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Psych CASC / OSCEAddiction psychiatry — hallucinogen-related disorders

Psych CASC / OSCE · Addiction psychiatry — hallucinogen-related disorders

Explain bad trip care, HPPD risk, and why trial psilocybin is not a microdosing script — CASC communication station

MRCPsych/FRANZCP-style communication station: explain intoxication versus primary psychosis, supportive acute care, HPPD risk in plain language, and honest PAT trial framing without colluding with unsupervised use.

communication2 min readVerification in progress

Target exams

FRANZCPMRCPsychABPNMD-DNB
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Study tools

Target exams

FRANZCPMRCPsychABPNMD-DNB
Prompt
A 23-year-old is clearing after a mushroom bad trip managed with talk-down. His mother fears he has schizophrenia and wants lifelong depot. He wants a 'microdosing prescription like in the depression studies.' He has mild residual anxiety, no ongoing psychosis, and asks whether he can drive home tonight.

Station brief

Format. Communication station, approximately 7–10 minutes active time after reading. You are the psychiatry/addiction registrar. Examiner may play patient and/or mother. [1]

Candidate instructions. Explain what happened during the bad trip in plain language. Address schizophrenia fears without day-one lifelong labelling. Describe rare but real HPPD risk. Explain why research psilocybin doses with psychological support are not the same as unsupervised microdosing. Advise on driving, follow-up and safer-use/harm reduction without moralising. Check understanding and agree a plan. [1][4]

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References5ShowHide
  1. [1]Johnson MW, Richards WA, Griffiths RR Human hallucinogen research: guidelines for safety J Psychopharmacol, 2008.PMID 18593734
  2. [2]Nichols DE Psychedelics Pharmacol Rev, 2016.PMID 26841800
  3. [3]Halpern JH, Pope HG Jr Hallucinogen persisting perception disorder: what do we know after 50 years? Drug Alcohol Depend, 2003.PMID 12609692
  4. [4]Goodwin GM, Aaronson ST, Alvarez O, et al. Single-Dose Psilocybin for a Treatment-Resistant Episode of Major Depression N Engl J Med, 2022.PMID 36322843
  5. [5]Carbonaro TM, Bradstreet MP, Barrett FS, et al. Survey study of challenging experiences after ingesting psilocybin mushrooms J Psychopharmacol, 2016.PMID 27578767
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