A case of brief psychosis upon cannabis withdrawal

Abstract

Psychosis related to Cannabis use has been reported in several literatures. This relationship has been reported to be dose dependent, with individuals who frequent use Cannabis and those who use a large amount of cannabis developing psychosis.1, 2 Cannabis use has been associated with episodes of psychosis during acute intoxication and also past the point of acute intoxication, that is during the withdrawal phase.3,4 However, the actual causality is unclear as reports have been equivocal as to whether Cannabis in itself causes psychosis or if it exacerbates or precipitates psychosis in an individual who is already predisposed.5 Some characteristics associated with Cannabis related psychotic episodes are a) disorientation, b) confusion, and c) amnesia. This group of symptoms is referred to as “toxic psychosis” and usually occurs after the use of large amounts of Cannabis within a short period.6 Though acute intoxication is the bulk of the current literature, limited cases of psychosis have been reported in relation to marijuana withdrawal. In this case, we present a 23-year old Hispanic woman who experienced a brief psychotic break not during acute intoxication but upon Cannabis withdrawal.