Marijuana variant of concern: Delta 8-tetrahydrocannabinol (Delta-8-THC, Δ8-THC)

Bozman, Mack Elijah; Manoharan, Senthil Vel Rajan Rajaram; Vasavada, Tarak

doi:10.1016/j.psycr.2022.100028

Cited by 12 publications

(10 citation statements)

References 11 publications

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“…However, anecdotally, there has been an increase in the use of Δ 8 -THC within our patient population, and the large body of evidence on cannabis (Δ 9 -THC) association with psychosis and schizophrenia cannot be ignored. Furthermore, other cases exist documenting similar presentations of patients using Δ 8 -THC ( 21 , 22 ). A recognized limitation of Δ 8 -THC reporting is that a UDS cannot distinguish Δ 8 -THC from Δ 9 -THC.…”

Section: Literature Review and Discussionmentioning

confidence: 89%

“…The first case describes acute encephalopathy in a pediatric patient following accidental ingestion of Δ 8 -THC gummies ( 21 ). The second case report documents a 23-year-old male and a 35-year-old female who self-reported Δ 8 -THC use before presenting with delusions and suicidal ideation that was persistent and resistant to conventional treatment ( 22 ). This manuscript also presents three additional cases, in which the chief complaint was psychosis in self-reported Δ 8 -THC users who did not report using other substances, summarized in Table 1 .…”

Section: Introductionmentioning

confidence: 99%

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Delta-8-THC association with psychosis: A case report with literature review

et al. 2023

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BackgroundCannabis (Δ9-THC) is the most commonly consumed illicit drug. The Agricultural Improvement Act of 2018 removed hemp, a strain of Cannabis sativa, as a controlled substance. This law allowed the plant to be processed into its components, which contain <0.3% Δ9-THC. As a result, delta-8-tetrahydrocannabinol (Δ8-THC), a federally unregulated substance, grew in popularity in 2020. Δ8-THC is readily available in most gas stations or head shops and may be considered harmless by patients. However, an increasing number of patients admitted for psychiatric hospitalization report use, with limited literature on the effects.Case presentationsThis case report describes three individual cases of patients who required admission to a university psychiatric hospital after the regular use solely of Δ8-THC. All three patients developed psychotic and paranoid symptoms concurrently with the use of Δ8-THC, with a severity exceeding their previous historical presentations. The presenting psychotic symptoms were also atypical for all three patients. New-onset violence and visual hallucinations were noted in two of the patients, one patient with no previous psychiatric history and one patient while on a therapeutic dose of his antipsychotic. In the third case, a new onset of bizarre, fixed delusions of puppies dissolving in the bathtub developed.ConclusionThis report adds to the limited body of evidence on Δ8-THC documenting a temporal association between Δ8-THC use and the development of psychotic symptoms. A strong body of research already correlates the continued use of Δ9-THC with psychosis, and Δ8-THC acts at the same CB1 and CB2 receptors as Δ9-THC. Therefore, it is hypothesized that Δ8-THC may have similar adverse psychiatric effects as Δ9-THC. These conclusions are not without speculation, due to the need for self or collateral-reporting of Δ8-THC use as urine drug screening cannot distinguish Δ8-THC from Δ9-THC, and the patients' symptoms could be explained by medication non-adherence and primary psychotic disorders. However, physicians should be encouraged to gather a specific history of Δ8-THC use and treat patients with Δ8-THC-related intoxication and symptoms.

show abstract

Section: Literature Review and Discussionmentioning

confidence: 89%

Section: Introductionmentioning

confidence: 99%

Delta-8-THC association with psychosis: A case report with literature review

et al. 2023

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“…2,3 There have been earlier reports of psychotic symptoms secondary to the use of D 8 -THC. 5,6 The similarities between D 8 -THC and D 9 -THC have been implicated behind the psychotomimetic effects of the former. 6 Various D 8 -THC compounds are being increasing marketed on many online platforms without adequate regulation.…”

Section: Discussionmentioning

confidence: 99%

Delta-8-tetrahydrocannabinol Associated Manic Switch: A Case Report

Raghunathan,

Purohith,

Sharma

2024

Indian Journal of Psychological Medicine

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“…Furthermore, there has been an increase in reports of hospitalizations related to the use of delta-8-THC, which is an isomer of the delta-9-THC compound typically invoked when discussing cannabis consumption. Delta-8-THC is an easily available yet dangerously potent cannabis product that is associated with acute psychosis, suicidality, anxiety, tremors, and unconsciousness, and it contains contaminants resulting from an unregulated synthesis process [21]. It will be important for physicians to be vigilant in recognizing substance-induced psychiatric symptoms associated with new variants of cannabis products, as well as educate patients about their harms.…”

Section: Discussionmentioning

confidence: 99%

A Case of Panic Attacks Developing After 10 Years of Chronic Cannabis Use in a Patient With No Prior Psychiatric History

Johnson¹,

Guerra²,

Oxner³

2023

Cureus

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Cannabis use for medical and recreational purposes is increasing. Inhibitory activity of cannabinoids (CB) at the CB1 and CB2 receptors centrally and peripherally mediate the therapeutic effects that are wielded for palliation of pain, anxiety, inflammation, and nausea in indicated conditions. Cannabis dependence is also associated with anxiety; however, the direction of causality is unknown, such as whether anxiety disorders lead to cannabis use, or whether cannabis contributes to the development of anxiety disorder. The evidence hints that both may have validity. Here we present a case of cannabis-associated panic attacks following 10 years of chronic cannabis dependence in an individual with no prior psychiatric history. The patient is a 32year-old male with no significant past medical history who presented complaining of five-minute episodes of palpitations, dyspnea, upper extremity paresthesia, subjective tachycardia, and cold diaphoresis occurring in a variety of circumstances for the past two years. His social history was significant for 10 years of smoking marijuana multiple times daily, which he had quit over two years ago. The patient denied past psychiatric history or known anxiety problems. Symptoms were unrelated to activity and only relieved with deep breathing. The episodes were not associated with chest pain, syncope, headache, or emotional triggers. The patient had no family history of cardiac disease or sudden death. The episodes were refractory to the elimination of caffeine, alcohol, or other sugary beverages. The patient had already stopped smoking marijuana when the episodes began. Due to the unpredictable nature of the episodes, the patient reported a growing fear of being in public. On laboratory workup, metabolic and blood panels were within normal limits, as well as thyroid studies. Electrocardiogram showed normal sinus rhythm, and continuous cardiac monitoring revealed no arrhythmias or abnormalities despite the patient indicating multiple triggered events within the duration of monitoring. Echocardiography also showed no abnormalities. With organic cardiac causes of the subjective palpitation episodes ruled out, a psychogenic etiology of the episodes was presumed, and the patient was referred to behavioral health services. In conclusion, cannabis-induced anxiety or panic disorders should be considered in patients with no prior psychiatric history presenting with anxiety-like attacks following a period of cannabis dependence or current use. These patients should be advised to cease cannabis use and referred to behavioral medicine.

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Marijuana variant of concern: Delta 8-tetrahydrocannabinol (Delta-8-THC, Δ8-THC)

Cited by 12 publications

References 11 publications

Delta-8-THC association with psychosis: A case report with literature review

Delta-8-THC association with psychosis: A case report with literature review

Delta-8-tetrahydrocannabinol Associated Manic Switch: A Case Report

A Case of Panic Attacks Developing After 10 Years of Chronic Cannabis Use in a Patient With No Prior Psychiatric History

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