Psychiatric and Medical Management of Marijuana Intoxication in the Emergency Department

A 34-year-old woman developed psychosis, mild hypokalemia, and QT interval prolongation after ingesting edible cannabis. In the emergency setting, her symptoms resolved over two days with supportive treatment and minimal intervention. Psychiatric management of cannabis psychosis involves symptomatic care and safety during detoxification; acute medical complications are primarily cardiovascular and respiratory, warranting electrolyte and electrocardiogram monitoring. Patients with cannabis psychosis are at risk for further psychotic sequelae, and emergency providers can reduce this risk through appropriate diagnosis, acute treatment, and referral for outpatient care.

Study at a glance

Abstract

We use a case report to describe the acute psychiatric and medical management of marijuana intoxication in the emergency setting. A 34-year-old woman presented with erratic, disruptive behavior and psychotic symptoms after recreational ingestion of edible cannabis. She was also found to have mild hypokalemia and QT interval prolongation. Psychiatric management of cannabis psychosis involves symptomatic treatment and maintenance of safety during detoxification. Acute medical complications of marijuana use are primarily cardiovascular and respiratory in nature; electrolyte and electrocardiogram monitoring is indicated. This patient’s psychosis, hypokalemia and prolonged QTc interval resolved over two days with supportive treatment and minimal intervention in the emergency department. Patients with cannabis psychosis are at risk for further psychotic sequelae. Emergency providers may reduce this risk through appropriate diagnosis, acute treatment, and referral for outpatient care. [West J Emerg Med. 2015;16(3):414–417.]