Cannabis psychosis following bhang ingestion.

The purpose of this preliminary investigation is to systematically characterize the signs and symptoms of cannabis psychosis in individuals who presented for psychiatric treatment in Pakistan after ingestion of bhang; a beverage containing cannabis. In order to control for the behavioral effects of cannabis alone, symptoms produced by bhang ingestion among non-patients consuming the same beverage were compared with those symptoms found among psychotic patients. Patients differed from controls in that a higher proportion of patients were found to be chronic users of bhang, and had a past history of psychotic episodes. Presenting symptoms of bhang-induced psychosis found in patients included grandiosity, excitement, hostility, uncooperativeness, disorientation, hallucinatory behavior and unusual thought content. Neuroleptic treatment successfully attenuated psychotic symptoms within five days of the initiation of the episode. The presenting symptoms of bhang-induced psychosis are consistent with a brief mania-like disorder with paranoid psychotic features, and cognitive dysfunction. Several etiologic hypotheses are proposed.

Plasma concentrations of haloperidol and prolactin and clinical outcome in acutely psychotic patients.

This study was aimed at disclosing possible relationships between short term therapeutic outcome and certain ranges in plasma concentrations of haloperidol and of prolactin. Acutely psychotic patients (n = 28) were diagnosed (by RDC) as schizophrenics acute subtype (n = 17), schizoaffectives manic type, acute subtype (n = 8) and manics (n = 3). Parenteral haloperidol was the pharmacological treatment mostly given; the dose was kept constant intraindividually but varied between patients from 5 to 40 mg/d (median 15 mg/d). Data for statistical analyses of possible psychobiological relationships were analyzed at 12 days (median) of haloperidol regimen, that is at a relatively early cut-off in treatment. Keeping the methodological difficulties in mind, certain ranges in plasma concentrations of haloperidol (16-26.9 mg/ml; (Fig. 1) and of prolactin (64-159.9 mg/ml; (Fig. 2) were found to be associated-statistically independently-with a favourable therapeutic outcome. The rate of recovery was best if a patient came to lie with both plasma levels within these therapeutic ranges (Fig. 3). It is concluded that the combination of pharmacological and neuroendocrinological techniques in psychiatric research may be of substantial use for clinical purposes.