Muscimol, also known as agarin, pantherine, or pyroibotenic acid, is a GABAA receptor agonist with sedative and hallucinogenic effects and the principal psychoactive constituent of Amanita mushrooms such as Amanita muscaria (fly agaric) and Amanita pantherina (panther cap). It is a 3-hydroxyisoxazole alkaloid and is closely related structurally to the neurotransmitter γ-aminobutyric acid (GABA). The compound is widely used as a ligand and agonist of the GABAA receptor in scientific research. Muscimol is typically taken orally, but may also be smoked. Peak effects occur after 1 to 3hours orally and its duration is 4 to 10hours but up to 24hours.
The effects of muscimol intoxication in humans include central depression, sedation, induction of sleep, cognitive and motor impairment, hallucinations, perceptual distortion, and muscle twitching, among others. Muscimol acts as a potent GABAA receptor full agonist. However, it acts as a preferential supra-maximal agonist at extrasynaptic δ subunit-containing GABAA receptors. It is also a potent GABAA-ρ receptor partial agonist and a weak GABA reuptake inhibitor. The drug is inactive at the GABAB receptor but is a substrate of GABA transaminase (GABA-T). Muscimol mostly exerts its effects via GABAA receptor activation. It is very different from drugs like benzodiazepines and barbiturates as it is an orthosteric agonist of the GABAA receptor rather than an allosteric modulator. Unlike GABA, muscimol crosses the blood–brain barrier and hence is centrally active. Muscimol is a conformationally restrained analogue of GABA. The related compound and Amanita species constituent ibotenic acid is a prodrug of muscimol, but also has neurotoxic effects.
Muscimol was first isolated from Amanita muscaria and hence was discovered in 1964. It has been limitedly clinically studied as a potential pharmaceutical drug for a number of uses, such as treatment of epilepsy. In addition, analogues and derivatives of muscimol, such as the selective GABAA receptor agonist gaboxadol (THIP; LU-2-030) and the selective GABA reuptake inhibitor tiagabine (Gabitril), have been developed as pharmaceutical drugs. Muscimol and Amanita muscaria mushrooms have rarely been used as recreational drugs historically. By the mid-2020s however, use of these substances, including recreational use for hallucinogenic effects and microdosing for claimed therapeutic benefits, has become increasingly prominent. The most commonly cited therapeutic reason for their use is to improve sleep. Muscimol is not a controlled substance and is unregulated in most of the world, including in most of the United States and Europe.
Natural occurrence
The main natural sources of muscimol are fungi of the genus Amanita, such as Amanita muscaria (fly agaric) and Amanita pantherina (panther cap). It is produced in the mushrooms along with muscarine (which is present in trace amounts and it is not active), muscazone, and ibotenic acid. In Amanita muscaria, the layer just below the skin of the cap contains the highest amount of muscimol, and is therefore the most psychoactive portion.
Use and effects The properties and effects of muscimol in humans have been limitedly assessed in clinical studies. It has been assessed in these studies at doses of 5 to 15mg orally. The oral threshold dose of muscimol is approximately 6mg, while the psychoactive dose range has been said to range from approximately 8 to 15mg. As little as 1g of dried Amanita muscaria button may contain this amount of muscimol, although the potency varies greatly among mushrooms. According to Jonathan Ott, a 15mg dose is "psychoptic" while a 20mg dose is "visionary". The onset of action of muscimol, via isolated muscimol or Amanita muscaria consumption orally, is between 30minutes and 2hours, with peak effects occurring after 1 to 3hours. The duration is 4 to 10hours, but some effects may persist for up to 24hours. In one publication, the effects of muscimol were described as follows:
"Waser (1967) describes the effects of self-administration of 10–15 mg. of muscimol as '. . . intense hallucinations as with LSD were missing . . . there resulted considerable disturbances of psychic functions, such as orientation in space and time, visual perception, process of thinking, speech, and some new psychic phenomena of illusions and echo pictures'. Higher doses tended to produce severe intoxication in man, with painful muscular twitching, considerable agitation, and vivid hallucinations."
The effects of muscimol in humans in different studies have been found to include sedation, central depression, dizziness, incoordination or clumsiness, relaxation, reduced anxiety, mood improvement or euphoria, sleep, rich dreaming, difficulty speaking, impaired attention, focus, and concentration, impaired learning, confusion, a glassy-eyed stare, loss of appetite, stimulation, agitation, hallucinogenic effects, echo-like pseudohallucinations (visual and auditory, vivid hallucinations, dissociation, psychosis, and delirium). At higher doses, coma, seizures, and death can occur. Physical effects of muscimol can include muscle twitching or tremors, flushing, slightly increased blood pressure, nausea, vomiting, abdominal pain, diarrhea, and increased salivation, among others. After-effects have been reported to include fatigue, inactivity, and headache and migraine. Some can find the hallucinogenic effects of muscimol to be highly unpleasant, for instance one person being "shaken and frightened" by the experience.
