In an unprecedented case report, doctors in Austria have documented the first known instance of psilocybin-induced penile amputation. After consuming a large quantity of magic mushrooms, a 37-year-old man suffering from depression and alcohol abuse severed his penis with an axe. Fortunately, doctors were able to reattach part of the amputated organ. The unique case is detailed in the Mega Journal of Surgery.

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The case report published by doctors at Hospital Feldkirch in Austria outlines the shocking details of a 37-year-old man who consumed a large dose of psilocybin and, during a severe psychotic episode, amputated his penis using an axe. The man, who had a history of depression and alcohol abuse, ingested four or five dried psilocybin mushrooms while staying alone in a secluded vacation home.

Not long after consuming the mushrooms, the man began to experience a terrifying hallucination or delusion, which led him to take an axe and sever his penis into multiple pieces. The details of the event are unclear to the patient, as he did not fully remember what had occurred.

The man reportedly tied a piece of cloth around his genital area to control the bleeding and placed the severed parts of his penis in a jar filled with snow. He then left the house, bleeding profusely, in search of help. A passerby found him in a confused state and called for emergency services. The man was transported to a nearby village and later to a hospital, arriving approximately five hours after the amputation.

Upon arrival, the patient was in a critical condition, having lost a significant amount of blood. He was immediately taken into surgery, where doctors worked to stabilize him and control the bleeding. His penis was contaminated with soil and snow, and parts of the organ were severely damaged. Surgeons were able to save the glans (the tip of the penis) and about two centimeters of the penile shaft, but the other sections were too damaged to be repaired.

Remarkably, the replantation was successful, despite the significant challenges posed by the extent of the injury and contamination. Despite initial difficulties, the patient’s condition improved after the surgery, although he continued to suffer from severe psychotic symptoms, including auditory hallucinations and religious delusions. He was placed under psychiatric care, and his treatment included antipsychotic medications to help control the hallucinations. His mental state gradually stabilized, and after a week, he was moved back to the urology department to continue his recovery.

In the weeks following the surgery, the patient experienced some complications. Superficial necrosis (death of skin tissue) developed on the glans of his penis, likely due to the loss of blood flow during the period of ischemia, but this healed over time. Remarkably, the patient was able to regain some erectile function within three months of the surgery, though the overall length of his penis was significantly reduced due to the damage. At his last follow-up visit, he was able to urinate normally while seated, though a minor complication called hypospadias developed, where the urethral opening is located further down the shaft than normal.

While this case is the first documented instance of psilocybin-induced self-amputation, it brings attention to a broader phenomenon of self-mutilation during psychotic episodes, particularly among individuals with underlying mental health conditions. Known as Klingsor syndrome, these rare but extreme events often involve self-inflicted injury to the genitals and can be associated with a range of psychiatric conditions, from schizophrenia to substance-induced psychosis.