Serotonin toxicity of serotonergic psychedelics
Psychopharmacology July 12, 2021 B. Malcolm, Kelan L Thomas 131 citations
Combining psychedelic substances with common psychiatric medications such as SSRIs carries varying risks of serotonin toxicity, a potentially severe reaction. True serotonin toxicity typically arises only from overdoses or combinations involving a monoamine oxidase inhibitor (MAOI). Serotonergic psychotropics without MAOIs pose low risk when combined with psychedelics that also lack MAOIs. Symptoms that require immediate medical attention include myoclonus, extreme and fluctuating vital signs, agitation or coma, muscle rigidity, pronounced fever, and seizures. The review concludes that some drug combinations present significant risk for serotonin toxicity while others are likely benign, depending on their specific serotonergic mechanisms.