Clinical trials of psychedelics for neurological and psychiatric disorders have systematically excluded people with past or current seizures, despite a lack of evidence that supervised psychedelic use causes or worsens seizures. No clinical trial or preclinical seizure model has shown that psychedelics induce seizures. This review presents cases where individuals experienced either seizures or seizure remission after psychedelic use, with the overall trend indicating safety in controlled clinical settings. The authors propose future research directions to include this population.
People with spinal cord injury (SCI) who use classical serotonergic psychedelics such as psilocybin and LSD often experience intense muscle spasms, sweating, and tremors, a phenomenon not previously described in academic literature. These symptoms resemble a peripherally dominant serotonin syndrome-like clinical picture and can interfere with any beneficial effects. The authors propose a theoretical framework for this hypersensitivity and call for awareness to guide harm reduction, informed consent, and development of protocols that allow safe use of psychedelic-assisted therapy in this population.