5-MeO-DMT for post-traumatic stress disorder: a real-world longitudinal case study

Blue dotted line indicates the cut-off point for a complete mystical experience (≥60% of total scores across factors). 5-MeO-DMT, 5-methoxy-N,N-dimethyltryptamine; MEQ-30, Mystical Experience Questionnaire. At baseline, the subject’s score for ‘illness severity’, regarding PTSD, was 6 of 7, meeting threshold criteria for ‘severely ill’.

Ocular Hypotonia and Transient Decrease of Vision as a Consequence of Exposure to a Common Toad Poison

For example, vaporization induces effects within ~10–15 s and peak experiences within ~2–5 min, resolving within ~25–30 min (6, 22, 23). Conversely, insufflation has a slower onset of action, due to delayed absorption, inducing effects within ~3–4 min and peak experiences within ~35–40 min, resolving within ~60–70 min (24). Irrespective of route, 5-MeO-DMT produces diverse subjective effects, including visual and auditory hallucinations, distorted time perception, and memory impairment (4). It also occasions peak mystical experiences comparable to high-dose psilocybin (25). Ego dissolution, a complete loss of self-identity, is frequently reported, as are profound near-death experiences (22, 25–28).

Furthermore, the overall amount of bufadienolides per unit dry mass of parotoid secretion was higher in adult toads from agricultural habitats, suggesting that their toxin secretion was more potent. These results parallel the earlier experimental findings on toad tadpoles that herbicide exposure increases their bufadienolide content26. Altogether, one potential explanation for these results is that chemical pollutants in anthropogenic habitats may enhance the production of bufadienolides, which may be either a non-adaptive constraint or an adaptive response. On the one hand, bufadienolides are synthesized from the same precursor as glucocorticoid stress hormones and steroid sex hormones, starting with the same initial steps20.

Figure 4.

LA has served as a Consultant, Speaker and/or Advisory Board Member for Guidepoint, Transcend Therapeutics, Beond, Source Research Foundation, Reason for Hope, Beond, The Cohen Foundation, Ampelis, and is owner of NPSYT, PLLC. The original contributions presented in the study are included in the article/supplementary material, further inquiries can be directed to the corresponding author. Fast poisoning advice 24 hours, 7 days a week, from anywhere in Australia.

• The main composition of dry toad, toad skin and toad clothing compared to toad venom is basically the same; however, the difference in the concentration of the components is large.
• The subject’s dose and setting likely impacted her perceptual experience (38).
• The common toad produces venom (bufotoxin) that is produced in the parotid gland of the toad as well as in the skin.
• Despite the therapeutic effects of toad-derived medicines on human health, there is insufficient research and development of toad-derived medicines by leading drug companies.
• This indicates the cytotoxicity of BL and its effect on promoting apoptosis 47.

Toad skin as raw materials for drugs

This rarely described effect of the bufotoxin can be used as a basis for further research of toad venom and its pharmacological potential. To present a case of a 67-year-old female patient who experienced a sudden decrease in vision after exposure to the poison from a common toad (Bufo bufo). Toads have toxic substances in the skin and parotid glands.1,3,4 Ingestion of toad or toad cake can lead to intoxication. Most toxic compounds of this venom are steroids similar to digoxin. Most patients have gastrointestinal symptoms consisting of nausea, vomiting, and abdominal discomfort.

Toxin on the skin

• In extreme cases following ingestion of mucus or skin of the toad, death generally occurs within 6 and 24 hours.
• Finally, no laboratory test was performed to confirm the identity of the specific toad toxin.
• We obtained a toxin sample from each toad by pressing the right parotoid gland and wiping off the secretion with a cotton swab (in 4 animals, both parotoids had to be sampled to get enough secretion).
• Four years later, the subject pursued 5-MeO-DMT, independent from her psychiatrist, supported by a trauma-informed facilitator.
• Therefore, the chemical composition and the concentrations in toad skin from different regions in the world display a large difference.

However, there were nominal increases in blood pressure and heart rate. Interestingly, 5-MeO-DMT produced more visual content than previously described (30). Colors appeared at the beginning of her experience, then faded into transcendent light; the latter being more consistent with literature (30). The subject’s dose and setting likely impacted her perceptual experience (38).

We performed a 5-year retrospective study (January 2012–December 2016) using data collected from the RPC Toxic Exposure Surveillance System, which is the database of our poison center. The primary objective was to describe the clinical characteristics and outcomes in patients with toad poisoning in Thailand during the 5-year period. On the PCL-5, the subject had a clinically significant change in PTSD, which sustained across time. This was evidenced by a ≥ 10-point reduction in total scores from baseline to 24 h (−54 points), 1 month (−49 points), 3 months (−37 points), 6 months (−46 points), and 12 months (−50 points) follow-up. A research of Jin Qiquan 68 shown that a mixture of toad skin water and fat displayed bufotoxin effects on humans an intravenous LD50 of 3.81 ± 0.22 mg/kg in mice, and an intraperitoneal injection showed an LD50 of 26.27 ± 0.30 mg/kg.

Bone sarcoma cells, U2OS, treated with BL for 48 h, display condensed chromatin and have the typical apoptotic body that increases with the increase in the concentration of BL. This indicates the cytotoxicity of BL and its effect on promoting apoptosis 47. BL has an effect on target-induced tumor cell apoptosis, for example, BL can increase the expression of the Bax protein and lower the Bel-2 protein levels, to induce the apoptosis of tumor cells (eg, U2OS, HL60, HepG2, A549) 48.

The facilitator had extensive experience with 5-MeO-DMT, who advised on dosing and guided her experience. A licensed clinician, likewise, supported the subject in this pursuit. The clinician administered assessments, monitored her experience, and completed follow-ups. Assessments included the PTSD Checklist for DSM-5 PCL-5; (33), the Beck Hopelessness Scale BHS; (34) and the Clinical Global Impressions CGI; (35) questionnaire. These were used to track the subject’s progress over time, administered prior to 5-MeO-DMT dosing (i.e., at baseline), and again 24 h-, 1 month-, 3 months-, 6 months-, and 12 months later (i.e., at follow-ups).

She noticed that her eyes were red and that her vision was very blurry. The oral LD50 of toad venom is 0.36 mg/kg, and the common adult clinical oral dose is 3-5 mg/day (the maximum dose cannot exceed 135 mg/day) 64. He Shilin 65 confirmed the LD50 of toad venom extracts by different fabrication processes. Intravenous injection of mice produced a rough extract of 0.04 g/kg of toad venom, an alcohol extract of 0.21 g/kg, and a water extract of 0.9 g/kg of toad venom.

This study was performed to describe the clinical characteristics and outcomes of patients with toad poisoning in Thailand. This case study is the first to report the longitudinal effects of 5-MeO-DMT for chronic refractory PTSD, complicated by hopelessness and suicidality. The results showed that 5-MeO-DMT offered fast-acting, robust, and sustained improvements in symptomatology, and was generally tolerable and safe to administer. However, this was not without risks, as evidenced by acute nausea, overwhelming subjective effects, and late onset of night terrors. This can be achieved through clinical and naturalistic studies, in controlled and uncontrolled environments, to effectively converge on safety, efficacy, effectiveness, and durability of 5-MeO-DMT for PTSD. Evidence can then be leveraged to optimize therapeutic delivery, as well as develop standard clinical practice guidelines.