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Substance-induced acute psychosis — RCPSC EM MCQ

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HardPsychiatric emergenciesSubstance-induced acute psychosisRCPSC EM

A 23-year-old man is brought after bizarre behaviour and severe paranoia after using synthetic cannabinoids. He is tachycardic, hypertensive and terrified but afebrile. Glucose, sodium and CT head are normal; he has no rigidity or clonus. What is the most appropriate investigation?

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Correct answer: E — Provide a low-stimulation environment, benzodiazepines if needed and assess for medical causes and safety before disposition

Substance-induced agitation requires safety, de-escalation, treatment of sympathetic distress, screening for medical mimics and reassessment of suicidality, psychosis and capacity once intoxication improves.

Reference: Canadian emergency psychiatry practice; CanMEDS Communicator and Professional roles