Cannabinoids and Psychosis

Abstract

There is growing interest in the relationship between cannabis and psychosis. The link between cannabis use and psychosis comprises three distinct relationships: acute psychosis associated with cannabis intoxication, acute psychosis that lasts beyond the period of acute intoxication, and persistent psychosis not time-locked to exposure. Experimental studies reveal that cannabis, tetrahydrocannabinol (THC) and synthetic cannabinoids reliably produce transient positive, negative, and cognitive symptoms in healthy volunteers. Case-studies indicate that cannabinoids can induce acute psychosis which lasts beyond the period of acute intoxication and persisting as long as a month. Exposure to cannabis in adolescence is associated with an increased risk for later psychotic disorder in adulthood; this association is consistent, somewhat specific, shows a dose-response, and is biologically plausible. The link between cannabinoids and psychosis is greater with earlier age of exposure to cannabinoids, childhood abuse and genetic vulnerability. However, cannabinoids are neither necessary nor sufficient to cause a persistent psychotic disorder. More likely cannabinoids are a 'component cause' interacting with other known (family history) and unknown factors to result in psychosis outcomes. While more research is needed to better understand the relationship between cannabinoid use and psychosis, and the neural underpinnings of this link, clinicians should be mindful of the potential risk of psychosis especially in vulnerable populations, including adolescents and those with a psychosis diathesis.

Disposable 3D Printed Electrode for the Electrochemical Detection of Delta-9-Tetrahydrocannabinol in Aqueous Solution and 11-Nor-9-Carboxy-Tetrahydrocannabinol in Saliva

“…Its main forms of presentation are as herbs (in one piece or crushed) or resins (hashish), whose concentration of Δ9-THC is higher. It can also be found in the form of a cigarette, ready to use, whose consumption can cause euphoria and hallucinations [3][4][5][6] .…”

Cannabinoids: from pot to lab

“…In this regard, there are epidemiological and toxicological data coming from surveys, poison centers, intoxication registers, clinical cases and case series. Data reported suggest that severe adverse reactions and fatal intoxications are much more common with SCs than with cannabis probably linked to high potency and the unintentionally high doses used 50 , 51 , 83 , 84 .…”

“…SCs in comparison to cannabis have been described have high-risk of developing psychosis especially in young individuals 50 , 51 , 83 , 84 . At this respect, findings from brain imaging studies suggest that SC could produce alterations/changes in brain regions that are often implicated in psychosis 50 .…”

Cannabis and Psychosis Through the Lens of DSM-5

“…Cannabis use has been associated with psychotic symptoms and disorders including schizophrenia across many populations and in many different study designs [6,7,8,9]. The nature of this association is complex and can be rife with confounders.…”

“…Cannabis is also associated with psychotic symptoms of widely variable timeframes. Cannabis-associated psychosis can be seen on the order of minutes, hours, days, or weeks in addition to the months and years timeframe seen in a schizophrenia diagnosis [6,31,32].…”