A man on vacation in Austria who took ‘magic mushrooms’ entered psychosis that led him to amputate his penis and store it in a snow-filled jar.
Doctors are calling the first case of its kind and a harrowing reminder of the dangers of psychedelic drugs.
The 37-year-old ate four or five mushrooms at around 9pm before blacking out and taking an axe to his penile shaft and chopping it into several pieces.
As he came to, he staggered out of the home and dragged himself down a nearby street, bleeding profusely, searching for help.
Psilocybin in magic mushrooms has been linked to psychotic episodes, though primarily in people who have a history of depression, anxiety, other mood or personality disorders
A passerby picked him up at 2 a.m., brought him to the nearest village, and took the man to the closest hospital.
He was immediately carted to the operating room, where doctors got the bleeding under control and disinfected the myriad pieces of the man’s penis in the snow and soil-filled jar.
Some damaged parts had to be removed, but the head of the penis and shaft were intact.
After cleaning the wound, doctors reattached the penis, even though it had been without blood flow for about 9 hours in total (5 hours warm and 4 hours cold).
After inserting a catheter, the surgeon reconnected the tissues of the penis using dissolvable stitches. The scrotal skin was then sewn back to the cleaned skin of the amputated part.
Some of the skin on the tip of the man’s newly reconstructed penis started to die about a week later, a condition called necrosis due to lack of oxygenated blood flow there, but doctors were able to treat it and reverse the damage.
Despite all this, the man was still experiencing hallucinations, even trying to break out of the hospital at one point.
Doctors found that he had smuggled mushrooms into his hospital room, finding a handful of them in his nightstand in the urology ward.
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Because the patient was not following 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 severed fragments could be salvaged), his erectile function returned, 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 replantation.’
Experts’ primary worry when it comes to psychedelics, which are illegal for recreational use, is the risk that they will spark a psychotic episode.
The man had a history of depression and problematic drinking habits before eating the mushrooms, which, together, could weigh up to 50mg of psilocybin, the drug that gives mushrooms their hallucinogenic effect.
Around 35mg will cause heavy perceptual and cognitive distortions. A dose of 50mg, which is known in the psychedelic community as a ‘heroic’ dose, separates one’s mind from one’s body and causes overwhelming and perhaps bizarre delusions and hallucinations.
The case described by doctors in Austria is the first of its kind in which psilocybin causes this kind of mutilation
Psilocybin is illegal in the US, but the FDA approved it in 2018 as a ‘breakthrough therapy,’ which is reserved for treatments of severe conditions that might be more effective than existing ones.
Given that there have been so few innovations in recent decades in depression and mood disorder treatments, it was met with enthusiasm from both doctors and patients.
This designation means that regulators will accelerate clinical review and that the FDA will prioritize research into its benefits and downsides.
But several case studies have arisen of people entering psychosis linked to a psychedelic.
A healthy 32-year-old woman with a good job and a fulfilling social life. She had a history of anxiety and depression, which she was managing with medication.
Friends urged her to take psilocybin, and she had a positive experience. She retook mushrooms the next day, which prompted prolonged mania, paranoia, and insomnia for three months.
Once her manic and psychotic symptoms resolved, she entered a severe depressive phase, characterized by total emotional numbness, inability to connect with her dog, and loss of interest in daily activities.
Despite extensive medical testing and various treatments—including medications, therapy that uses magnetism on her brain, and holistic therapies—none of them worked.
She started taking a medication that mimics the action of dopamine in the brain that regulates mood and emotions. As she gradually increased her dose, her psychosis dissipated, and she was able to regain her 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 get psychedelics in the hands of people dealing with intractable depression and PTSD took a major blow this summer when the FDA swatted down an attempt by embattled pharma company Lykos Therapeutics to approve a form of MDMA (also known as ecstasy) for PTSD.
The trials’ methodologies were highly flawed. It was impossible to keep it blinded, as everyone who received the drug knew they had based on the effects they experienced, and placebo recipients knew with certainty that they did not receive the drug.
And the company overlooked problems, including reports from some patients that their symptoms actually got worse, making the study results untrustworthy.
Research has shown that uptake of psychedelics are ticking up, especially among young people.
Researchers from the University of Michigan discovered that 6.6 percent of individuals aged 19 to 30 reported using a hallucinogenic drug other than LSD in the past year, as of 2021.
In contrast, only 3.4 percent had reported such use less than five years earlier, in 2018. Researchers noted that this significant rise is concerning, especially given recent studies suggesting that psychedelics like magic mushrooms may aid in treating depression and other mental health issues.
