.png)
Marijuana is the most frequently used illicit substance throughout the world. Psychoactive compound of marijuana is tetrahydrocannabinol, which acts on CB1 and CB2 receptors. New products that contain synthetic cannabinoids are becoming increasingly popular among substance users. Little is known about the toxicology of these compounds. Synthetic cannabinoid compounds are psychoactive compounds, which act on cannabinoid receptors stronger and cause serious clinical and psychiatric presentations. It was previously reported that JWH-018, the most common compound, might precipitate psychosis in vulnerable individuals. Although alleged rape is a frequently reported phenomenon, delusional rape is very rarely reported in clinical practice. In this paper, we aim to share two male patients, who had persistent delusional rape thoughts after using synthetic cannabinoid products. Case 1.A 26-year-old male was referred for alcohol addiction. He had been using alcohol, designer drugs, cocaine and cannabis for several years. His compulsive usage resulted in selling of all his belongings. After a remission period, he started using Bonzai and Jamaica (synthetic cannabinoid products in Turkey) with his friends. Since then, delusional thoughts about being raped by his friends occurred, resulting in homicidal thoughts and behavior. He had reference delusions that all people could understand at a glance that he had been raped. He was compulsively exploring about anal transplantation. He was planning to go abroad for this operation. Because of delusions, he had severe social withdrawal. After he has bought two knives for homicidal intention, he was brought to our clinic. His symptoms resolved partially after addition of 6 mg risperidone. Case 2.A 22-year-old male started using “Bonzai” after cannabis and designer drugs. Since then, reference delusions, Schneiderian delusions and delusions of being raped occurred. He had been seeking the alleged rappers for five months with homicidal intention when he was hospitalized. His homicidal thoughts disappeared and delusions resolved partially after three injections of 150 mg paliperidone palmitate. To our knowledge, this is the first report of delusional rape thoughts induced by synthetic cannabinoid compounds. Their examination of anal region was normal. Patients also had reference delusions that people know they had been raped when they saw the patients. Both patients had no previous or family history of psychotic symptoms. Delusions appeared after synthetic cannabinoid abuse and resulted in hospitalization due to suicidality and homicidality in both cases. Therefore, patients who have risk factors for psychosis should be counseled against using synthetic cannabinoids and abusers of these products should be assessed and followed for psychotic symptoms. In conclusion, recreational use of products, which include synthetic cannabinoid compounds, is an ever-increasing problem, which can cause various psychotic manifestations including persistent delusional rape thoughts and clinicians must be aware of psychotic disorders induced by synthetic cannabinoids.