A man who was on holiday in Austria and took ‘magic mushrooms’ went into a psychosis that led him to amputate his penis and store it in a jar filled with snow.
Doctors call it the first case of its kind and a heartbreaking reminder of the dangers of psychedelic drugs.
The 37-year-old ate four or five mushrooms at around 9pm before passing out, hitting his penis with an ax and cutting it into several pieces.
When he came to, he staggered out of the house and crawled down a nearby street, bleeding profusely, in search of help.
The psilocybin contained in magic mushrooms has been linked to psychotic episodes, although mainly in people with a history of depression, anxiety, and other mood or personality disorders.
A passerby picked him up at 2 in the morning, took him to the nearest town and took him to the nearest hospital.
He was immediately taken to the operating room, where doctors controlled the bleeding and disinfected the countless pieces of the man’s penis in the jar filled with snow and dirt.
Some damaged parts had to be removed, but the penis head and shaft were intact.
After cleaning the wound, doctors reattached the penis, even though it had been without blood flow for about 9 hours total (5 hours hot and 4 hours cold).
After inserting a catheter, the surgeon reconnected the penile tissues using dissolvable stitches. The skin of the scrotum was then sewn to the clean skin of the amputated part.
Some of the skin on the tip of the man’s newly reconstructed penis began to die about a week later, a condition called necrosis due to a lack of oxygenated blood flow there, but doctors were able to treat it and reverse the damage.
Despite all this, the man continued to experience hallucinations and even tried to escape from the hospital at one point.
Doctors discovered he had smuggled mushrooms into his hospital room and found a handful of them on his nightstand in the urology ward.
Because the patient did not follow medical instructions, he was transferred to the Intensive Care Unit the day after surgery.
Over time, his psychotic symptoms improved with continued medication, allowing him to return to the urology department.
Despite the drastically reduced size of his penis (not all the severed fragments could be saved), his erectile function recovered and he was able to urinate on his own.
The doctors said: “To our knowledge, this is the first report of psilocybin-induced penile amputation with subsequent macroscopic reimplantation.”
Experts’ main concern when it comes to psychedelics, which are illegal for recreational use, is the risk of them causing a psychotic episode.
The man had a history of depression and problematic drinking habits before eating the mushrooms, which together could contain up to 50 mg of psilocybin, the drug that gives the mushrooms their hallucinogenic effect.
Around 35 mg will cause strong cognitive and perceptual distortions. A 50 mg dose, known in the psychedelic community as a “heroic” dose, separates the mind from the body and causes overwhelming and perhaps strange delusions and hallucinations.
The case described by doctors in Austria is the first of its kind in which psilocybin causes this type of mutilation.
Psilocybin is illegal in the US, but the FDA approved it in 2018 as a “breakthrough therapy,” reserved for treatments of serious conditions that could be more effective than existing ones.
Because there have been so few innovations in recent decades in treatments for depression and mood disorders, it was greeted with enthusiasm by doctors and patients alike.
This designation means that regulators will expedite clinical review and that the FDA will prioritize research into its benefits and drawbacks.
But several case studies have emerged of people entering psychosis related to a psychedelic.
Healthy 32-year-old woman, with a good job and full social life. He had a history of anxiety and depression, which he was managing with medication.
Her friends urged her to take psilocybin and she had a positive experience. He took mushrooms again the next day, causing prolonged mania, paranoia, and insomnia for three months.
Once his manic and psychotic symptoms resolved, he entered a severe depressive phase, characterized by complete emotional numbness, inability to connect with his dog, and loss of interest in daily activities.
Despite extensive medical testing and various treatments (including medications, therapy that uses magnetism in his brain, and holistic therapies), none of them worked.
He began taking a medication that mimics the action of dopamine in the brain that regulates mood and emotions. As he gradually increased his dose, his psychosis dissipated and he was able to regain his life.
From 2018 to 2021, the use of psychedelic drugs, other than LSD, has nearly doubled, with rates increasing from 3.4 percent to 6.6 percent.
The movement to put psychedelics in the hands of people suffering from untreatable depression and post-traumatic stress disorder took a serious blow this summer when the FDA rejected an attempt by pharmaceutical company Lykos Therapeutics to approve a form of MDMA (also known as ecstasy) for post-traumatic stress disorder.
The trial methodologies were very flawed. It was impossible to keep it blind, since everyone who received the drug knew they had done so based on the effects they experienced, and those who received placebo knew for a fact that they did not receive the drug.
And the company overlooked problems, including some patients’ reports that their symptoms actually worsened, making the study results unreliable.
Research has shown that psychedelic use is increasing, especially among young people.
Researchers at the University of Michigan found that 6.6 percent of people ages 19 to 30 reported using a hallucinogenic drug other than LSD in the past year, as of 2021.
By contrast, only 3.4 percent had reported such use less than five years earlier, in 2018. The researchers noted that this significant increase is concerning, especially given recent studies suggesting that psychedelics such as magic mushrooms They can help in the treatment of depression and other mental health problems.