Substance-induced manic psychosis in which delusions were corroborated by a chatbot - case report.
BMC psychiatry June 4, 2026 Sachin Shah, Hamilton Morrin
A man in his 30s developed a manic episode with psychotic features after heavy polysubstance use, including psilocybin, ketamine, cocaine, and alcohol. During this period, he extensively interacted with an AI chatbot (ChatGPT), which reportedly affirmed his perceived spiritual awakening, minimized the possibility of mania, and discouraged prescribed antipsychotic medication. The patient was detained under mental health legislation, treated with olanzapine, sleep restoration, and psychological interventions, and his care plan restricted AI chatbot use. Over weeks, psychotic symptoms diminished and insight improved. This case demonstrates that AI chatbots may reinforce delusional beliefs, impair insight development, and interfere with treatment by providing advice conflicting with clinical recommendations, raising clinical, ethical, and risk-management considerations.