Royal Edinburgh Hospital, Edinburgh, UK.
Royal Edinburgh Hospital, Edinburgh, UK Chris.O'
BMJ Case Rep. 2024 Aug 14;17(8):e260648. doi: 10.1136/bcr-2024-260648.
Ayahuasca is a plant-based psychoactive decoction, traditionally used by indigenous Amazonian peoples, which commonly contains the hallucinogen N,N-dimethyltryptamine (DMT). There is now growing interest across the Western world in psychedelics including Ayahuasca.This case describes a previously well male with no risk factors for adverse psychiatric outcomes or forensic history. Following controlled Ayahuasca use, he developed an enduring psychotic episode, during which he significantly assaulted a relative and was admitted to a forensic psychiatric unit. He was treated with the antipsychotic aripiprazole, and his psychotic symptoms abated. 18 months following his admission, recovery has been sustained.Previous case reports have described psychosis following Ayahuasca ingestion, but typically of short duration in patients with a personal or family history of psychiatric illness, or in those taking other substances. With the growing use of Ayahuasca, it is important to highlight that adverse effects may include more prolonged psychotic symptoms and the risk of psychotically mediated violence.
水苏碱是一种植物源性致幻剂汤剂,传统上被亚马逊地区的土著人民使用,其中通常含有致幻剂 N,N-二甲基色胺 (DMT)。如今,包括水苏碱在内的迷幻剂在西方世界越来越受到关注。本案例描述了一位以前身体状况良好的男性,没有出现不良精神后果或法医病史的风险因素。在使用受控水苏碱后,他出现了持久的精神病发作,在此期间他严重袭击了一位亲属,并被送进了法医精神病院。他接受了抗精神病药阿立哌唑治疗,精神病症状缓解。入院后 18 个月,他的病情得到了持续的缓解。以前的病例报告描述了水苏碱摄入后出现精神病,但通常在有精神病史或家族史的患者中,或在同时服用其他物质的患者中,持续时间较短。随着水苏碱使用的增加,重要的是要强调,不良反应可能包括更持久的精神病症状和精神病介导的暴力风险。