A 32-year-old man with no prior mental health problems amputated both of his testicles by hand after his first use of LSD combined with alcohol. Six months later, he had not developed any psychiatric disorder. This case shows that even a single first use of LSD with alcohol can lead to severe intoxication and extreme self-harm.
Depression in people who formerly used ecstasy heavily may not improve with standard antidepressants like SSRIs, possibly because long-term ecstasy use damages serotonin pathways. A patient with MDMA-induced depression who did not respond to several antidepressants, including an SNRI and an SSRI, achieved stable remission of mood and cognitive symptoms after receiving repeated bilateral electroconvulsive therapy (ECT), with improvement lasting over 1.5 years. Add-on ECT could be a treatment option for former ecstasy users with severe depression that does not respond to antidepressants, though clinical trials are needed to confirm its usefulness.