Originally published by our sister publication Pharmacy Practice News

By Karen Blum

Toxicology experts in Virginia are warning about adverse health effects in people ingesting mushroom gummies marketed as nootropics (substances taken to enhance cognitive function) or psychedelics, purchased from gas stations and smoke shops. The products have been found to contain several ingredients not listed on the labels.

Four adults who intentionally ingested gummies labeled as containing either Amanita muscaria or proprietary mushroom nootropic blends reported to emergency departments from Sept. 1 to Nov. 20, 2023, experiencing tachycardia, confusion, anxiety or somnolence, and nausea, investigators wrote in Morbidity and Mortality Weekly Report (2024;73:628-630). A. muscaria, although legal, can cause symptoms such as gastrointestinal upset, agitation and seizures. Two patients received benzodiazepines, three were given antiemetics, and four were treated with intravenous fluids before discharge.

In June 2024, a 3-year-old child who accidentally ingested two gummies was hospitalized with somnolence and vomiting. The child was discharged one day later with no intervention.

As a result, investigators with the University of Virginia Health Toxicology Laboratory evaluated the content of six products from five brands, using mass spectrometry.

“We were surprised and concerned to find psilocybin and psilocin [in four of them], knowing that they are Schedule I drugs in Virginia,” study co-author Rita Farah, PharmD, MPH, PhD, told Pharmacy Practice News. She is a research assistant professor and an epidemiologist with the medical toxicology division of UVA’s Department of Emergency Medicine, in Charlottesville. “We found undisclosed stimulants, namely caffeine and ephedrine. We found mitragynine in one of the brands. Mitragynine produces an opioid-like effect. While [it] is legal in Virginia, it was not disclosed as an ingredient.”

Pharmacists should “be aware of ‘edibles’ or ‘food-like’ products with nonspecific health benefits that patients may report taking,” Dr. Farah said. “Keep these products on your radar as they can cause severe adverse health effects.”

Issues related to these types of items are not limited to Virginia, Dr. Farah added. As of July 15, 69 illnesses and 36 hospitalizations related to Diamond Shruumz−brand chocolate bars, cones and gummies have been reported in 28 states, according to the FDA. The products, which cause a variety of severe symptoms, including seizures, central nervous system depression, agitation, abnormal heart rates, nausea and vomiting, have been recalled by the parent company as of June 27 and should not be available for sale, the agency noted.

Dr. Farah reported no relevant financial disclosures.