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.
Two cases of rhabdomyolysis, a destruction of muscle tissue with elevated creatine kinase levels, occurred after administration of nasal esketamine for treatment-resistant depression. A 33-year-old male patient developed muscle pain and fatigue after the fourth dose, with creatine kinase levels above 22,000 U/L. A 22-year-old male patient exhibited muscle weakness and elevated creatine kinase levels (8,032 U/L) after the tenth dose. In both cases, creatine kinase levels returned to normal after discontinuation of esketamine and supportive care. The temporal connection suggests a possible causal relationship. No prior literature on esketamine-induced rhabdomyolysis following nasal administration was found.