Amotivational Syndrome Caused by Cannabis Use: A Case Who Improved with Additional Testosterone Combination Treatment

Abstract

SUMMARYCannabis which is obtained from seeds and dried leaves of the cannabis sativa plant is widely used in the world due to its recreational effect. Epidemiological studies were suggested huge differences among countries in terms of using cannabis at least once. The percentiles of use for countries were determined as 41% in England, 17% in Denmark, 6% in Hungary, and 1.2-4% in Turkey.Lots of studies about cannabis use disorders, clinical classification, and treatment were conducted. However, amotivational syndrome caused by cannabis use is not only a clinically less known phenomenon but also we have limited clinical experience about this syndrome. Amotivational syndrome is a syndrome which is caused by cannabis use and which goes along with the cognitive and emotional dysfunctions such as decrease in energy and motivation, lack of social interaction, apathy, decrease in goal-oriented activities, poor judgement, lack of concentration, and memory problems. In studies, it was shown that clinical symptoms of motivational syndrome such as decrease in motivation and energy in 16-21% of people with cannabis use disorder was observed but motivational syndrome emerges as a clinical phenomenon which has been diagnosed less and we have a few studies about definitive diagnosis and treatment. For treatment, it is recommended that underlying problem should be eliminated and that cannabis use should be stopped.. In this article, a case which had amotivational syndrome caused by cannabis use and which had a recovery in clinical symptoms with the treatment of adding testosterone.Key Words: Cannabis use disorder, amotivational syndrome, testosteron, treatment ÖZET Esrar, cannabis sativa adlý bitkinin tohumlarýndan ve kurutulmuþ yapraklarýndan elde edilir, keyif verici etkisi nedeniyle dünyada yaygýn olarak kullanýlmaktadýr. Yapýlan epidemiyolojik çalýþmalarda, en az bir kez esrar kullanýmý ülkeler arasýnda büyük farklýlýklar göstermekte-dir. Ýngiltere'de %41, Danimarka %17, Macaristan %6, Türkiye'de %1.2-4 kullaným oranlarý belirlenmiþtir. Esrar kullaným bozukluklarýnýn, klinik sýnýflandýrýlmasý ve tedavisiyle ilgili bir çok çalýþma yapýlmýþtýr. Esrar kullanýmýna baðlý geliþen amotivasyonel sendrom ise klinik olarak az bilinmekte ve tedavisi ile ilgili günümüzde çok az klinik çalýþma bulunmaktadýr. Amotivasyonel sendrom, kronik esrar kullanýmý ile ortaya çýkan; enerjide azalma, motivasyon düþüklüðü, sosyal etkileþimsizlik, duygulanýmda küntleþme, amaca yönelik aktivitelerde azalma, zayýf muhakeme, konsantrasyon eksikliði, bellek kusuru gibi biliþsel ve duygusal fonksiyonlarda bozulmayla seyreden bir sendromdur.Yapýlan çalýþmalarda, kronik esrar kullaným bozukluðu olanlarda, motivasyon düþüklüðü, enerji azlýðý gibi amotivasyonel sendrom klinik belirtileri %16-21 oranýnda görülmekte buna raðmen amotivasyonel sendrom, az taný konulan, ayrýcý tanýsý ve tedavisi konusunda çok az çalýþmalarýn olduðu bir klinik tablo olarak karþýmýza çýk-maktadýr. Tedavisinde, öncelikle altta yatan nedenin ortadan kaldýrýlmasý, esrar kullanýmý varsa b...