Consumption of Psilocybe mushrooms, which contain the hallucinogen psilocybin, can cause both mental disturbances and life-threatening kidney injury. A 22-year-old man with confirmed Psilocybe mushroom ingestion presented with disorientation, restlessness, auditory hallucinations, unstable mood, stereotypical behavior, and bizarre movements. The report emphasizes the need for prompt physical examination and supportive care that addresses life-threatening symptoms, particularly nephrotoxicity, alongside symptomatic treatment.
Psilocybin-assisted therapy produces a large reduction in depressive symptoms, but the evidence is preliminary and limited by methodological problems. A meta-analysis of nine randomized controlled trials involving 514 participants found a large effect size (SMD = 1.270). However, the certainty of the evidence is rated low due to risk of bias, high heterogeneity, short-term follow-up, and publication bias. Effects were much larger when psilocybin was compared to a waitlist rather than an active placebo, and blinding is compromised by the drug's subjective effects. The authors conclude that robust Phase 3 trials are needed before routine clinical use.