# Psychotic Risk Associated With Cannabinoid Use: A Case Report of Ekbom-Like Delusional Infestation > **Author:** Benjamin Caplan, MD (ABFM Board Certified, MA Lic. #240562, NPI: 1962722637) > **Publisher:** CED Clinic (https://cedclinic.com) > **Canonical URL:** https://cedclinic.com/cannabis-induced-psychosis-case-report-ekbom-delusional-infestation/ > **Published:** 2026-03-25T23:08:46-04:00 | **Last Modified / Clinically Audited:** 2026-09-28T10:38:58-04:00 > **Clinical Summary:** Explore a cannabis-induced psychosis case report revealing Ekbom-like delusional infestation linked to high-potency cannabinoid use and psychotic risk. --- CED Clinical Relevance  #62Notable Clinical Interest  Emerging findings or policy developments worth monitoring closely. 🔬 Evidence Watch  |  CED Clinic PsychosisCannabisThcDelusional DisorderCase Report Journal Cureus Study Type Clinical Study Population Human participants Why This Matters This case report highlights an underrecognized presentation of [cannabis-induced psychosis](https://cedclinic.com/adolescent-cannabis-psychiatric-outcomes-2026-digest/) that may challenge diagnostic acuity in clinical practice. Somatic delusions like delusional infestation can masquerade as dermatological or neurological conditions, potentially leading to delayed psychiatric intervention and unnecessary medical workups. Clinical Summary A 49-year-old man with chronic daily [cannabis use](https://cedclinic.com/cannabis-cardiovascular-health-insights-2024/) developed Ekbom-like syndrome characterized by delusional infestation, persistent pruritus, and tactile hallucinations. Extensive medical workup including dermatological, neurological, laboratory, and imaging studies revealed no organic etiology. The patient demonstrated fixed somatic delusions with absent insight. Treatment with olanzapine and psychoeducation resulted in gradual symptomatic improvement, supporting a cannabis-induced psychotic etiology. Dr. Caplan’s Take “This case reinforces my clinical experience that cannabis-induced psychosis can present in unexpected ways beyond the classic paranoid or disorganized presentations we typically recognize. The somatic nature of this patient’s delusions could easily mislead clinicians away from considering substance-induced psychosis as the underlying diagnosis.” Clinical Perspective 🧠 Clinicians should maintain high suspicion for cannabis-induced psychosis in patients presenting with unexplained somatic complaints, particularly when combined with daily high-potency [cannabis use](https://cedclinic.com/cannabis-cardiovascular-health-insights-2024/). A thorough substance use history is essential in any patient presenting with new-onset delusional beliefs, even when the presentation appears primarily dermatological or neurological rather than psychiatric. 💬 Join the Conversation Have a question about how this applies to your situation? [Ask Dr. Caplan →](https://benjamincaplan.com/ask-dr-caplan) Want to discuss this topic with other patients and caregivers? [Join the forum discussion →](https://cedclinic.com/interact/discussion-forums/forum/cannabis-industry/) Have thoughts on this? Share it: [𝕏 Share on X](https://twitter.com/intent/tweet?text=Just%20read%20this%20on%20CEDclinic.com%3A%20Psychotic%20Risk%20Associated%20With%20Cannabinoid%20Use%3A%20A%20Case%20Report%20of%20Ekbom-Like%20Delu...%20%40drcaplan&url=https%3A//pubmed.ncbi.nlm.nih.gov/41658693/)[in Share on LinkedIn](https://www.linkedin.com/sharing/share-offsite/?url=https%3A//pubmed.ncbi.nlm.nih.gov/41658693/)[🦥 Share on BlueSky](https://bsky.app/intent/compose?text=Just%20read%20this%3A%20Psychotic%20Risk%20Associated%20With%20Cannabinoid%20Use%3A%20A%20Case%20Report%20of%20Ekbom-Like%20Delu...%20--%20via%20%40drcaplan.bsky.social%20https%3A//pubmed.ncbi.nlm.nih.gov/41658693/)[📷 Follow on Instagram](https://www.instagram.com/drbenjamincaplan/)[📝 Read more on Substack](https://substack.com/@doctorapproved)[🔔 Subscribe via RSS](https://cedclinic.com/category/cannabis-news/feed/) 📰 Source: [https://pubmed.ncbi.nlm.nih.gov/41658693/](https://pubmed.ncbi.nlm.nih.gov/41658693/) Table of Contents - [FAQ](#FAQ)[What is the link between chronic cannabis use and psychosis risk?](#What_is_the_link_between_chronic_cannabis_use_and_psychosis_risk) - [What is Ekbom-like delusional infestation and how does it relate to cannabis use?](#What_is_Ekbom-like_delusional_infestation_and_how_does_it_relate_to_cannabis_use) - [How should clinicians evaluate patients presenting with delusional infestation symptoms who use cannabis?](#How_should_clinicians_evaluate_patients_presenting_with_delusional_infestation_symptoms_who_use_cannabis) - [What treatment approach is effective for cannabis-induced somatic delusions?](#What_treatment_approach_is_effective_for_cannabis-induced_somatic_delusions) - [Why might cannabis-induced somatic psychosis be diagnostically challenging?](#Why_might_cannabis-induced_somatic_psychosis_be_diagnostically_challenging) - [Related](#Related) ## FAQ #### What is the link between chronic cannabis