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复发性大麻所致紧张症:一例报告及全面系统的文献综述

Recurrent cannabis-induced catatonia: a case report and comprehensive systematic literature review.

作者信息

Moshfeghinia Reza, Hosseinzadeh Mehrnaz, Mostafavi Sara, Jabbarinejad Roxana, Malekpour Mahdi, Chohedri Elnaz, Ahmadi Jamshid

机构信息

Student Research Committee, Shiraz University of Medical Sciences, Shiraz, Iran.

Research Center for Psychiatry and Behavior Sciences, Shiraz University of Medical Sciences, Shiraz, Iran.

出版信息

Front Psychiatry. 2024 Jan 18;15:1332310. doi: 10.3389/fpsyt.2024.1332310. eCollection 2024.

Abstract

BACKGROUND

Catatonia presents itself as a complex neuropsychiatric syndrome, giving rise to various motor, speech, and behavioral challenges. It is noteworthy that approximately 10% of psychiatric hospital admissions can be attributed to this condition. It is imperative to note that cannabis-induced catatonia, while infrequent, has been linked to the use of marijuana. This connection has the potential to disrupt neurotransmitter systems, necessitating further research for a comprehensive understanding and effective treatment, particularly given the evolving trends in cannabis use. In this context, we shall delve into a unique case of recurrent cannabis-induced catatonia.

CASE PRESENTATION

A 23-year-old gentleman, who has previously struggled with substance use disorder, experienced the emergence of mutism, social isolation, and a fixed gaze subsequent to his use of cannabis. Remarkably, despite the absence of hallucinations, he exhibited recurrent episodes of catatonia. These episodes were effectively addressed through a combination of electroconvulsive therapy (ECT) and lorazepam administration. Notably, when the lorazepam dosage was gradually reduced to below 2 mg per day, the catatonic symptoms resurfaced; however, they promptly abated upon reinstating the medication. The diagnosis of cannabis-induced catatonia was established, and its management primarily involved a therapeutic approach encompassing ECT and lorazepam. It is pertinent to underscore that this catatonic condition can be directly linked to the individual's cannabis usage.

CONCLUSION

The connection between cannabis and catatonia is intricate and not entirely comprehended. Although cannabis possesses therapeutic advantages, it can paradoxically trigger catatonia in certain individuals. Multiple factors, such as genetics, cannabinoids, and neurotransmitter systems, contribute to this intricacy, underscoring the necessity for additional research.

摘要

背景

紧张症表现为一种复杂的神经精神综合征,引发各种运动、言语和行为方面的挑战。值得注意的是,精神病医院约10%的住院病例可归因于这种情况。必须指出的是,大麻所致紧张症虽不常见,但与大麻使用有关。这种关联有可能扰乱神经递质系统,鉴于大麻使用的不断变化趋势,需要进一步研究以全面了解并进行有效治疗。在此背景下,我们将深入探讨一例复发性大麻所致紧张症的独特病例。

病例介绍

一名23岁男性,既往有物质使用障碍史,在使用大麻后出现缄默、社交隔离和凝视固定。值得注意的是,尽管没有幻觉,但他出现了反复发作的紧张症。这些发作通过电休克治疗(ECT)和使用劳拉西泮有效缓解。值得注意的是,当劳拉西泮剂量逐渐减至每日2毫克以下时,紧张症症状复发;然而,重新用药后症状迅速缓解。确诊为大麻所致紧张症,其治疗主要包括ECT和劳拉西泮的治疗方法。需要强调的是,这种紧张症状况可直接与该个体的大麻使用相关联。

结论

大麻与紧张症之间的联系错综复杂,尚未完全明了。尽管大麻具有治疗优势,但在某些个体中却可能反常地引发紧张症。遗传、大麻素和神经递质系统等多种因素导致了这种复杂性,凸显了进一步研究的必要性。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/488a/10835799/2930eb38712a/fpsyt-15-1332310-g001.jpg

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