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Psychotic Cannabis Withdrawal: A Clinical Case

Berta Rita Martins Ramos, Ana Filipa Santos Martins, Eva Sofia Lima Osório

Cureus November 13, 2022 DOI: 10.7759/cureus.31465 (opens in new tab)

Study at a glance

AI-extracted from the abstract
Characteristics Case study Case report Peer reviewed
Sample size 1
Population A 32-year-old woman with heavy, prolonged cannabis use since age 10 and no personal or family psychiatric history
Topics Cannabis
Citations 5
Key findings The authors present a 32-year-old woman with heavy cannabis use since age 10 and no psychiatric history who experienced two brief psychotic episodes with disorganized behavior and persecutory delusions, each occurring one week after discontinuing cannabis. They suggest these episodes were induced by cannabis withdrawal, a rare presentation.

Abstract

Cannabis use has been associated with several psychiatric comorbidities and there appears to be a dose-response relationship between the intensity and duration of its use and the risk of psychosis. More commonly, acute episodes of cannabis induced-psychosis manifest immediately following exposure, are precipitated after the use of large amounts of cannabis, resolve with abstinence, and are of shorter duration than those observed with primary psychotic disorders. Cannabis withdrawal symptoms usually manifest when heavy, prolonged consumption of this substance is interrupted or significantly reduced. The withdrawal syndrome may include sympathetic autonomic hyperactivity, irritability, anxiety, sleep disturbance, and reduced appetite. On the other hand, cases of psychosis induced by cannabis withdrawal are rare. In this case, we present a 32-year-old healthy woman without personal or family psychiatric history who showed a heavy and continued consumption of cannabis since she was 10 years old, without developing any psychiatric symptoms. However, recently she experienced two brief psychotic episodes with disorganized behavior and persecutory delusions, both episodes happening a week after discontinuing cannabis consumption.

Comparable studies

Other case reports and case series on cannabis, most cited first.

Study Year Design Participants
Psychotic Reactions Following Cannabis Use in East Indians Patients at an Indian drug addiction clinic who developed acute cannabis-related psychosis 1974 Descriptive report (case series of clinical observations) n = 200
Psychiatric effects of cannabis use Swedish cases of cannabis psychosis 1985 Case series n = 70
Forty-Six Cases of Psychosis in Cannabis Abusers Gunila Bernhardson Habitual cannabis users treated for psychosis at Swedish psychiatric clinics and mental... 1972 Case series (retrospective survey of psychiatric records) n = 46
Hallucinogen persisting perception disorder after psilocybin consumption: a case study 18-year-old man with HPPD after mixed psilocybin and cannabis intoxication 2005 Case study n = 1
Cannabis‐induced Koro in Americans American men aged 22-26 with years of cannabis experience who reported negative... 2001 Case series n = 3

Citations in the library

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