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Date of last update: 8/24/2017.

Forum Name: Psychiatric Topics

Question: drug induced psychosis

 bigben100 - Thu Aug 19, 2010 11:36 am

My brother went to see a doctor who prescribed him Adderall and Klonopin, both of which he abused. Due to this, he he failed the majority of his college classes last semester. He is currently seeing a new doctor who will only prescribe him an antidepressent. In addition, he smokes marijuana daily. However even without the abuse of the other drugs, the bizarre behaviors are still evident. His bizarre behavior involve laughing to himself, talking to himself, pacing around the house for multiple hours, lack of sleep, complete lack of motivation, and unable to keep focused. Almost as if he has a loss of contact with reality. He is obsessed with the lives of his peers from high school and can spend all day looking through a yearbook or asking questions/talking about/to these people. If I don't remember who they are he becomes angry. My parents have forced him to move back home where they can keep him in a structured environment(he is 25 years old). I want to know, if it's possible for him to be temporarily psychotic due to Marijuana inducement or even permanently psychotic induced to due prolong use? If he were to totally stop Marijuana,do you think will his psychotic episodes subside eventually? Thanks!
 Faye Lang, RN, MSW - Mon Aug 23, 2010 3:03 pm

Hi -

Your brother's symptoms could be related to his regular use of marijuana. Some people are more sensitive to its effects than others, and part of the effects are dependent on the potency of the marijuana itself. Marijuana, or cannabis, has properties of being a stimulant, a depressive, and a hallucinogen, all of which can create significant changes in a person's behavior. The most active ingredient in cannabis is known as THC, or tetrahydrocannabinol; it also has approximately 66 additional cannabinoids. The amount of THC is used as the standard to determine the potency of the drug. "Homegrown" cannabis can be very potent. There also may be adulterants present in marijuana forms for usage (as, cigarettes), such as additional drugs, soil, animal feces, oil, or other contaminants. Smoking cannabis is probably the most harmful way to use it, since inhaling the smoke from organic matter can cause health problems.

Short term effects of marijuana include changes in perception, change in mood (either good or bad), increased heart rate, lowered blood pressure, insomnia or hypersomnia, lethargy or restlessness, episodic impairment of short-term memory and working memory, impairment of psychomotor coordination, impaired concentration, easing of nausea and/or vomiting, stimulation of hunger, lowered pressure in the eye, and pain relief. These effects are why the person uses cannabis. Long term effects are possible, especially in those who are more sensitive to cannabis, or in those who regularly use the drug. Long term effects can include anxiety, depression, psychosis and derealization and depersonalization.

Derealization is a sense that reality has changed, or a sense of detachment from one's surroundings. Depersonalization is a disorder in which the person has a sense of observing oneself, with no control over a situation or their environment. The environment seems less real and dreamlike, and the person feels separate from body sensations, feelings, emotions and behaviors. Psychosis can occur; psychosis is a mental disorder in which there is disintegration of the personality and loss of contact with reality. The person is unable to mirror reality as it is, reacts erroneously to reality, and builds false concepts regarding reality. Behavior is peculiar, abnormal, scattered and/or antisocial. In most cases, discontinuing use of cannabis will result in the disappearance of such symptoms, but they can become permanent.

With chronic use of cannabis, it can be very difficult to convince a person to alter their consumption of the drug or to receive help in discontinuing its use. His doctor may be able to help you identify resources in your community for dealing with this issue. Public or private mental health providers can give you information on treatment options, and whether involuntary admission to a treatment facility is a possibility. The central issue is your brother's safety, including his mental health, function in the environment while impaired, and physical status.

I hope this information is helpful to you and your family in dealing with your brother's situation. I wish you all the best of luck.

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