35th AM (2024) - Poster Session-First Case of Mania and Psychosis after Psilocybin Ingestion in a Disorder

First Case of Mania and Psychosis after Psilocybin Ingestion in a Disorder

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The document reports the first case of mania and psychosis in a man without a history of Bipolar Disorder (BD) following the use of psilocybin, a naturally occurring psychedelic compound. Psilocybin, derived from magic mushrooms, is becoming increasingly researched for potential therapeutic benefits in treating mental health disorders such as depression, anxiety, and PTSD. However, its use has been associated with induced mania in individuals with a history of BD. This report highlights a unique case involving a 40-year-old male with a history of depression, PTSD, and cannabis abuse, but no known history of BD, who developed mania and psychosis after psilocybin use during a retreat. <br /><br />The patient presented with symptoms that included bizarre behavior, paranoia, grandiose delusions, and suicidal thoughts, stemming from a self-reported spiritual quest involving psilocybin ingestion. Despite an improvement in depressive symptoms, prolonged use of psilocybin seemingly led to hyper-stimulation of 5HT-2A receptors, inducing mania and psychosis. Notably, there is a limited understanding of psilocybin’s effects at the dose consumed by the patient, as it remains unknown.<br /><br />Clinical observations showed the patient in a hyper-alert state with pressure in speech and disorganized thoughts, ultimately necessitating psychiatric intervention and medication including Aripiprazole and Valproic Acid. The case accentuates the safety concerns surrounding recreational and unsupervised use of psilocybin, stressing the need for further research in controlled settings, especially given its increasing use and the possibility of undiagnosed predispositions to BD aggravating its effects. The report suggests reconsidering the assumption of psilocybin's safety in patients without a history of BD and recommends more clinical exploration under stringent protocols.

Keywords

mania

psychosis

psilocybin

Bipolar Disorder

magic mushrooms

mental health

depression

PTSD

cannabis abuse

psychiatric intervention

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