Akathisia and psilocybin

Hello! My girlfriend recently took 4 mg of psilocybin at the suggestion of her psychiatrist and experienced akathisia. Can you help me figure out what happened and how to prevent in the future?

She is on the following meds:

trazodone 50mg (took night before) spironolactone 150mg (took night before) eletriptan PRN (took 72 hours before) Zyrtec (took night before) lamotrigine ER 400 mg (held night before) vyvanse (only occasional, took 1x a week before) ondansetron (took day of)

had IV ketamine administered by a doctor two days prior.

She has experienced akathisia before in response to compazine, reglan, and haldol which were administered for migraines and they were treated with IV benzos, propanolol, and benadryl.

Yesterday she took .5 of klonipin and it subsided. Akathisia was significant. She could not stop kicking her legs. Had the exact same dose of shrooms a week before with no akathisia. Only thing that was different was she took her lamotrigine the night before that and had not had ketamine tx recently.

Some questions: 1- why did this occur? 2- can she take anything prophylacticly in the future to prevent this adverse effect? 3- if it does happen again, what medications can she take? Would it warrant a trip to the ER?

Her psychiatrist is certain that the psilocybin would help her depression and OCD. She has tx-resistant symptoms that did not respond to any class of meds, including SSRI and she wants to continue (now micro dosing only).