Cannabis use in individuals at clinical high-risk for psychosis: a comprehensive review

Farris, Megan S.; Shakeel, Mohammed K.; Addington, Jean

doi:10.1007/s00127-019-01810-x

Cited by 40 publications

(42 citation statements)

References 66 publications

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“…Whereas some observed a higher risk of transition to psychosis in CHR patients who used cannabis (Auther et al 2015 ; McHugh et al 2017 ; Valmaggia et al 2014 ), other did not find this (Auther et al 2012 ; Corcoran et al 2008 ). Importantly, a recent meta-analysis found that the pooled relative risk of developing psychosis in CHR individuals following cannabis use was not statistically significant (Farris et al 2019 ). Further to the evidence of the association between cannabis use and onset of psychotic illness, a different meta-analysis that pooled data from over 16,500 patients with psychosis identified associations between continued cannabis use and an increased risk of psychotic relapse, hospitalisation, and longer inpatient admission (Schoeler et al 2016a ).…”

Section: Cannabis Use Endocannabinoid Dysfunction and Psychosismentioning

confidence: 99%

Cannabinoids, reward processing, and psychosis

2021

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Background Evidence suggests that an overlap exists between the neurobiology of psychotic disorders and the effects of cannabinoids on neurocognitive and neurochemical substrates involved in reward processing. Aims We investigate whether the psychotomimetic effects of delta-9-tetrahydrocannabinol (THC) and the antipsychotic potential of cannabidiol (CBD) are underpinned by their effects on the reward system and dopamine. Methods This narrative review focuses on the overlap between altered dopamine signalling and reward processing induced by cannabinoids, pre-clinically and in humans. A systematic search was conducted of acute cannabinoid drug-challenge studies using neuroimaging in healthy subjects and those with psychosis Results There is evidence of increased striatal presynaptic dopamine synthesis and release in psychosis, as well as abnormal engagement of the striatum during reward processing. Although, acute THC challenges have elicited a modest effect on striatal dopamine, cannabis users generally indicate impaired presynaptic dopaminergic function. Functional MRI studies have identified that a single dose of THC may modulate regions involved in reward and salience processing such as the striatum, midbrain, insular, and anterior cingulate, with some effects correlating with the severity of THC-induced psychotic symptoms. CBD may modulate brain regions involved in reward/salience processing in an opposite direction to that of THC. Conclusions There is evidence to suggest modulation of reward processing and its neural substrates by THC and CBD. Whether such effects underlie the psychotomimetic/antipsychotic effects of these cannabinoids remains unclear. Future research should address these unanswered questions to understand the relationship between endocannabinoid dysfunction, reward processing abnormalities, and psychosis.

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Section: Cannabis Use Endocannabinoid Dysfunction and Psychosismentioning

confidence: 99%

Cannabinoids, reward processing, and psychosis

2021

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“…As a group, CHR individuals have problems with neurocognition, which tends to be intermediary to healthy controls and those with a first episode of psychosis 93 , 94 . Cannabis use is also of concern in this population and a recent review suggests that ~50% of CHR individuals use cannabis 95 . Attenuated psychotic symptoms typically decline overtime in longitudinal studies and there are CHR individuals who achieve complete remission within the first few months or even weeks 83 , although the differences in those who remit early versus later have not been established.…”

Section: Clinical Heterogeneitymentioning

confidence: 99%

Progression from being at-risk to psychosis: next steps

et al. 2020

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Over the past 20 years there has been a great deal of research into those considered to be at risk for developing psychosis. Much has been learned and studies have been encouraging. The aim of this paper is to offer an update of the current status of research on risk for psychosis, and what the next steps might be in examining the progression from CHR to psychosis. Advances have been made in accurate prediction, yet there are some methodological issues in ascertainment, diagnosis, the use of data-driven selection methods and lack of external validation. Although there have been several high-quality treatment trials the heterogeneity of this clinical high-risk population has to be addressed so that their treatment needs can be properly met. Recommendations for the future include more collaborative research programmes, and ensuring they are accessible and harmonized with respect to criteria and outcomes so that the field can continue to move forward with the development of large collaborative consortiums as well as increased funding for multisite projects.

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“…Cannabis use may result in psychosis and delusions such as Ekbom syndrome (7). The symptom of Ekbom syndrome continues even though there is no medical evidence of parasites or small insects that the patient claims invaded his body.…”

Section: Discussionmentioning

confidence: 99%

Ekbom Sendromu Belirtileri ve Trifluoperazin Kullanımı ile Tedavisi

Örüm

2020

Medical Records

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Substance use may result in schizophrenia. Ekbom syndrome is characterized by the conviction of being infested by invisible mites or insects, despite clear evidence of the contrary and can be seen in schizophrenia. These patients usually go to non-psychiatric physicians and have lost faith in psychiatric treatment during psychiatric admission. Therefore, early diagnosis and subsequent psychiatric treatment are important. Antipsychotics can be used for treatment, but drug response characteristics vary. Conventional antipsychotics can be considered when there is no response with the commonly used drugs. In this case report, we present a male patient with Ekbom syndrome who had symptomatic improvement with short-term trifluoperazine therapy..

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Cannabis use in individuals at clinical high-risk for psychosis: a comprehensive review

Cited by 40 publications

References 66 publications

Cannabinoids, reward processing, and psychosis

Cannabinoids, reward processing, and psychosis

Progression from being at-risk to psychosis: next steps

Ekbom Sendromu Belirtileri ve Trifluoperazin Kullanımı ile Tedavisi

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