N,N-Dimethyltryptamine-Induced Psychosis.
Neil E Paterson, W Connor Darby, Preetpal S Sandhu
Clinical Neuropharmacology 2015 DOI: 10.1097/wnf.0000000000000078 (opens in new tab)
Study at a glance
AI-extracted from the abstract| Characteristics | Case study Case report Peer reviewed |
|---|---|
| Sample size | 1 |
| Population | 42-year-old white man with no significant past psychiatric history and long-term cannabis use |
| Interventions | Quetiapine Divalproex sodium Gabapentin Hydroxyzine |
| Duration | 3-week inpatient treatment; approximately 6-month follow-up after discharge |
| Topics | 5-MeO-DMT DMT |
| Key findings | The authors describe a 42-year-old man with no prior psychiatric history who developed substance-induced psychosis attributed to repeated DMT use, with symptoms including disinhibited behavior, elevated affect, disorganized thought, and delusions of reference, along with rhabdomyolysis. His symptoms resolved after about three weeks of treatment with quetiapine, divalproex sodium, gabapentin, and hydroxyzine, and he remained drug- and symptom-free at roughly six months. The authors argue this case illustrates DMT-related substance-induced psychosis and warn that rising DMT use may increase similar presentations. |
Abstract
N,N-dimethyltryptamine (DMT) is a 5-hydroxytryptamine 2A and 1A receptor agonist that exhibits potent psychoactive properties in humans. Recreational use of this drug has increased precipitously and is likely to result in an increase in patients presenting with substance-induced psychoses. The present case provides an early example of substance-induced psychosis attributable to repeated use of DMT. A 42-year-old white man, with no significant past psychiatric history, was brought to the emergency department by the police and was found to exhibit disinhibited behavior, elevated affect, disorganized thought process, and delusions of reference. Laboratory studies revealed elevated creatinine kinase level indicative of rhabdomyolysis. The patient endorsed recent and repeated use of DMT, as well as long-term Cannabis (marijuana) use. Over the course of the next 3 weeks, the patient was successfully treated with quetiapine for psychosis, divalproex sodium (Depakote) for impulsivity, gabapentin for anxiety, and hydroxyzine for sleep, which resulted in the resolution of his symptoms and development of reasonable insight and judgment. Approximately 6 months after discharge, the patient remained treatment compliant, as well as drug and symptom free. This case report illustrates an important example of substance-induced psychosis that resolved with antipsychotic treatment in a 42-year-old white man with no past psychiatric history likely attributable to the use of DMT. Given the increasing use of this substance, the emergency department, primary care, and inpatient services are likely to see a significant increase in similar cases.
Comparable studies
Other case reports and case series on 5-MeO-DMT, most cited first.
| Study | Year | Design | Participants |
|---|---|---|---|
| A fatal intoxication following the ingestion of 5-methoxy-N,N-dimethyltryptamine in an ayahuasca preparation. 25-year-old white male | 2005 | Case study | n = 1 |
| Combined intoxication with methylone and 5-MeO-MIPT 27-year-old male patient | 2006 | Case report | n = 1 |
| Sudden death associated with intravenous injection of toad extract. A 24-year-old male | 2009 | Case study | n = 1 |
| 5-Meo-DALT-induced Cyclic Myoclonus (P3.013) A 29-year-old man with history of heroin and marijuana abuse | 2015 | Case report | n = 1 |
| A case report SPECT study and theoretical rationale for the sequential administration of ibogaine and 5-MeO-DMT in the treatment of alcohol use disorder. 31-year-old male military veteran with moderate alcohol use disorder | 2018 | Case study | n = 1 |
Citations in the library
Cited by 17
- Psychedelics in Psychiatry: Neuroplastic, Immunomodulatory, and Neurotransmitter Mechanisms Pharmacological Reviews December 16, 2020
- Ayahuasca: Psychological and Physiologic Effects, Pharmacology and Potential Uses in Addiction and Mental Illness Current Neuropharmacology March 2, 2018
- Ayahuasca, dimethyltryptamine, and psychosis: a systematic review of human studies Therapeutic Advances in Psychopharmacology February 23, 2017
- Psychedelics: Alternative and Potential Therapeutic Options for Treating Mood and Anxiety Disorders Molecules April 13, 2022
- Toxicology and Analysis of Psychoactive Tryptamines International Journal of Molecular Sciences December 4, 2020
and 12 more in the library
Cites 8
- Dose-Response Study of N,N-Dimethyltryptamine in Humans Archives of General Psychiatry February 1, 1994
- Monoamine oxidase inhibitors in South American hallucinogenic plants: Tryptamine and β-carboline constituents of Ayahuasca Journal of Ethnopharmacology April 1, 1984
- Human Pharmacology of Ayahuasca: Subjective and Cardiovascular Effects, Monoamine Metabolite Excretion, and Pharmacokinetics Journal of Pharmacology and Experimental Therapeutics June 18, 2003
- A critical review of reports of endogenous psychedelic N, N-dimethyltryptamines in humans: 1955-2010. Drug Testing and Analysis 2012
- Dimethyltryptamine (DMT): Prevalence, user characteristics and abuse liability in a large global sample Journal of Psychopharmacology November 27, 2013
and 3 more in the library