Hallucinogen-related disorders — structured clinical viva

This is an acute intoxication and dual-diagnosis viva, not a pure research seminar. Clear consciousness with geometric visual change and panic after mushrooms fits classic serotonergic psychedelic intoxication. First-line care is medical exclusion of toxicity, then low-stimulus talk-down and observation; benzodiazepines if severe agitation; antipsychotics only if dangerous persistent psychosis.^[1][2]

Mechanism answer expected: 5-HT2A agonism (Nichols). Contrast with NMDA dissociatives if the examiner probes street "hallucinogen" mislabelling.^[2]

Partner's schizophrenia fear: use timeline and dual formulation — do not diagnose lifelong primary psychosis from a single intoxication episode, but do not dismiss vulnerability or need for follow-up if symptoms persist after washout.^[1]

HPPD: uncommon but real post-cessation perceptual re-experiencing with distress/impairment (Halpern); counsel risk without catastrophising every use.^[3]

Microdosing demand: cite research precisely — Goodwin 25 mg vs 1 mg TRD signal under protocol; Carhart-Harris primary endpoint nuance versus escitalopram; Bogenschutz AUD heavy-drinking reduction with assisted psychotherapy — none authorise unsupervised recreational prescribing in standard ANZ care.^[4][5][6]

No classic life-threatening withdrawal detox; no methadone-equivalent substitution for classic psychedelics.^[2]