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The synthetic cannabinoid Spice as a trigger for an acute exacerbation of cannabis induced recurrent psychotic episodes

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Introduction

It is established that cannabis consumption cannot only trigger transient psychotic episodes but also predisposes for the development of lasting paranoid schizophrenia in a dose dependent manner (Moore et al., 2007, Muller-Vahl & Emrich, 2008). Patients with a positive family history are at a higher risk for such drug induced schizophrenic disorders (Fergusson et al., 2006, Morgan & Curran, 2008). Cross-reactions between different drugs to trigger recurrence of schizophrenic episodes are rare (Huffman et al., 2008). We present the case of a 25 year old man who had a history of cannabis induced recurrent psychotic episodes and an acute reactivation of symptoms after abuse of the synthetic cannabinoid “Spice”.

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Case report

We report on a twenty-five year old man presenting to our hospital complaining about increased anxiety over the past month. On further investigation severe psychotic symptoms mainly with feelings of manipulation were found. The patient felt that he was controlled through a chip which he thought was implanted in his abdomen several years before. The past medical history obtained through the mother of the patient revealed that the patient had recurrent psychotic episodes since the age of 18 which

Discussion

“Spice” contains a modified synthetic cannabinoid CP-47,497 which is four times stronger than natural cannabis, and the synthetic cannabinoid-mimetic JWH-018 that binds to cannabinoid-like receptors in the brain (Huffman et al., 2008). Its effects in the brain are comparable to those of tetrahydrocannabinol (THC) (Morgan and Curran, 2008). The main psychoactive component of cannabis is delta-9-tetrahydrocannabinol, which is directly associated with paranoid and psychotic symptoms (Moore et al.,

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Conflict of interest

None.

Acknowledgements

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