Persons With Spinal Cord Injury Report Peripherally Dominant Serotonin-Like Syndrome After Use of Serotonergic Psychedelics

This article discusses the use of psychedelic substances by people with spinal cord injuries (SCI) and a unique set of adverse reactions reported by this group. These reactions include intense muscle spasms, sweating, and tremors, which are not typically reported by people without SCI using the same substances. The authors propose that these reactions may be due to a peripherally dominant serotonin syndrome-like clinical picture, where the increased sensitivity to serotonin caused by the spinal cord injury interacts with the effects of the psychedelic drugs. The study aims to raise awareness about this phenomenon to improve understanding of serotonergic psychedelics in the SCI population and to develop safer treatment protocols for those who choose to use them.

• 1
  Persons with SCI report a consistent pattern of neuromuscular and autonomic hypersensitivity to classical serotonergic psychedelics, including intense muscle spasms, sweating, and tremors.
• 2
  These adverse effects appear to be peripherally dominant, suggesting a serotonin syndrome-like clinical picture that is more pronounced in individuals with SCI due to altered serotonin receptor expression.
• 3
  Online self-reports indicate that individuals with SCI are exploring psychedelics despite experiencing uncomfortable adverse effects, highlighting the need for harm reduction strategies and SCI-specific guidelines.