A Case of Prolonged Peyote-Induced Psychosis Resolved by Sleep

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Sir: Psychosis due to sleep deprivation has been frequently reported.¹ In hallucinogen use, however, the duration of sleep deprivation is usually limited to a few days, and psychosis is attributed to the direct effects of the hallucinogens on the central nervous system. As a source of hallucinogen, the peyote cactus has been used both as a psychedelic drug and, among many Native Americans in the southwestern United States and Mexico, as a spiritual sacrament. The active ingredient is believed to be mescaline, an alkaloid known to cause visual hallucinations and decreased sleep. These effects subside in a few days, with an average duration of 10 to 12 hours.² Here, we report a case of prolonged peyote-triggered psychosis and sleep deprivation that was resolved by sleep initiation.