From Mushrooms to Myolysis

A young patient who used a large amount of psilocybin developed a first psychotic and manic episode complicated by violent behavior and rhabdomyolysis. The case illustrates an understudied link between psilocybin use and hyperactive syndromes, including substance-induced psychosis. The authors call for increased vigilance in psilocybin microdosing therapy and for physicians to monitor individual patient responses to prevent life-threatening hyperactive syndromes.

Study at a glance

Abstract

Abstract The involvement of certain recreational drugs, namely, hallucinogens, in the development of hyperactive syndromes is well known, but not well studied. In this report, we expand on this relationship by documenting the development of substance-induced psychosis in a young patient who used a large amount of psilocybin and developed symptoms of a first psychotic and manic episode, complicated by violent behavior and rhabdomyolysis. We further evaluate the association between psilocybin use and rhabdomyolysis and explore this understudied phenomenon and differentiate it from the diagnoses of other hyperactive syndromes seen in psychiatry. This case exemplifies the need for increased vigilance in psilocybin microdosing therapy and for physicians to be mindful of how each patient responds to its use to prevent life-threatening hyperactive syndromes in its wake.