use and psychosis risk? Chronic use of high-potency cannabinoids has been consistently associated with increased [psychosis risk](https://cedclinic.com/adolescent-cannabis-psychiatric-outcomes-2026-digest/), particularly with early onset, daily use, and prolonged exposure. This risk includes both typical psychotic symptoms and atypical somatic presentations that may be underrecognized in clinical practice. #### What is Ekbom-like delusional infestation and how does it relate to cannabis use? Ekbom-like delusional infestation is characterized by persistent itching, tactile hallucinations, and fixed somatic delusions about being infested with parasites or insects. This case report demonstrates that cannabis-induced psychosis can present with these atypical somatic symptoms rather than classical psychotic features. #### How should clinicians evaluate patients presenting with delusional infestation symptoms who use cannabis? A comprehensive evaluation should include dermatological and neurological assessments, routine laboratory investigations, and neuroimaging to rule out organic causes. Mental status examination should assess for structured somatic delusions and evaluate insight, while taking a detailed substance use history. #### What treatment approach is effective for cannabis-induced somatic delusions? Treatment with antipsychotic medication (such as olanzapine) combined with psychoeducation has shown effectiveness. This case demonstrated gradual symptomatic improvement with this combined approach, emphasizing the importance of addressing both the psychotic symptoms and [patient education](https://cedclinic.com/medical-cannabis-patient-education-basics/). #### Why might cannabis-induced somatic psychosis be diagnostically challenging? Atypical somatic presentations of cannabis-induced psychosis may be underrecognized because they don’t present with classical psychotic symptoms. Patients may initially seek dermatological or medical care rather than psychiatric evaluation, potentially delaying appropriate diagnosis and treatment. {“@context”: “https://schema.org”, “@type”: “ScholarlyArticle”, “headline”: “Psychotic Risk Associated With Cannabinoid Use: A Case Report of Ekbom-Like Delusional Infestation.”, “url”: “https://pubmed.ncbi.nlm.nih.gov/41658693/”, “about”: “cureus clinical study psychotic risk associated”, “isPartOf”: “Cureus”} [https://cedclinic.com/contact/](https://cedclinic.com/contact/) Physician-Led, Whole-Person Care A doctor who takes the time to truly understand you. Personal care that starts with listening and is guided by experience and ingenuity. Health, Longevity, Wellness One-on-One Cannabis Guidance Metabolic Balance [Leave a Message](https://cedclinic.com/contact/) [Metabolic Care](https://cedclinic.com/metabolic/metabolic-how-it-works/) [Medical Consulting](https://cedclinic.com/book/) [Cannabis Care](https://cedclinic.com/book/) [https://cedclinic.com/contact/](https://cedclinic.com/contact/) RELATED READING AT CED CLINIC Continue exploring the evidence [A huge study finds a link between cannabis use in teens and psychosis later – WBAA](https://cedclinic.com/cannabis-youth-psychosis-risk-study-insights/) This study explores the long-term psychosis risk associated with [adolescent cannabis use](https://cedclinic.com/adolescent-cannabis-use-and-anxiety-research/), providing important context for clinical cases. [Read Study](https://cedclinic.com/cannabis-youth-psychosis-risk-study-insights/) Study links commercial cannabis markets to increased addiction – News-Medical.Net Examines how commercial cannabis availability correlates with addiction rates, relevant to understanding broader cannabis-related risks. Learn More [A disorder involving cannabis is gaining more attention](https://cedclinic.com/a-disorder-involving-cannabis-is-gaining-more-attention/) Discusses emerging recognition of cannabis-related psychiatric disorders, highlighting clinical challenges in diagnosis and treatment. [Explore Article](https://cedclinic.com/a-disorder-involving-cannabis-is-gaining-more-attention/) ### Related --- ### Verification & Medical Governance - **Lead Clinical Author:** Benjamin Caplan, MD - **Credentials:** Board Certified in Family Medicine (ABFM), Former CMO Canna Care Docs (250,000+ patients supervised), Founder & CMO CED Clinic & CED Foundation, Author of *The Doctor-Approved Cannabis Handbook* (Penguin Random House). - **Clinical Scale:** 350,000+ lifetime evaluations overseen; 81,008-patient Real-World Evidence Registry (`~/.ced_rwe_vault.db`); 125,000+ peer-reviewed study literature observatory (`http://localhost:8768/api/explorer/terminal`). - **License Verification:** Commonwealth of Massachusetts License #240562 (https://checkahealthlicense.mass.gov/). - **NPI Registry:** 1962722637 (https://npiregistry.cms.hhs.gov/provider-view/1962722637). - **Ethics & Data Privacy:** Clinical registry observations adhere strictly to HIPAA Safe Harbor de-identification (45 CFR § 164.514(b)) and criteria for secondary research exemption under 45 CFR § 46.104(d)(4).