The Effectiveness of Microdosed Psilocybin in the Treatment of Neuropsychiatric Lyme Disease: A Case Study

Introduction

Lyme borreliosis, caused by Borrelia burgdorferi sensu lato and transmitted by Ixodes ticks, can produce persistent, multisystem illness in which neuropsychiatric complaints such as anxiety and depression may predominate. Co-infections transmitted by the same ticks — notably Bartonella spp., Babesia and Mycoplasma spp. — often complicate the clinical picture and may contribute to psychiatric manifestations. The pathophysiology described in the paper emphasises neuroinflammation and microbe-triggered autoimmunity, including the production of anti-neuronal antibodies and proinflammatory cytokines; this model has parallels with syndromes such as PANS and motivates a multimodal treatment approach combining antimicrobials, psychotropic agents and anti-inflammatory interventions. Kinderlehrer frames the present report around an apparent treatment gap: some patients with neuropsychiatric Lyme disease are intolerant of, or resistant to, standard antimicrobial and psychopharmacologic therapies, and options that modulate autoimmune neuroinflammation without broad immune suppression are limited. The study describes a single immunocompetent patient whose chronic, treatment-refractory neuropsychiatric symptoms remitted after he began microdosed psilocybin, and it situates this case against emerging literature that highlights both serotonergic and anti-inflammatory properties of psilocybin. The paper's stated aim is to document this clinical observation and to argue for further research on microdosed psilocybin in neuropsychiatric Lyme disease and related autoimmune encephalopathies.