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大麻二酚诱发的躁狂发作:一例报告

Cannabidiol Induced Manic Episode: A Case Report.

作者信息

Auf Anas Ibn, Almakki Razan A, Alhummayani Nora M

机构信息

Auf, Erada and mental health complex, Taif, Saudi Arabia; Department of Psychiatry, Eastern Sudan University for Medical Sciences and Technology, Port Sudan, Sudan.

Almakki, Erada and mental health complex, Taif, Saudi Arabia.

出版信息

Psychopharmacol Bull. 2025 Jul 4;55(4):116-122.

Abstract

BACKGROUND

Cannabidiol (CBD), a non-intoxicating compound derived from Cannabis sativa, has gained widespread popularity for its proposed therapeutic effects in conditions such as anxiety, insomnia, and chronic pain. Unlike tetrahydrocannabinol (THC), CBD is often perceived as safe, with minimal psychoactive properties. However, its psychiatric safety profile, particularly in relation to mood disorders, remains poorly understood.

CASE PRESENTATION

We report the case of a 31-year-old male with no prior psychiatric history who developed a manic episode characterized by irritability, decreased need for sleep, hyperactivity, and aggression. These symptoms emerged after three months of escalating daily CBD use via vaping, reaching high doses shortly before admission. Toxicology screening was negative for other substances, and the patient showed clinical improvement with mood stabilizers and antipsychotics following the discontinuation of CBD.

DISCUSSION

This case raises concerns about the potential of high-dose CBD to induce manic symptoms in certain individuals. While CBD has been proposed to have anxiolytic and antipsychotic effects, its influence on mood regulation may be complex and dose-dependent. The variability in commercial CBD product composition, including possible contamination or mislabeling, further complicates risk assessment. Current evidence from clinical trials on CBD's effects in mood disorders is limited and inconclusive.

CONCLUSION

Clinicians should remain alert to the psychiatric effects of CBD, particularly in patients presenting with new-onset mood symptoms. This report underscores the need for controlled studies to assess the safety of CBD in psychiatric populations and calls for stricter regulation of cannabinoid products.

摘要

背景

大麻二酚(CBD)是一种从大麻中提取的无成瘾性化合物,因其在焦虑、失眠和慢性疼痛等病症中的潜在治疗作用而广受欢迎。与四氢大麻酚(THC)不同,CBD通常被认为是安全的,几乎没有精神活性。然而,其精神安全性,尤其是与情绪障碍相关的安全性,仍知之甚少。

病例介绍

我们报告一例31岁男性,既往无精神病史,出现了以易怒、睡眠需求减少、多动和攻击行为为特征的躁狂发作。这些症状在通过电子烟每天递增使用CBD三个月后出现,入院前不久达到高剂量。毒理学筛查未发现其他物质呈阳性,停用CBD后,患者使用情绪稳定剂和抗精神病药物后临床症状改善。

讨论

该病例引发了人们对高剂量CBD在某些个体中诱发躁狂症状可能性的担忧。虽然有人提出CBD具有抗焦虑和抗精神病作用,但其对情绪调节的影响可能很复杂且依赖剂量。商业CBD产品成分的变异性,包括可能的污染或标签错误,进一步使风险评估复杂化。目前关于CBD对情绪障碍影响的临床试验证据有限且尚无定论。

结论

临床医生应警惕CBD的精神影响,尤其是在出现新发情绪症状的患者中。本报告强调需要进行对照研究以评估CBD在精神疾病患者中的安全性,并呼吁对大麻素产品进行更严格的监管。

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