www.ncbi.nlm.nih.gov
pubmed.ncbi.nlm.nih.gov
pubmed.ncbi.nlm.nih.gov
ive yet to see a condition that doesnt qualify for it. Insomnia? MM. Pain? MM. Depression? MM. Bad day? MM. Girlfriend dumped you? MM
In the ER and see it all the time, at least 3-4x per month. Saw one yesterday that was 100% THC-induced as patient was using a home-grown source. Not necessarily chronic psychosis, but patients using some form of THC or Delta-whatever who come in with really bizarre behaviors and delusions. Sometimes they clear up in a day or two and other times they spend a week or so in our psych unit clearing up. Occasionally family will bring them in after the symptoms are there for a couple weeks and they end up going to the state hospital. Idk if I'd say there's an "explosion" in cases, but it's certainly not uncommon where I'm at.
Update, saw another one this morning. Patient started using a new dispensary a few weeks ago and per SO has been psychotic for the past week, hallucinating, bizarre behaviors, very guarded/paranoid, etc. Been in our ER for ~36 hours and wasn't seen by psych yesterday because EMS gave ketamine in the field and patient had to be sedated due to agitation and aggression. Today was linear and pleasant and actually pretty insightful about their substance use. Only other psychotic history was as a teenager and when using K2. SO provided collateral, pretty straightforward.
Before cannabis there was tobacco. And this song captures the sentiment. If you jump to 2:04 you'll hear everything it cures.
I wonder what the liability is like for the physicians working there full-time. Doing hundreds of marijuana certifications per month with the expectation for every patient to be certified and for none to be denied....
The same as the doctors "overseeing" 100 NPs prescribing Adderall IR to 95% of the patients they see.
Yes AND anyone who is using on a regular basis, particularly high quantities/amounts, should expect for increased glutamate firing actively worsening anxiety anytime they are not acutely intoxicated. This is not any better than using benzos on a daily basis. People somehow are trying to argue that they are solving their problem by using "natural" THC, you know the THC that grew around 5% in concentration in the wild, is now 20% in all the plant matter and 80-100% pure in carts/dabs/edibles. The fix to your problem is not just ingesting a substance, I'm not sure how the US population came to be this way to believe otherwise (I say as someone prescribing psychotropics all day long).
I read a good article recently saying that what I’m seeking is essentially a prodrome to cannabis hyperemesis syndrome and the prodrome can last years.
Very interesting.
Yeah doesn’t seem to happen to everyone. I tend to see it in young females. I hope it’s reversible.
I definitely see it more in women in general, and young women more I think because they’re more likely to use it. I’ve seen it with more than a few young men too though. Anecdotally, patients frequently will have noticeable cluster B traits or multiple other psychosomatic problems.
I really doubt that. THC is (unfortunately) comically cheap, event from dispensaries in many states, not withstanding the lower prices black markets have gone to keep up. I find it very hard to imagine someone trying to scam a Luvox script out to extend a high.
Better mileage from quetiapine. The mitigation of withdrawal effects is pretty much the entire reason it has street value and I think it’s the only non-controlled substance (other than gabapentin, but that’s semi-controlledish) that someone has tried to get from me that they clearly didn’t need. Street value is high enough that prisons in my state done have it on formulary due to the abuse potential.
Absolutely down for Seroquel usage in this setting as well. I like that if Remeron is effective some people will continue with it for the very high depression/anxiety co-morbidity in this population, whereas Seroquel you want to keep short-term much more and people run into issues with longer term use just perpetuating. But yes, people should certainly consider it for significant THC withdrawal, it's a great point.
I am thinking that it is similar to cannabinoid hyperemesis syndrome - it seems that smoking pot causes a rebound effect where it alleviates symptoms in the short term and causes them in the medium and long term. There is also probably some self selection at work.
I've seen it reverse, but it genuinely takes months and months of sobriety. It sucks. Some people get by with reducing use though, but most need complete abstinence.
Individuals that abuse GLP-1s, or take them inappropriately can develop severe gastroparesis, especially if they were already prone to it. This can also happen with people that already suffer from gastroparesis. In some cases this is either long-lasting or even permanent. I have not seen it in otherwise healthy patients that titrate appropriately (i.e. start at the lowest dose, titrate every 4 wks or longer, etc.) or get their meds from regular pharmacies (as opposed to self compounding or compound pharmacies). There was a case locally that was permanent, but this was an individual that went to a compounding pharmacy and took a much higher dose than would be recommended in order to lose weight "faster".
