Gary Sweet1, Sara Kim2, Samuel Martin3, Nicole B Washington4, Nancy Brahm5. 1. PGY-2 Psychiatric Pharmacy Resident, Veterans Affairs Health System of Western NY, Buffalo, New York. Previously: Department of Clinical Pharmacy Services, Saint John Medical Center, Tulsa, Oklahoma. 2. PGY-1 Pharmacy Resident, Oklahoma State University Medical Center, Tulsa, Oklahoma. Previously: University of Oklahoma College of Pharmacy, Tulsa, Oklahoma. 3. Assistant Professor of Psychiatry, Oklahoma State University Center for Health Sciences, Tulsa, Oklahoma. Previously: Department of Psychiatry, University of Oklahoma School of Community Medicine, Tulsa, Oklahoma. 4. Medical Director, Crisis Care Center, Family and Children's Services, Tulsa, Oklahoma. 5. Clinical Professor, University of Oklahoma College of Pharmacy, Tulsa, Oklahoma, Nancy-Brahm@ouhsc.edu.
Abstract
BACKGROUND: Limited treatment information is available when patients present with psychotic symptoms secondary to synthetic cannabinoid (SC) use. Symptoms associated with use are often indistinguishable from those encountered with a primary mental illness and also include aggression, confusion, and anxiety. For these patients, clinicians rely on physical presentation, symptom(s) onset, and episode duration when evaluating patients. PATIENT HISTORY: An adult man was involuntarily admitted to inpatient status secondary to reports of bizarre behaviors that included paranoia and psychomotor agitation. Because of the severity of the symptoms, he was unable to participate in the admission assessment. On day 2, he reported having smoked a substance provided by a friend. In addition, he admitted to previous SC use on 3 occasions, with each occasion resulting in an involuntary admission to inpatient status. The course of this admission was unremarkable. CONCLUSIONS: A brief overview of psychiatric signs and symptoms of SC use and information to help clinicians are included. The presentation of psychotic symptoms secondary to SC may be consistent with those of psychosis or other substances of abuse. Because of the variability in the symptoms produced by SC use, clinicians are encouraged to consider SC use in the diagnostic evaluation.
BACKGROUND: Limited treatment information is available when patients present with psychotic symptoms secondary to synthetic cannabinoid (SC) use. Symptoms associated with use are often indistinguishable from those encountered with a primary mental illness and also include aggression, confusion, and anxiety. For these patients, clinicians rely on physical presentation, symptom(s) onset, and episode duration when evaluating patients. PATIENT HISTORY: An adult man was involuntarily admitted to inpatient status secondary to reports of bizarre behaviors that included paranoia and psychomotor agitation. Because of the severity of the symptoms, he was unable to participate in the admission assessment. On day 2, he reported having smoked a substance provided by a friend. In addition, he admitted to previous SC use on 3 occasions, with each occasion resulting in an involuntary admission to inpatient status. The course of this admission was unremarkable. CONCLUSIONS: A brief overview of psychiatric signs and symptoms of SC use and information to help clinicians are included. The presentation of psychotic symptoms secondary to SC may be consistent with those of psychosis or other substances of abuse. Because of the variability in the symptoms produced by SC use, clinicians are encouraged to consider SC use in the diagnostic evaluation.
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