enzymes, electrolytes, and hematologic thresholds, whereas the 5-MeO-DMT extract stays more general. The ibogaine extract is the most cardiology focused, centring on QTc prolongation and specialist input, while the esketamine source also includes documentation of clinically relevant changes as adverse events when appropriate.