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CLINICAL CHALLENGES IN PATIENTS WITH FIRST EPISODE PSYCHOSIS AND CANNABIS USE: MINI-REVIEW AND A CASE STUDY
Josefina Gerlach
; Psychiatric Hospital "Sveti Ivan", Zagreb, Croatia
Barbara Koret
; Psychiatric Hospital "Sveti Ivan", Zagreb, Croatia
Natko Gereš
; Psychiatric Hospital "Sveti Ivan", Zagreb, Croatia
Katarina Matić
; Psychiatric Hospital "Sveti Ivan", Zagreb, Croatia
Diana Prskalo-Čule
; Psychiatric Hospital "Sveti Ivan", Zagreb, Croatia
Tihana Zadravec Vrbanc
; Psychiatric Hospital "Sveti Ivan", Zagreb, Croatia
Vanja Lovretić
; Psychiatric Hospital "Sveti Ivan", Zagreb, Croatia
Katarina Skopljak
; Psychiatric Hospital "Sveti Ivan", Zagreb, Croatia
Tin Matoš
; Psychiatric Hospital "Sveti Ivan", Zagreb, Croatia
Ivona Šimunović Filipčić
; University Hospital Center Zagreb, Zagreb, Croatia
Igor Filipčić
; Psychiatric Hospital "Sveti Ivan", Zagreb, Croatia; ;Faculty of Dental Medicine and Health, Josip Juraj Strossmayer University of Osijek, Osijek, Croatia ;School of Medicine, University of Zagreb, Zagreb, Croatia
Sažetak
The influence of cannabis use on the occurrence, clinical course and the treatment of the first psychotic episode (FEP) is well
documented. However, the exact link is still not clearly established. The aim of this article is to review and report the noticed
increase in the number of hospitalizations of young people with a clinical appearance of severe psychotic decompensation following
cannabis consumption and to show the clinical challenges in treatment of the FEP. The case study describes the clinical course of a
five selected patients with a diagnosis of the FEP and positive tetrahydrocannabinol (THC) urine test who were hospitalized in a
similar pattern of events. They all have a history of cannabis consumption for at least 6 years in continuity and were presented with
severe psychomotor agitation, disorganisation, confusion and aggression at admission. Although the chosen drug to treat all patients
was atypical antipsychotic and benzodiazepines, the course of the disorder and the clinical response to therapy were noticeably
different in each patient. The clinical presentation of FEP in cannabis users can be atypical and highly unpredictable from mild
psychotic symptoms to severe substance intoxication delirium. In clinical practice clinicians treating new onset psychosis need to be
watchful for cannabis and synthetic cannabinoids induced psychosis. Pharmacotherapeutic interventions include prompt and
adequate use of the benzodiazepine, second-generation antipsychotic, and mood-stabilizers. Further research in the pharmacotherapy
of cannabis-induced psychosis is required.
Ključne riječi
cannabis; synthetic cannabinoids; psychosis; first episode psychosis; early-phase psychosis; schizophrenia; case study
Hrčak ID:
262778
URI
Datum izdavanja:
29.5.2019.
Posjeta: 908 *