Akute psychiatrische Störungsbilder und medizinische Notfälle im Zusammenhang mit dem Gebrauch von Cannabinoiden

Maximilian Gahr

doi:10.1055/a-1953-2616

Nervenheilkunde, Inhaltsverzeichnis

Nervenheilkunde 2023; 42(04): 200-208
DOI: 10.1055/a-1953-2616

Schwerpunkt

Akute psychiatrische Störungsbilder und medizinische Notfälle im Zusammenhang mit dem Gebrauch von Cannabinoiden

Acute psychiatric disorders and medical emergencies related to the use of cannabinoids

Authors

Maximilian Gahr

¹Klinik für Psychiatrie und Psychotherapie III, Universitätsklinikum Ulm

Abstract

ZUSAMMENFASSUNG

Cannabinoidkonsum ist mit einem erhöhten Risiko für zahlreiche akute Erkrankungen assoziiert. Die bedeutsamsten akuten psychiatrischen Störungen durch Cannabinoidkonsum sind Intoxikationen. Diese können sich als Delir oder akute Psychose präsentieren. Cannabinoidkonsum erhöht insbesondere bei Adoleszenten das Risiko für Suizidalität und selbstverletzende Verhaltensweisen. Gelegentlich können Cannabinoidentzugssyndrome eine akute Therapie erfordern. Chronischer Cannabinoidkonsum kann zum Cannabinoid Hyperemesis Syndrome führen, das durch episodische, stereotype und akute Übelkeit mit Erbrechen und abdominellen Schmerzen charakterisiert ist. Cannabinoidkonsum hat möglicherweise prokonvulsive Effekte. Chronischer Cannabinoidkonsum führt zu zahlreichen pathologischen respiratorischen Veränderungen, die sich von denen des Tabakrauchens unterscheiden. Das Risiko für plötzlichen Herztod und kardio- und neurovaskuläre Erkrankungen wie Myokardinfarkt, akutes Koronarsyndrom, Vorhof- und Kammerflimmern, periphere arterielle Durchblutungsstörungen und Schlaganfall ist bei chronischem Cannabinoidkonsum erhöht. Cannabinoidkonsum ist zudem mit plötzlichem Tod und Suizid assoziiert. Die Toxizität und das Risiko für die genannten Erkrankungen sind bei synthetischen Cannabinoiden im Allgemeinen größer als bei Produkten aus Cannabis sativa. Cannabinoidkonsum sollte bei der Versorgung der genannten akuten Störungen berücksichtigt werden.

ABSTRACT

Cannabinoid use is associated with an increased risk of numerous acute diseases. The most significant acute mental disorders due to cannabinoid use are intoxications. These can present themselves as delirium or acute psychosis. Cannabinoid use increases the risk of suicidal tendencies and self-injury, particularly in adolescents. Occasionally, cannabinoid withdrawal may require acute treatment. Chronic cannabinoid use may result in cannabinoid hyperemesis syndrome that is characterised by episodic, stereotypical, acute nausea and vomiting accompanied by abdominal pain. Cannabinoid use has possibly proconvulsant effects. Chronic cannabinoid use may result in numerous pathological respiratory changes that differ from those related to tobacco smoking. The risk of sudden cardiac death and cardio- and neurovascular diseases as myocardial infarction, acute coronary syndrome, atrial and ventricular fibrillation, peripheral arterial occlusive disease and stroke is increased in cannabinoid use. In addition, cannabinoid use is associated with sudden death and suicides. Compared with products from cannabis sativa, toxicity and risk of the abovementioned diseases are generally higher in synthetic cannabinoids. Cannabinoid use should be considered in the care of the abovementioned diseases.

Schlüsselwörter

Cannabis - Intoxikation - Marihuana - Myokardinfarkt - spice

Key words

Cannabis - intoxication - Marijuana - myocardial infarction - spice

Volltext

Referenzen

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