title: Psychiatric and medical management of marijuana intoxication in the emergency department.
abstract: We use a case report to describe the acute psychiatric and medical management of marijuana intoxication in the emergency setting. A 34-year-old woman presented with erratic, disruptive behavior and psychotic symptoms after recreational ingestion of edible cannabis. She was also found to have mild hypokalemia and QT interval prolongation. Psychiatric management of cannabis psychosis involves symptomatic treatment and maintenance of safety during detoxification. Acute medical complications of marijuana use are primarily cardiovascular and respiratory in nature; electrolyte and electrocardiogram monitoring is indicated. This patient's psychosis, hypokalemia and prolonged QTc interval resolved over two days with supportive treatment and minimal intervention in the emergency department. Patients with cannabis psychosis are at risk for further psychotic sequelae. Emergency providers may reduce this risk through appropriate diagnosis, acute treatment, and referral for outpatient care.
authors.affiliation: University of Colorado School of Medicine, Department of Psychiatry, Aurora, Colorado. University of Colorado School of Medicine, Denver Health Medical Center, Department of Psychiatry, Denver, Colorado.
authors.forename: Quan M
authors.initials: QM
authors.lastname: Bui
authors.affiliation: University of Colorado School of Medicine, Department of Psychiatry, Aurora, Colorado. University of Colorado School of Medicine, Denver Health Medical Center, Department of Psychiatry, Denver, Colorado.
authors.forename: Scott
authors.initials: S
authors.lastname: Simpson
authors.affiliation: University of Colorado School of Medicine, Department of Psychiatry, Aurora, Colorado. University of Colorado School of Medicine, Denver Health Medical Center, Department of Psychiatry, Denver, Colorado.
authors.forename: Kimberly
authors.initials: K
authors.lastname: Nordstrom
mesh_terms: D000328:Adult; D002099:Cacao; D002188:Cannabis / Q000009:adverse effects*; D004562:Electrocardiography; D004573:Electrolytes; D004636:Emergency Service, Hospital; D005260:Female; D006801:Humans; D007008:Hypokalemia / Q000139:chemically induced / Q000175:diagnosis* / Q000628:therapy; D008133:Long QT Syndrome / Q000139:chemically induced / Q000175:diagnosis* / Q000628:therapy; D011605:Psychoses, Substance-Induced / Q000175:diagnosis* / Q000523:psychology / Q000628:therapy; D011618:Psychotic Disorders / Q000523:psychology; D012017:Referral and Consultation
chemical_list: D004573:Electrolytes