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.
α-Methyltryptamine (α-MT) is a hallucinogenic and stimulant drug linked to overdose deaths. To identify biomarkers proving its use, metabolites were analyzed in lab-grown human liver cells and in urine and blood from a fatal overdose case. Nine metabolites formed in liver cells, with eight more in urine and five in blood. Transformations included hydroxylation, sulfation, glucuronidation, and acetylation. The liver cell model matched real samples, confirming its usefulness. Recommended urine biomarkers are α-MT, hydroxy-α-MT glucuronide, and two hydroxy-α-MT sulfates; blood biomarkers are α-MT, two hydroxy-α-MT sulfates, and N-acetyl-α-MT. More studies with varied doses are needed.