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Chemsex, the voluntary use of psychoactive substances to facilitate, initiate, increase, intensify, or prolong sexual intercourse and performance, often involves multiple substance use. These include synthetic cathinones, methamphetamine, ketamine, and cocaine, all of which can induce psychic disorders. The aim of this article is to explore, with the help of a literature review and clinical data from a specialized consultation: 1) The psychiatric complications most frequently associated with chemsex: comedown, psychotic symptoms, and drug addiction. 2) The comorbidities associated with chemsex, in particular the most frequent: depressive and anxiety disorders, and their implications for treatment. 3) The role played by chemsex users’ previous psychiatric problems, if any, in particular the vulnerabilities that may pre-exist substance use and their systemic effects.