Case series of psilocybin self-medication for spinal cord injury

Abstract

Current spinal cord injury treatments primarily manage symptoms rather than promote neurological recovery. Psilocybin enhances neuroplasticity through 5-HT2A agonism and brain-derived neurotrophic factor upregulation, suggesting therapeutic potential for spinal cord injury rehabilitation. We conducted semi-structured interviews with three individuals who had incomplete spinal cord injuries (C4–C5, T7, T12; American Spinal Injury Association Impairment Scale grades B–D) and self-medicated with psilocybin. Case 1 reported improved motor function and gait automaticity. Case 2 reported activation of a previously non-responsive hamstring muscle. Case 3 reported rapid strength gains with enhanced proprioceptive awareness. All participants reported psychological benefits including increased wellbeing, enhanced motivation for recovery and improved adjustment to their post-injury reality, suggesting that psilocybin may serve dual therapeutic purposes. Benefits seemed greatest in partially innervated muscles. Subjects reported both acute and sustained maintenance effects, with gradual diminishment of benefits following cessation. Adverse effects included temporary spasticity. These observations suggest that psilocybin may enhance motor recovery and sensory integration in incomplete spinal cord injury through amplification of existing neural pathways and warrant controlled clinical trials.