Hypothermia is a rare, potentially life-threatening adverse effect of antipsychotics, including risperidone. Defined as a core temperature<35°C (95°F), it can occur even at therapeutic doses and may be underrecognized, particularly in older adults or medically complex patients.

[This corrects the article DOI: 10.3389/fpsyt.2025.1584719.].

Vitamin B12 is a water-soluble nutrient found mainly in animal-derived foods. Vitamin B12 deficiency is a common condition, presenting with hematologic and neurologic abnormalities, but rarely presents as isolated psychosis in a young adult. A 28-year-old male patient was brought in for severe agitation and confusion. Laboratory evaluation revealed severe vitamin B12 deficiency (serum vitamin B12 of <73.8 pmol/L) with elevated homocysteine (25.4 umol/L) and methylmalonic acid (0.95 umol/L) levels. The patient received vitamin B12 replacement, after which his confusion and behavioral disturbances improved significantly, and further psychiatric evaluation failed to reveal a primary psychotic or mood disorder. This case highlights the importance of considering vitamin B12 deficiency in patients with isolated neuropsychiatric symptoms, even in the absence of typical macrocytosis, and demonstrates the potential for significant clinical recovery following timely treatment with vitamin supplementation.

Acidic cannabinoids, including tetrahydrocannabinolic acid (THCA), cannabidiolic acid (CBDA), cannabigerolic acid (CBGA), and related biosynthetic precursors, represent the predominant phytocannabinoid forms naturally produced by Cannabis sativa. Long considered pharmacologically inactive intermediates, these compounds are now increasingly recognized as bioactive molecules with potential therapeutic relevance for brain disorders. Compared with their decarboxylated counterparts, acidic cannabinoids exhibit distinct physicochemical, pharmacokinetic, and pharmacodynamic properties that may confer reduced psychotropic liability together with unique neurobiological effects. Emerging preclinical evidence indicates that acidic cannabinoids modulate multiple processes implicated in neurological and psychiatric disorders, including serotonergic and endocannabinoid signaling, neuroinflammation, oxidative stress, mitochondrial dysfunction, calcium dyshomeostasis, and synaptic transmission. In this review, we critically examine current knowledge regarding acidic cannabinoids in the context of brain disorders. We first summarize their biosynthesis, chemical stability, pharmacokinetic characteristics, and pharmacological differences from neutral cannabinoids. We then examine preclinical evidence supporting their potential therapeutic effects in epilepsy, anxiety, depression, psychosis-related conditions, and neurodegenerative diseases, including Alzheimer's disease, Parkinson's disease, Huntington's disease, and amyotrophic lateral sclerosis. We also discuss how artificial intelligence and computational approaches may support target identification, formulation optimization, pharmacokinetic modeling, and the development of personalized cannabinoid-based interventions. Finally, we highlight key methodological and translational challenges limiting the field and outline priorities for future research. Overall, acidic cannabinoids emerge as promising but still underexplored multitarget compounds with potential relevance for the treatment of brain disorders.

Disturbances in the endocannabinoid system (ECS) have been reported in psychosis, with evidence suggesting consistent alterations in N-arachidonoylethanolamine (anandamide; AEA) and inconclusive findings for 2-arachidonoylglycerol (2-AG). Lower AEA concentrations have been associated with greater symptom severity, while the relationship between ECS and cannabis use remains unclear. However, the prognostic value of peripheral endocannabinoid concentrations for clinical outcomes and cannabis use in first-episode psychosis (FEP) remains largely unknown. This study examined whether baseline plasma endocannabinoid concentrations are associated with clinical outcomes and cannabis use at one-year follow-up in antipsychotic-naïve patients with FEP. Plasma AEA and 2-AG concentrations were measured in 58 antipsychotic-naïve patients. Psychopathology was assessed using the Positive and Negative Syndrome Scale (PANSS), and cannabis use was evaluated using Standard Joint Units to estimate THC consumption. Associations were examined using correlation and regression analyses adjusted for relevant covariates. Higher baseline AEA concentrations were associated with lower general psychopathology scores at follow-up. No significant associations were observed between endocannabinoid concentrations and total PANSS scores or positive and negative symptom subscales. Age emerged as a significant predictor of cannabis use at follow-up, while 2-AG showed a non-significant trend toward a higher likelihood of use. These findings suggest that higher baseline plasma AEA concentrations may be associated with a more favourable course of general psychopathology in early psychosis, potentially reflecting ECS involvement in stress- and anxiety-related symptom domains. Further studies are warranted to clarify the role of endocannabinoids in clinical outcomes and substance use trajectories in early phases of psychosis.

Genomics is increasingly influencing psychiatric practice as evidence links genetic variation with neurodevelopmental disorders, treatment response, and complex psychiatric presentations. Psychiatric nurse practitioners are well positioned to incorporate genomics into patient assessment and management; however, familiarity with testing options and clinical indications remains limited. This column reviews key genomic considerations for psychiatric practice, including pharmacogenomics, chromosomal microarray analysis, and exome or genome sequencing. Clinical "red flags," such as developmental delay, dysmorphic features, early-onset psychosis, epilepsy, and strong family patterns of neuropsychiatric disease, can guide decisions on when to refer for further genetic evaluation. Integrating genomics enhances diagnostic clarity, supports precision prescribing, and informs risk assessment, ultimately improving patient outcomes. Strengthening nurse practitioner genomic literacy is essential to advancing person-centered mental health care and ensuring that emerging genomic tools are applied responsibly, ethically, and effectively in practice.