Hi, I'm Writing For Guidance About My Husband. We Tried
He has set up a telehealth appointment but I'm writing for your thoughts because I want more insight to this issue ahead of the appointment. i've been searching online to see if anyone else has experienced this before and can't seem to find anything. I'm hoping there is a medication potentially. Do you recommend it? Fear is that this won't go away. We're looking for help on this now because for several months we were thinking it would just subside but he is not getting relief and it persists. Looking to see is there is more information out there and when he does have the telehealth appointment what is the best way to describe his condition, if you are familiar with this.
Worried and looking for more information.
Thanks,
Valerie
He has set up a telehealth appointment but I'm writing for your thoughts because I want more insight to this issue ahead of the appointment. i've been searching online to see if anyone else has experienced this before and can't seem to find anything. I'm hoping there is a medication potentially. Do you recommend it? Fear is that this won't go away. We're looking for help on this now because for several months we were thinking it would just subside but he is not getting relief and it persists. Looking to see is there is more information out there and when he does have the telehealth appointment what is the best way to describe his condition, if you are familiar with this.
Worried and looking for more information.
Thanks,
Valerie
Please provide me more details
Detailed Answer:
Hello thanks for using ask a doctor service
Marijuana is a Cannabis derivative. A lot of individuals develop psychosis like symptoms, severe anxiety even apathy after taking Marijuana. It is very common.
You've mentioned that he developed severe panic after taking Marijuana and this responded to Ativan and Haldol. Currently he has fear and also anticipatory thoughts about panic.
He was given Haldol which is an antipsychotic and most likely at that time he developed Acute Psychosis though I am not sure. What kind of symptoms has he developed at that time?
Did he show any symptoms like fear, ideas that others are talking about him or hearing voices which others can't hear?
What are his current symptoms?
Please provide details in follow up.
Thanks
Please provide me more details
Detailed Answer:
Hello thanks for using ask a doctor service
Marijuana is a Cannabis derivative. A lot of individuals develop psychosis like symptoms, severe anxiety even apathy after taking Marijuana. It is very common.
You've mentioned that he developed severe panic after taking Marijuana and this responded to Ativan and Haldol. Currently he has fear and also anticipatory thoughts about panic.
He was given Haldol which is an antipsychotic and most likely at that time he developed Acute Psychosis though I am not sure. What kind of symptoms has he developed at that time?
Did he show any symptoms like fear, ideas that others are talking about him or hearing voices which others can't hear?
What are his current symptoms?
Please provide details in follow up.
Thanks
A: In December when this took place he thought he was going to die or possibly be killed. He was yelling/crying. While at the hospital they have him the Ativan first and when that showed some relief but not enough, they gave him Haldol. (To get his heart rate down)
Q: Did he show any symptoms like fear, ideas that others are talking about him or hearing voices which others can't hear?
A: Fear yes. Voices no, I do not believe so although he was saying things like "is this real" and "am I dying"
Q: What are his current symptoms?
A: Currently he will have disorientation/disassociation and panic, where his heart is racing and he is sweating. He will ask me, "is everything ok or going to be ok" His eyes look like he is elsewhere. This happens several times a month from XXXXXXX till now. It will usually last 10 minutes or so (the intense part) but he feels uneasy and abnormal for the rest of the day. Certain things can trigger this like too much excitement or sometimes it just happens without knowing the trigger.
He also has some reoccurring thoughts that he first experienced during the cannabis induced incident: Thoughts include: If he doing enough in life or has he messed up his life in some way; Is anything going on in the outside world and is his reality "real". I think he just feels disoriented with panic. This is similar to what he went through the night in December on cannabis but to a much lesser extent. I would say now he experiences fear when he's having the panic attack whereas when he was hospitalized with cannabis he was feeling terror.
He never had these insecurities before and he says all of these thoughts first occurred the night of the cannabis evening when he was hospitalized. He has not used cannabis since December and was not a frequent user prior to that either.
My concern is that I understand how cannabis could have triggered the psychosis and panic in December when he took it, but why is he going through similar (albeit less severe) symptoms months after the incident?
