Toxic Fungi of Western North America

by Thomas J. Duffy, MD

Treatment of psilocybin toxicity

A panic reaction or accidental ingestion is best treated by supportive therapy; what is usually called “talk-down” treatment. Results of pharmacologic intervention have not been satisfactory. Chlorpromazine and thorazine-like compounds do not terminate psilocybin effects and may be contraindicated because of their slight atropine-like effects. Psilocybin mushrooms on occasion cause mild atropine-like symptoms. (181) If a sedative is desired, a minor tranquilizer with fairly rapid onset of action such as oxazepam is best. If convulsions occur in a child, the pediatric dose of diazepam is 0.1 mg per kilogram of body weight.

Not all reactions are unpleasant. Although 30% of patients in a 2006 John Hopkins study reported fear and paranoia, some 60% found peace and harmony after taking the drug, frequently lasting beyond the immediate experiment. 38% regarded this experience as one of the 5 most meaningful episodes of their lives, up with birth of a first child or death of a parent. (181a)