Consumption of the hallucinogenic plant Salvia divinorum may be linked to the development of psychotic disorders, according to a review of literature and two original case reports. While hallucinogens typically cause transient psychedelic effects, sometimes these persist and cause distress requiring intervention. The authors hypothesize an association between Salvia divinorum and psychosis, particularly among youth, and recommend that clinicians routinely ask about Salvia use in patients with substance use or psychotic disorders. They call for more research and increased public and medical awareness of this and other emerging drugs.
Recreational use of salvia divinorum, a potent naturally occurring hallucinogen, is increasing internationally despite limited information about its long-term health effects. The substance is readily available and often portrayed as safe and non-addictive. Two patients presented with an enduring and pervasive pattern of salvia use. The authors strongly encourage evaluating patients for salvia use during clinical assessment, especially among young polysubstance users. Clinicians should be mindful of the multifaceted psychiatric effects of salvia, including the potential for a use disorder.