Perna John, Trop Justin, Palitsky Roman, Bosshardt Zachary, Vantine Helen, Dunlop Boadie W, Zarrabi Ali J
Department of Psychiatry and Behavioral Sciences, Emory University School of Medicine, Atlanta, GA, USA.
Emory Center for Psychedelics and Spirituality, Emory University, Atlanta, GA, USA.
BMC Psychiatry. 2025 Feb 28;25(1):184. doi: 10.1186/s12888-024-06303-z.
Psychedelic-assisted therapy has gained growing interest to improve a range of mental health outcomes. In response, numerous training programs have formed to train the necessary workforce to deliver psychedelic therapy. These include both legal and 'underground' (i.e., unregulated) programs that use psychedelics as part of their training. Prolonged adverse experiences (PAEs) may arise from psychedelic use, though they are poorly characterized in the clinical literature. Thus, understanding the potential harms related to psychedelic use is critical as psychedelic therapy training programs consider strategies to potentially integrate psychedelic use into therapy training.
We present the case of a psychologist who underwent psychedelic therapy training that involved repeated high doses of psilocybin-containing mushrooms and subsequently developed prolonged adverse effects including severe sleep impairment, anhedonia, and suicidal ideation requiring hospitalization. Despite worsening symptoms, her psychedelic therapy trainers advised her against seeking psychiatric support, delaying treatment. Ultimately, the patient's symptoms resolved after a course of electroconvulsive therapy (ECT).
This case highlights the tensions between legal and underground psychedelic use within psychedelic therapy training programs, psychiatry and neo-shamanism, and the use of psychiatric interventions (i.e., ECT) and energy medicine to address prolonged adverse effects from psychedelics. Clinicians should be aware of these potential conflicts between psychiatric conceptualizations of PAEs and frameworks maintained in psychedelic community practices and their impacts on patients' presenting symptoms, decision making, and emotional challenges.
迷幻剂辅助疗法在改善一系列心理健康结果方面越来越受到关注。相应地，已经形成了许多培训项目来培养提供迷幻剂疗法所需的劳动力。这些项目包括合法的和“地下”（即不受监管的）项目，它们在培训中使用迷幻剂。使用迷幻剂可能会产生长期不良体验（PAEs），尽管临床文献对其描述甚少。因此，鉴于迷幻剂疗法培训项目正在考虑将迷幻剂使用纳入治疗培训的潜在策略，了解与迷幻剂使用相关的潜在危害至关重要。
我们介绍一位心理学家的案例，她接受了迷幻剂疗法培训，其中涉及反复高剂量服用含裸盖菇素的蘑菇，随后出现了长期不良反应，包括严重睡眠障碍、快感缺失和自杀意念，需要住院治疗。尽管症状不断恶化，但她的迷幻剂疗法培训师建议她不要寻求精神科支持，从而延误了治疗。最终，患者在接受了一个疗程的电休克疗法（ECT）后症状得到缓解。
该案例凸显了迷幻剂疗法培训项目中合法与地下使用迷幻剂之间的矛盾、精神病学与新萨满教之间的矛盾，以及使用精神科干预措施（即ECT）和能量医学来解决迷幻剂引起的长期不良反应。临床医生应意识到PAEs的精神病学概念与迷幻剂社区实践中所维持的框架之间的这些潜在冲突，以及它们对患者呈现的症状、决策和情感挑战的影响。