Muscimol is said to have similar effects on sleep in rodents as the related experimental pharmaceutical drug gaboxadol (THIP). In humans, gaboxadol decreases sleep onset latency, increases sleep duration, increases slow wave sleep (SWS) and slow wave activity (SWA), and does not suppress REM sleep. The effects of muscimol and gaboxadol on sleep differ from those of widely used GABAA receptor positive allosteric modulators like benzodiazepines and Z-drugs, which can instead disrupt SWS and SWA despite improving sleep onset and duration. Although muscimol and gaboxadol have similar effects on sleep, muscimol has additionally been found to increase REM sleep unlike gaboxadol.
Ibotenic acid, a prodrug of muscimol, is active at doses of approximately 20 to 100mg orally in humans. About 10 to 20% of ibotenic acid is said to be converted into muscimol following decarboxylation. Substantial amounts of ibotenic acid are also rapidly excreted unchanged.
Overdose and toxicity The German Federal Institute for Risk Assessment warns that muscimol and products containing it pose serious health risks, especially to children.
The toxicity and safety profile of muscimol has been studied in various contexts, both experimental and clinical. It is described as being a relatively toxic compound in animals. The median lethal dose (LD50) in mice is 5.6 to 7mg/kg intravenously, 3.8mg/kg subcutaneously, 2.5 to 12mg/kg intraperitoneally, and 22mg orally. The LD50 in rats is 4.5mg/kg intravenously and 45mg/kg orally. Muscimol shows considerably greater lethal potency or toxicity than gaboxadol.
A study on non-human primates indicated that muscimol, when administered in escalating doses, caused reversible hyperkinesia and dyskinesias at higher doses, but no long-term toxicity was observed on histological examination. Muscimol has shown potential as an anticonvulsant, blocking seizures induced by various agents in animal models without causing significant toxicity at therapeutic doses. Muscimol exhibits dose-dependent effects with higher doses leading to significant, but reversible, central nervous system symptoms.
The dose of muscimol that is thought to be potentially fatal in humans has been reported to be approximately 90mg, which is 15times the reported threshold hallucinogenic dose of 6mg. According to the North American Mycological Association (NAMA) however, "[i]n humans, no reliably documented cases of death from toxins in these mushrooms [mushrooms that contain isoxazole derivatives] in the past100 years, though there is one case where a camper froze to death while in the comatose state".
Interactions The actions and effects of muscimol may be potentiated by benzodiazepines such as diazepam. Diazepam has been found to strongly potentiate the central depressant effects of muscimol in rodents. Conversely, the barbiturate phenobarbital did not potentiate the effects of muscimol in rodents. Neurosteroids like allopregnanolone and pregnanolone may potentiate the effects of muscimol.
Pharmacology Pharmacodynamics
Muscimol is a potent GABAA receptor full agonist, activating the receptor for the brain's principal inhibitory neurotransmitter, γ-aminobutyric acid (GABA). Muscimol binds to the same site on the GABAA receptor complex as GABA itself, unlike other GABAergic drugs such as barbiturates, benzodiazepines, and Z-drugs, which interact with separate allosteric sites. GABAA receptors are widely distributed in the brain, so when muscimol is administered, it alters neuronal activity in multiple regions including the cerebral cortex, hippocampus, and cerebellum. By mimicking GABA, muscimol activates these receptors, leading to the opening of chloride channels and subsequent hyperpolarization of neurons. This results in decreased neuronal excitability, which is crucial for maintaining the balance between excitation and inhibition in the central nervous system.
Muscimol was originally reported to show relatively uniform effects on GABAA receptors of differing subunit compositions. However, it was found to act as a superagonist of extrasynaptic α4β3δ subunit-containing GABAA receptors ( = 120 to 140% relative to GABA). This was found to be due to reduced receptor desensitization with muscimol compared to GABA. Subsequent research has found that muscimol is a preferential agonist of the relatively small population of extrasynaptic and/or δ subunit-containing GABAA receptors and that these receptors have a substantial contribution to its effects. Relatedly, muscimol, similarly to gaboxadol, has been described as being highly though incompletely selective for these GABAA receptors. In contrast, benzodiazepines and Z-drugs do not activate δ subunit-containing GABAA receptors. On the other hand, alcohol is known to selectively potentiate δ subunit-containing extrasynaptic GABAA receptors analogously to muscimol.
While muscimol is often thought of as a selective GABAA agonist with exceptionally high affinity to δ subunit-containing GABAA receptors, it is also a potent partial agonist of the GABAA-ρ receptor, and so its range of effects results from a combined action on more than one GABAA receptor subtype. In fact, it is more potent as a partial agonist of the GABAA-ρ receptor than as a GABAA receptor agonist. Muscimol has been said to be inactive at the GABAB receptor. However, a subsequent study reported that muscimol may have GABAB receptor-mediated inhibitory activity, although more research is needed to further characterize this activity. Muscimol is inactive in terms of affecting GABA transaminase (GABA-T). There is little evidence that muscimol interacts with other biological targets besides the GABA receptors and the GABA transporters.