Transient multidomain functional improvement in advanced Alzheimer's disease following high-dose psilocybin-containing mushroom administration: a case report.

A single case report describes an 80-year-old woman with a 10-year history of Alzheimer's disease and severe functional decline who showed temporary improvements in multiple domains after taking 5 grams of psilocybin-containing mushrooms. Before the intervention, she had urinary incontinence, difficulty walking, minimal speech, and required help with daily activities. About 19 hours after administration, she began speaking spontaneously about her life. Over the following days and weeks, she regained bladder control, walked better, dressed herself, showed more emotion, engaged in conversations, and recalled recent social interactions. The authors suggest that some functional capacity may persist even in late-stage Alzheimer's and can become temporarily accessible under certain conditions, but the findings do not indicate disease reversal.

Study at a glance

Abstract

Advanced Alzheimer's disease (AD) is generally regarded as a stage of irreversible functional decline. Psilocybin is known to transiently alter large-scale brain network dynamics and to induce plasticity-related mechanisms in preclinical models, yet clinical data in advanced dementia remain lacking. We report the case of an octogenarian Japanese-American woman with a 10-year history of Alzheimer's disease, including 5 years of marked hypofunction and predominantly monosyllabic speech. Baseline features included chronic urinary incontinence, executive dysfunction, dysphagia, dependent mobility, flat affect, and severe reduction in spontaneous communication. The patient received 5 g of orally administered psilocybin-containing mushrooms (Enigma strain). The acute phase was marked by autonomic activation, clinically suspected hyperthermia, profuse sweating, and a prolonged deep sleep-like state. Approximately 19 h post-administration, spontaneous autobiographical speech emerged. Over subsequent days and weeks, functional improvements included restoration of urinary continence, improved ambulation, autonomous dressing, increased emotional responsiveness, sustained social interaction, contextual memory retrieval, preserved working memory for social context, and spontaneous conversational engagement. This case documents transient multidomain functional improvement in advanced Alzheimer's disease following psilocybin administration. The findings do not imply disease reversal but suggest that residual functional capacity may persist in late-stage neurodegeneration and may become transiently accessible under specific neuromodulatory conditions.