A: In December when this took place he thought he was going to die or possibly be killed. He was yelling/crying. While at the hospital they have him the Ativan first and when that showed some relief but not enough, they gave him Haldol. (To get his heart rate down)
Q: Did he show any symptoms like fear, ideas that others are talking about him or hearing voices which others can't hear?
A: Fear yes. Voices no, I do not believe so although he was saying things like "is this real" and "am I dying"
Q: What are his current symptoms?
A: Currently he will have disorientation/disassociation and panic, where his heart is racing and he is sweating. He will ask me, "is everything ok or going to be ok" His eyes look like he is elsewhere. This happens several times a month from XXXXXXX till now. It will usually last 10 minutes or so (the intense part) but he feels uneasy and abnormal for the rest of the day. Certain things can trigger this like too much excitement or sometimes it just happens without knowing the trigger.
He also has some reoccurring thoughts that he first experienced during the cannabis induced incident: Thoughts include: If he doing enough in life or has he messed up his life in some way; Is anything going on in the outside world and is his reality "real". I think he just feels disoriented with panic. This is similar to what he went through the night in December on cannabis but to a much lesser extent. I would say now he experiences fear when he's having the panic attack whereas when he was hospitalized with cannabis he was feeling terror.
He never had these insecurities before and he says all of these thoughts first occurred the night of the cannabis evening when he was hospitalized. He has not used cannabis since December and was not a frequent user prior to that either.
My concern is that I understand how cannabis could have triggered the psychosis and panic in December when he took it, but why is he going through similar (albeit less severe) symptoms months after the incident?
Cannabis induced psychosis
Detailed Answer:
Hello again, THANKS FOR PROVIDING DETAILS
Sudden onset of fear and ideas that he might die most likely occurred because of severe anxiety or this could be psychotic symptom too. If he had symptoms like someone is spying on him or listening his conversations or conspiring against him then this points more towards psychosis. Haloperidol is usually given in psychotic conditions. To reduce heart rate there are other drugs. The ideas that he might die could have occurred due to acute psychosis precipitated by marijuana.
His current symptoms are not psychotic symptoms. These symptoms are more of anxiety and panic rather than psychotic. The symptoms like sudden restlessness, feeling of disorientation which is occurring in episodes are of anxiety. He is relatively behaving normal (though he feel uneasy and slight abnormal in day time too) in most of the day time.
In my opinion he should be given proper treatment of anxiety in present situation. Low dose antipsychotic which will act as anti anxiety in low dose can be tried like Olanzapine or Quetiapine etc. This shall help in quick recovery.
Some fraction of patients develop panic after remission from cannabis induced psychosis. This is normal and is not a very serious condition. This will respond to drugs. But he should keep one thing in mind that he should never take Marijuana or any other cannabis derivative again. This could result in development of schizophrenia. Such individuals are at risk after cannabis abuse.
Thanks.
Still have doubts please don't hesitate to ask again.
Cannabis induced psychosis
Detailed Answer:
Hello again, THANKS FOR PROVIDING DETAILS
Sudden onset of fear and ideas that he might die most likely occurred because of severe anxiety or this could be psychotic symptom too. If he had symptoms like someone is spying on him or listening his conversations or conspiring against him then this points more towards psychosis. Haloperidol is usually given in psychotic conditions. To reduce heart rate there are other drugs. The ideas that he might die could have occurred due to acute psychosis precipitated by marijuana.
His current symptoms are not psychotic symptoms. These symptoms are more of anxiety and panic rather than psychotic. The symptoms like sudden restlessness, feeling of disorientation which is occurring in episodes are of anxiety. He is relatively behaving normal (though he feel uneasy and slight abnormal in day time too) in most of the day time.
In my opinion he should be given proper treatment of anxiety in present situation. Low dose antipsychotic which will act as anti anxiety in low dose can be tried like Olanzapine or Quetiapine etc. This shall help in quick recovery.
Some fraction of patients develop panic after remission from cannabis induced psychosis. This is normal and is not a very serious condition. This will respond to drugs. But he should keep one thing in mind that he should never take Marijuana or any other cannabis derivative again. This could result in development of schizophrenia. Such individuals are at risk after cannabis abuse.
Thanks.
Still have doubts please don't hesitate to ask again.