Unpredictable Behavior Under the Influence of “Magic Mushrooms”: A Case Report and Review of the Literature

A young man without psychiatric history died after jumping from a second-story balcony while under the influence of psilocybin mushrooms. Psilocin concentrations measured 60 ng/mL in peripheral blood, 67 ng/mL in cardiac blood, 2230 ng/mL in urine, 3102 ng/mL in bile, and 57 ng/mL in vitreous humor. The case and literature review demonstrate that even regular users in seemingly safe circumstances can suffer fatal outcomes from psilocybin mushrooms alone.

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Abstract

Abstract Fatalities implicating psychedelic mushrooms are not a common clinical situation in everyday forensic medicine. Despite classification as an illegal drug in many countries, psilocybin mushrooms have the reputation of being safe. We report the case of a young man who jumped from a second story balcony under the influence of psilocybin mushrooms. The psilocin assay was performed by gas chromatography coupled to an electron‐impact ionization time‐of‐flight detector ( GC ‐ EI ‐ TOF ) after solid‐phase extraction. Total psilocin was quantified in peripheral and cardiac blood as 60 and 67 ng/ mL , respectively, and in urine (2230 ng/ mL ), bile (3102 ng/ mL ), and vitreous humor (57 ng/ mL ). This case report and review of literature highlights the danger of psilocybin mushrooms. Isolated use of psilocybin mushrooms by a regular consumer without psychiatric history, even under “safe” circumstances, can lead to a fatal outcome.