Alhassan, MD, (ORCID: 0000-0003-4770-9538), PGY2 Psychiatry resident, Department of Psychiatry and Behavioral Neurobiology, University of Alabama at Birmingham, Heersink School of Medicine, Birmingham, AL.
Prahad, MS-4, Department of Psychiatry and Behavioral Neurobiology, University of Alabama at Birmingham, Heersink School of Medicine, Birmingham, AL.
Psychopharmacol Bull. 2024 Mar 4;54(1):33-39.
Synthetic cannabinoids (SCs), a class of new psychoactive substances (NPS) commonly known as "spice," has rapidly gained popularity and become the most ubiquitous NPS on the illegitimate drug market. SCs, unlike natural cannabis (NC), are not controlled by international drug conventions, posing a significant risk to public health. These substances are easily accessible, relatively inexpensive, and challenging to detect in routine drug screenings. The existing literature provides strong evidence of an association between NC use and psychosis, but there is significantly less data on SC psychosis. We present a clinical case report of a 51-year-old African American female with no known psychiatric history who was admitted to the inpatient psychiatric unit after reported paranoia and altered mental status for the preceding six days. During hospitalization, she exhibited disorganization, persecutory delusions, extreme agitation, and bizarre behaviors that included the concealment of a set of stolen keys in her vagina, necessitating an ethics consult. After consideration of differentials, the patient was diagnosed with substance-induced psychotic disorder secondary to SC. The patient was stabilized on 3 mg Risperidone at bedtime. After 16-day hospitalization, she reached her baseline and later revealed that she had recently smoked SC for the first time. The primary goal of this case is to highlight the sequelae of SC-associated psychosis. A SC-associated psychosis could drastically vary from NC and is often undetectable on a typical UDS, which may result in a lifelong primary psychotic disorder misdiagnosis.
合成大麻素（SCs），一类通常被称为“香料”的新精神活性物质（NPS），迅速流行起来，成为非法毒品市场上最普遍的 NPS。SCs 与天然大麻（NC）不同，不受国际毒品公约管制，对公众健康构成重大风险。这些物质容易获得，相对便宜，且在常规药物筛查中难以检测到。现有文献提供了强有力的证据表明 NC 使用与精神病有关，但关于 SC 精神病的数据要少得多。我们报告了一例临床病例，一名 51 岁的非裔美国女性，无已知精神病史，因六天前出现妄想和精神状态改变而被收入住院精神科病房。住院期间，她表现出精神错乱、被害妄想、极度激动和奇异行为，包括将一套偷来的钥匙藏在阴道里，需要进行伦理咨询。在考虑了不同的鉴别诊断后，患者被诊断为 SC 引起的精神病性障碍。患者睡前给予 3mg 利培酮稳定病情。住院 16 天后，她恢复到基线水平，后来透露她最近第一次吸食 SC。该病例的主要目的是强调 SC 相关精神病的后遗症。SC 相关的精神病可能与 NC 有很大的不同，且通常在常规 UDS 上无法检测到，这可能导致终生误诊为原发性精神病。
