Advertisement

Use of dexmedetomidine to treat delirium primarily caused by cannabis

Published:October 10, 2016DOI:https://doi.org/10.1016/j.ajem.2016.10.027
      Dexmedetomidine is increasingly used to treat major withdrawal symptoms and hyperadrenergic crisis. We present 3 young adult cases of cannabis/drug-induced delirium unresponsive to traditional tranquilizer treatment but were responsive to dexmedetomidine as adjunct therapy. All cannabis metabolite urine concentrations were greater than 264 ng/mL upon presentation. Appropriate sedation was achieved within 5 hours in all 3 cases. Thus, dexmedetomidine, along with other tranquilizers, was effective in treating delirium due to cannabis/drug ingestion.
      To read this article in full you will need to make a payment
      One-time access price info
      • For academic or personal research use, select 'Academic and Personal'
      • For corporate R&D use, select 'Corporate R&D Professionals'

      Subscribe:

      Subscribe to The American Journal of Emergency Medicine
      Already a print subscriber? Claim online access
      Already an online subscriber? Sign in
      Institutional Access: Sign in to ScienceDirect

      References

        • Darrouj J.
        • Puri N.
        • Prince E.
        • Lomonaco A.
        • Spevetz A.
        • Gerber D.R.
        Dexmedetomidine infusion as adjunctive therapy to benzodiazepines for acute alcohol withdrawal.
        Ann Pharmacother. 2008; 42: 1703-1705
        • Rayer S.G.
        • Weinert C.R.
        • Peng H.
        • Jepsen S.
        • Broccard A.F.
        Dexmedetomidine as adjunct treatment for severe alcohol withdrawal in the ICU.
        Ann Intensive Care. 2012; 2: 1-6
        • Gerlach A.T.
        • Dasta J.F.
        Dexmedetomidine: an updated review.
        Ann Pharmacother. 2007; 41: 245-254
        • Jiang Y.K.
        • Wang S.
        • Lam T.S.
        • Hanna A.
        • DeMuro J.P.
        • Calixte R.
        • et al.
        Prevalence of delirium and coma in mechanically ventilated patients sedated with dexmedetomidine or propofol.
        Pharm Ther. 2016; 41: 442-445
        • Neville D.N.W.
        • Hayes K.R.
        • Ivan Y.
        • McDowell E.P.
        • Pitetti R.D.
        Double-blind randomized controlled trial of intranasal dexmedetomidine versus intranasal midazolam as anxiolysis prior to pediatric laceration repair in the emergency department.
        Acad Emerg Med. 2016; 23: 910-917
        • Lipowski Z.J.
        Delirium (acute confusional states).
        JAMA. 1987; 258: 1789-1792
        • Cerejeira J.
        • Mukaetova-Ladinska E.B.
        A clinical update on delirium: from early recognition to effective management.
        Nurs Res Pract. 2011; 2011 ([12 pages])875196https://doi.org/10.1155/2011/875196
        • Andre C.
        • Jaber-Filho J.A.
        • Bento R.M.
        • Damasceno L.M.
        • Aquino-Neto F.R.
        Delirium following ingestion of marijuana present in chocolate cookies.
        CNS Spectr. 2006; 11: 262-264
        • Mannion V.
        Case report: adverse effects of taking tricyclic antidepressants and smoking marijuana.
        Can Fam Phys. 1999; 45: 2683-2684
        • Wilens T.E.
        • Biederman J.
        • Spencer T.J.
        Case study: adverse effects of smoking marijuana while receiving tricyclic antidepressants.
        J Am Acad Child Adolesc Psychiatry. 1997; 36: 45-48
        • Bechtold J.
        • Hipwell A.
        • Lewis D.A.
        • Loeber R.
        • Pardini D.
        Concurrent and sustained cumulative effects of adolescent marijuana use on subclinical psychiatric symptoms.
        Am J Psychiatry. 2016; 173: 781-789
        • Cipriani F.
        • Mancino A.
        • Pulitanὸ S.M.
        • Piastra M.
        • Conti G.
        A cannabinoid-intoxicated child treated with dexmedetomidine: a case report.
        J Med Case Reports. 2015; 9: 152https://doi.org/10.1186/s13256-015-0636-2
        • Menon D.V.
        • Wang Z.
        • Fadel P.J.
        • Arbique D.
        • Leonard D.
        • Li J.L.
        • et al.
        Central sympathology as a novel counter measure for cocaine-induced sympathetic activation and vasoconstriction in humans.
        J Am Coll Cardiol. 2007; 50: 626-633
        • Akingloola O.A.
        • Singh D.
        Dexmedetomidine to treat lisdexamfetamine overdose and serotonin toxicidrome in a 6-year-old girl.
        Am J Crit Care. 2012; 21: 456-459
        • Levine M.
        • Zorn L.
        • O'Connor A.D.
        • Truitt C.
        Use of dexmedetomidine in the treatment of scorpion envenomation.
        Clin Toxicol. 2009; 47: 763
        • Mohorn J.
        • Vakkalanka J.P.
        • Rushton W.
        • Hardison L.
        • Woloszyn A.
        • Holstege C.
        • et al.
        Evaluation of dexmedetomidine therapy for sedation in patients with toxicological events at an academic medical center.
        Clin Toxicol. 2014; 52: 525-530
        • Amusina O.
        • Zell-Kanter M.
        • Clouse A.
        • Leikin J.B.
        Dexmedetomidine as an adjunct in patients undergoing treatment for ethanol withdrawal in the critical care setting.
        Clin Toxicol. 2015; 50: 579-580