Prolonged psychosis after Amanita muscaria ingestion.
Miran Brvar, Martin Mozina, Matjaz Bunc
Wiener klinische Wochenschrift May 1, 2006 Peer reviewed DOI: 10.1007/s00508-006-0581-6 via PubMed
Summary
A 48-year-old man experienced paranoid psychosis with visual and auditory hallucinations for five days after ingesting Amanita muscaria mushrooms, which he mistakenly identified as A. caesarea. Symptoms began 18 hours after consumption, following initial vomiting and a seizure-like episode. He was treated with activated charcoal and showed complete recovery one year later without psychiatric symptoms. This case highlights that psychotic symptoms can arise significantly after ingestion of A. muscaria.
Study at a glance
| Sample size | 1 |
|---|---|
| Population | a 48-year-old man who ingested A. muscaria |
| Key finding | Paranoid psychosis with visual and auditory hallucinations can appear 18 hours after ingestion of A. muscaria and can last for up to five days. |
Abstract
Amanita muscaria has a bright red or orange cap covered with small white plaques. It contains the isoxazole derivatives ibotenic acid, muscimol and muscazone and other toxins such as muscarine. The duration of clinical manifestations after A. muscaria ingestion does not usually exceed 24 hours; we report on a 5-day paranoid psychosis after A. muscaria ingestion. A 48-year-old man, with no previous medical history, gathered and ate mushrooms he presumed to be A. caesarea. Half an hour later he started to vomit and fell asleep. He was found comatose having a seizure-like episode. On admission four hours after ingestion he was comatose, but the remaining physical and neurological examinations were unremarkable. Creatine kinase was 8.33 microkat/l. Other laboratory results and brain CT scan were normal. Toxicology analysis did not find any drugs in his blood or urine. The mycologist identified A. muscaria among the remaining mushrooms. The patient was given activated charcoal. Ten hours after ingestion, he awoke and was completely orientated; 18 hours after ingestion his condition deteriorated again and he became confused and uncooperative. Afterwards paranoid psychosis with visual and auditory hallucinations appeared and persisted for five days. On the sixth day all symptoms of psychosis gradually disappeared. One year later he is not undergoing any therapy and has no symptoms of psychiatric disease. We conclude that paranoid psychosis with visual and auditory hallucinations can appear 18 hours after ingestion of A. muscaria and can last for up to five days.