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Brain Sci. 2018, 8(7), 133; https://doi.org/10.3390/brainsci8070133

Synthetic Cannabinoid use in a Case Series of Patients with Psychosis Presenting to Acute Psychiatric Settings: Clinical Presentation and Management Issues

1
Highgate Mental Health Centre, Camden & Islington NHS Foundation Trust, London NW1 0PE, UK
2
Department of Psychological Medicine, King’s College London, London WC2R 2LS, UK
3
Department of Mental Health, ASL Rome 1, 00135 Rome, Italy
4
Department of Psychosis Studies, King’s College London, London WC2R 2LS, UK
5
National and Kapodistrian University of Athens, Eginition Hospital, 11528 Athens, Greece
6
Department of Human Neurosciences, University of Rome ‘La Sapienza’, 00185 Rome, Italy
7
Department of Psychopharmacology, University of Hertfordshire, Hertfordshire AL10 9AB, UK
*
Author to whom correspondence should be addressed.
Received: 19 June 2018 / Revised: 29 June 2018 / Accepted: 5 July 2018 / Published: 14 July 2018
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Abstract

Background: Novel Psychoactive Substances (NPS) are a heterogeneous class of synthetic molecules including synthetic cannabinoid receptor agonists (SCRAs). Psychosis is associated with SCRAs use. There is limited knowledge regarding the structured assessment and psychometric evaluation of clinical presentations, analytical toxicology and clinical management plans of patients presenting with psychosis and SCRAs misuse. Methods: We gathered information regarding the clinical presentations, toxicology and care plans of patients with psychosis and SCRAs misuse admitted to inpatients services. Clinical presentations were assessed using the PANSS scale. Vital signs data were collected using the National Early Warning Signs tool. Analytic chemistry data were collected using urine drug screening tests for traditional psychoactive substances and NPS. Results: We described the clinical presentation and management plan of four patients with psychosis and misuse of SCRAs. Conclusion: The formulation of an informed clinical management plan requires a structured assessment, identification of the index NPS, pharmacological interventions, increases in nursing observations, changes to leave status and monitoring of the vital signs. The objective from using these interventions is to maintain stable physical health whilst rapidly improving the altered mental state. View Full-Text
Keywords: synthetic cannabinoids; SCRAs; NPS; novel psychoactive substances; NPS testing; antipsychotics; mental health; physical health; nursing care; psychosis synthetic cannabinoids; SCRAs; NPS; novel psychoactive substances; NPS testing; antipsychotics; mental health; physical health; nursing care; psychosis
This is an open access article distributed under the Creative Commons Attribution License which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly cited (CC BY 4.0).
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Bonaccorso, S.; Metastasio, A.; Ricciardi, A.; Stewart, N.; Jamal, L.; Rujully, N.-U.-D.; Theleritis, C.; Ferracuti, S.; Ducci, G.; Schifano, F. Synthetic Cannabinoid use in a Case Series of Patients with Psychosis Presenting to Acute Psychiatric Settings: Clinical Presentation and Management Issues. Brain Sci. 2018, 8, 133.

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