“Wood-lover paralysis”: describing a toxidrome with symptoms of weakness caused by some lignicolous “wood-loving” Psilocybe mushrooms

Psilocybin-containing mushrooms have long been used for their psychoactive effects, but emerging evidence suggests that certain lignicolous (“wood-loving”) species may also induce a distinct toxidrome known as “wood-lover paralysis” (WLP). WLP is characterised by transient weakness following mushroom ingestion, but its aetiology and prevalence remain poorly understood. In this paper, we present an investigation of WLP, based on a retrospective online survey conducted in 2020 (N = 392: 71.8 % male; 34.1 % aged 26–35 years; mainly from Australia and New Zealand). We found that 42.1 % of respondents reported experiencing WLP, with onset typically occurring within 4 h of ingestion. Weakness primarily impaired mobility (80.4 %), with some reporting difficulties swallowing (26.7 %) and breathing (16.6 %). Symptoms persisted into the following day for nearly half of those affected (48.1 %), and 21.5 % experienced a fall or accident. WLP was reported across different methods of mushroom preparation and environmental growth conditions, with no significant associations observed between WLP occurrence and age, gender, health status, or allergies. While the true prevalence of WLP remains unclear, our results suggest it is an under-recognised potential adverse outcome that can occur with ingestion of certain lignicolous Psilocybe species. Given the increasing medical and recreational use of psilocybin-containing mushrooms following policy shifts toward decriminalisation and legalisation, further research is needed to elucidate the currently unknown mechanism of WLP and inform harm reduction strategies and healthcare responses. Awareness among consumers, service providers and regulators will be crucial in improving recognition, reporting, and appropriate responses to this toxidrome.