ReviewPsychopharmacology2022
Serotonin toxicity of serotonergic psychedelics.
Review in Psychopharmacology, 2022. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 48 papers, 3 of them syntheses that pooled it.
What it found
Each row is one number read from the abstract, on the scale the paper reported it, with its interval. Left of the dashed line favours the treatment, right favours the comparator. Under each row is the sentence it came from. New to these charts? A ten-minute tutorial.
The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.
The trial behind it
Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.
Neither the registry nor the abstract names a trial number. If this is a trial report, that itself is worth knowing.
Who cites it
48 citing papers in PubMed, 3 syntheses or guidelines pooled it, 130 citations in OpenAlex.
- The Use of Psychedelics in the Treatment of Adult ADHD: A Systematic and Mechanistic Review.International journal of molecular sciences · 2026Pooled it
- The Canadian Network for Mood and Anxiety Treatments (CANMAT) Task Force Report: Serotonergic Psychedelic Treatments for Major Depressive Disorder.Canadian journal of psychiatry. Revue canadienne de psychiatrie · 2023Pooled it
- Drug-drug interactions between psychiatric medications and MDMA or psilocybin: a systematic review.Psychopharmacology · 2022Pooled it
- Acute Effects and Pharmacokinetics of LSD after Paroxetine or Placebo Pre-Administration in a Randomized, Double-Blind, Cross-Over Phase I Trial.Clinical pharmacology and therapeutics · 2025Trial
- Naturalistic psychedelic therapy: The role of relaxation and subjective drug effects in antidepressant response.Journal of psychopharmacology (Oxford, England) · 2024Trial
- Effects of discontinuation of serotonergic antidepressants prior to psilocybin therapy versus escitalopram for major depression.Journal of psychopharmacology (Oxford, England) · 2024Trial
- Psychological flexibility as a mechanism of change in psilocybin-assisted therapy for major depression: results from an exploratory placebo-controlled trial.Scientific reports · 2024Trial
- Acute Effects of Psilocybin After Escitalopram or Placebo Pretreatment in a Randomized, Double-Blind, Placebo-Controlled, Crossover Study in Healthy Subjects.Clinical pharmacology and therapeutics · 2022Trial
- Serotonergic Toxicity and Hyponatremia Associated with Antidepressant Therapy: The Pivotal Role of SIADH.Clinical drug investigation · 2026Review
- Risks from self-medicating with psychedelic drugs.World psychiatry : official journal of the World Psychiatric Association (WPA) · 2026Article
- Review
- Medical and Psychiatric Consultation for Patients Considering State-Regulated Psilocybin Services: A Risk-Reduction Model and Two Illustrative Cases.Research square · 2026Article
- Psychedelics and women's mental health: the effects of female sex hormones on psychedelics' efficacy and tolerability.Molecular psychiatry · 2026Review
- Severe Serotonin Syndrome With Acute Respiratory Failure Following Ayahuasca and Dextromethorphan Use: A Case Report.Cureus · 2026Article
- Psilocybin and Bipolar Depression: Promise and Prudence.CNS drugs · 2026Review
- Reported Safety Practices of Publicly Advertised Psychedelic Retreats.JAMA network open · 2026Article
- Acute Effects and Long-Term Neuropsychological Consequences of Classic Psychedelics Use.Current topics in behavioral neurosciences · 2026Review
- Psychedelics and Ibogaine "Pain Medications" at the Pharmacy Counter: Implications for Pharmacy Practice.Journal of pain research · 2026Article
- Mind the gap! Addressing unresolved aspects of abuse potential evaluation and scheduling of classic and novel psychedelic drugs.Journal of psychopharmacology (Oxford, England) · 2026Review
- Pharmacological Properties of Psychedelics with a Special Focus on Potential Harms.Current topics in behavioral neurosciences · 2026Review
Corrections and comments
PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.
Authors and funding
2 authors at 2 institutions in 3 countries.
Funding
No grant is acknowledged in the PubMed record.
Abstract
rationaleIn recent years, psychedelic substances with serotonergic mechanisms have accumulated substantial evidence that they may provide therapeutic benefits for people suffering with psychiatric symptoms. Psychiatric disorders targeted by these psychedelic-assisted therapies are managed with serotonergic drugs like selective serotonin reuptake inhibitors (SSRIs) as the current standard of care, so it is important to evaluate the potential risks of drug-drug interactions and serotonin toxicity (ST) between these agents.
objectivesA critical evaluation of the scientific literature is necessary to delineate the risks of ST when combining psychedelics with available serotonergic pharmacotherapy options. This review article describes signs and symptoms of ST, characterizes mechanisms of ST risk, summarizes what is known about serotonergic psychedelic drug interactions, and outlines potential management strategies.
resultsTrue ST typically occurs with a serotonergic drug overdose or in combinations in which a drug that can increase intrasynaptic serotonin is combined with a monoamine oxidase inhibitor (MAOI). Serotonergic psychotropics that do not contain MAOIs are low risk in combination with psychedelics that also do not contain MAOIs. Signs and symptoms warranting immediate medical attention include myoclonus, extreme and fluctuating vital signs, agitation or comatose mental state, muscle rigidity, pronounced hyperthermia (fever), and/or seizure activity.
conclusionsSerotonin-related adverse reactions exist along a spectrum with serotonin syndrome being the most severe manifestations of ST. Due to varying serotonergic mechanisms of psychedelics and psychotropics, with varying propensities to increase intrasynaptic serotonin, some combinations may present a significant risk for serotonin toxicity (ST) while others are likely benign.
Indexed as
Identifiers
What OpenQuestion holds
Registered trials
Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the OpenQuestion graph.