Delirium and High Creatine Kinase and Myoglobin Levels Related to Synthetic Cannabinoid Withdrawal

Table 3

Case 2 clinical observation and treatment.

Day	Psychiatric evaluation	Biochemical parameters							Treatment
		CK^1	CK-MB^2	MB^3	AST^4	THC^5	BNZ^6	ETG^7
1.	Insomnia; Irritability; Agitation	1233	93,1	413	39	88	0	2000	0,9% isotonic 1500 cc/d; Diazepam 10 mg/d, quetiapine 100 mg/d; Mirtazapine 30 mg/d
2.	Insomnia; Irritability; Agitation; Instable mood	2954	230		74	91	3000	94	0,9% isotonic 1500 cc/d; Diazepam 30 mg/d; Lorazepam 2,5 mg/d, haloperidol 5 mg/d
3.	Stable mood; Normal sleep and; behavior	1840	28		57				0,9% isotonic 1500 cc/d; Diazepam 30 mg/d; Lorazepam 2,5 mg/d, haloperidol 5 mg/d
4.	Stable mood; Normal sleep and; behavior	1408	25		50				0,9% isotonic 1500 cc/d; Diazepam 30 mg/d; Lorazepam 2,5 mg/d, haloperidol 5 mg/d
5.	Stable mood; Normal sleep and; behavior	1042	19,8		49	68,6	3000	48	0,9% isotonic 1500 cc/d; Diazepam 30 mg/d; Lorazepam 2,5 mg/d, haloperidol 5 mg/d
6.	Stable mood; Normal sleep and behavior	493	14,2		40				0,9% isotonic 1500 cc/d; Diazepam 30 mg/d; Lorazepam 2,5 mg/d, haloperidol 5 mg/d
7.	Stable mood; Normal sleep and; behavior	234	13,7		35,4				0,9% isotonic 1500 cc/d; Diazepam 30 mg/d; Lorazepam 2,5 mg/d, haloperidol 5 mg/d
8.	Stable mood; Normal sleep and behavior								Diazepam 10 mg/d,; 0,9% isotonic 500 cc/d; Lorazepam 2,5 mg/d

Creatine kinase, creatine kinase-MB, myoglobin, aspartate aminotransferase, Δ(9)-tetrahydrocannabinol, benzodiazepine, and ethyl glucuronide; test results exceed the measurable values.