Response to ‘Thinking clearly about climate change and mental health’

Abstract

1 mg/mL, unknown quantity) 1-2 hours before the episode. On Occasion 3, he presented as agitated, uncooperative and climbing off the bed. He was diaphoretic, GCS 13, tachycardic and hypertensive, and displayed horizontal jerky nystagmus, and had lower limb clonus and hyperreflexia. Collateral history suggested onset over <3 hours. Upon recovery, he disclosed using a THC 'vape pen' < 3 hours before the onset of altered consciousness. We acknowledge the limited information from patient records, including unquantified THC levels.Cannabis products were present on all occasions where serotonin syndrome emerged. For Occasions 2 and 3, there was clear evidence that cannabis products were used immediately before the onset of symptoms. Given emerging evidence regarding the potential for cannabis to precipitate serotonin syndrome, a cannabis use history should be taken before prescription of serotonergic medications. Patients should be cautioned about the risks of co-administration of cannabis products.