A Case Report of Psilocybin-induced Psychosis in a Predisposed Patient
Sorsha Lee Morris
Mental Health Service, San Francisco VA Health Care System, San Francisco, CA, USA
Correspondence to: Sorsha Lee Morris
San Francisco VA Health Care System, 4150 Clement St. 116, San Francisco, CA 94121, USA
E-mail: sorsha.morris@gmail.com
ORCID: https://orcid.org/0009-0001-0839-6244
Received: February 17, 2024; Revised: April 10, 2024; Accepted: April 17, 2024; Published online: May 21, 2024.
© The Korean College of Neuropsychopharmacology. All rights reserved.

This is an Open-Access article distributed under the terms of the Creative Commons Attribution Non-Commercial License (http://creativecommons.org/licenses/by-nc/4.0) which permits unrestricted non-commercial use, distribution, and reproduction in any medium, provided the original work is properly cited.
Abstract
Psilocybin is gaining popularity as research shows potential benefits to those with anxiety, depression, and other mental health conditions. Individuals with risk factors for psychosis are typically excluded from such studies, limiting the empiric research of the risks and benefits in vulnerable populations. In the real-world setting, many individuals who seek treatment with psilocybin will have comorbid psychiatric conditions and other factors that predispose them to psychosis. We report a case of a patient with multiple predisposing risk factors, including a history of depression, personality disorder traits, and cannabis use, who experienced a psychotic episode with catatonic features and suicidality after several months of heavy psilocybin use. A review of similar previously published case reports demonstrates a pattern of psilocybin-induced psychosis occurring primarily in individuals with predisposing factors who have consumed either high or repeated doses of the drug. This case report furthers this pattern, which serves as both a warning that psilocybin use is not without risks and reassurance for researchers using much lower doses to treat mental illness.
Keywords: Catatonia; Hallucinogens; Psilocybin; Substance induced psychoses; Suicidal Ideation


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