Cannabis-Associated Mania in Young Adult Males: A Case Series
Nikhar Satyapal, Parisha Kelkar, Abhimanyu Sinha, Suprakash Chaudhury, A. Javadekar
Medical Journal of Dr. D.Y. Patil Vidyapeeth October 1, 2026 DOI: 10.4103/mjdrdypu.mjdrdypu_860_25 (opens in new tab)
Study at a glance
AI-extracted from the abstract| Characteristics | Case series Case report Peer reviewed |
|---|---|
| Sample size | 3 |
| Population | Young adult males presenting with first-episode mania following recent escalation of cannabis consumption |
| Interventions | Antipsychotics Mood stabilizers Benzodiazepines Motivational enhancement therapy |
| Duration | Symptomatic improvement within 1–2 weeks |
| Topics | Cannabis |
| Key findings | Three young men without prior psychiatric illness developed first-episode mania after increasing cannabis use, with symptoms including grandiosity, decreased need for sleep, talkativeness, aggression, and risk-taking. Symptoms improved within 1–2 weeks on antipsychotics, mood stabilizers, and benzodiazepines plus motivational enhancement therapy. The authors argue the temporal association and absence of prior mood episodes support a substance-induced cause. |
Abstract
A BSTRACT Cannabis is the most widely used illicit psychoactive substance worldwide. While cannabis-related psychosis is well documented, cannabis-associated mania is a relatively under-recognized clinical entity that poses diagnostic and therapeutic challenges. We describe three young adult males who presented with first-episode mania following a recent escalation of cannabis consumption. All patients exhibited classic manic symptoms, including elevated or irritable mood, grandiosity, decreased need for sleep, increased talkativeness, aggression, and risk-taking behaviour. None had a prior psychiatric illness or family history of bipolar disorder. Mental status examinations revealed grandiose ideation, impaired insight, and ongoing craving for cannabis. Treatment included antipsychotics, mood stabilizers, and benzodiazepines along with motivational enhancement therapy, resulting in symptomatic improvement within 1–2 weeks. The temporal association between cannabis escalation and manic symptoms, alongside the absence of prior mood episodes, supports a substance-induced aetiology. These cases underscore the importance of thorough substance-use assessment in patients presenting with first-episode mania, especially young adults. Clinicians should remain vigilant for cannabis-related mood disturbances in psychiatric settings.
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 |