Abstract
Background Cannabis is the most commonly used illegal drug and its therapeutic aspects have a growing interest. Short-term psychotic reactions have been described but not clearly with synthetic oral THC, especially in occasional users.Case presentationsWe report two cases of healthy subjects who were occasional but regular cannabis users without psychiatric history who developed transient psychotic symptoms (depersonalization, paranoid feelings and derealisation) following oral administration of cannabis. In contrast to most other case reports where circumstances and blood concentrations are unknown, the two cases reported here happened under experimental conditions with all subjects negative for cannabis, opiates, amphetamines, cocaine, benzodiazepines and alcohol, and therefore the ingested dose, the time-events of effects on behavior and performance as well as the cannabinoid blood levels were documented.ConclusionWhile the oral route of administration achieves only limited blood concentrations, significant psychotic reactions may occur.
Highlights
Cannabis is the most commonly used illegal drug and its therapeutic aspects have a growing interest
Five large-scale longitudinal studies and a systematic review have shown that cannabis use in adolescence is associated with a two-to threefold increase in the relative risk of later developing schizophrenia [4]
A temporary form of drug-induced psychotic reaction after administration of oral cannabis has occurred in these two cases
Summary
As several countries in Europe have taken policies to decrease the penalties for cannabis possession, many people especially young persons have interpreted this move as giving support to consider cannabis as a benign drug [1]. Clinical applications include nausea and vomiting, muscle spasticity in demyelinating diseases, loss of appetite in cancer and AIDS, pain, insomnia, asthma as well as other applications [9] As these oral medications are becoming increasingly available, we think it is useful to report two cases of severe psychological sides effects, especially considering the lack of data in the literature on psychotic symptoms associated with oral synthetic or natural THC. This study was carried out to assess the effects of delta-9-tetrahydrocannabinol (THC) on psychomotor function and driving performance It compared a medication containing 20 mg dronabinol (MarinolR), and 2 hemp milk decoction containing either a medium (15.8 mg average dose determination) or a high dose of THC (45.7 mg) with matched placebos. To the other volunteer, he indicated a strong feeling of intoxication and a very important decrease in his self-reported capacity to drive (results not shown)
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