Continued versus discontinued cannabis use in patients with psychosis: a systematic review and meta-analysis

Schoeler, Tabea; Monk, Anna M.; Sami, Musa; Klamerus, Ewa; Foglia, Enrico; Brown, Ruth C.; Camuri, G.; Altamura, Alfredo Carlo; Murray, Robin M.; Bhattacharyya, Sagnik

doi:10.1016/s2215-0366(15)00363-6

Cited by 276 publications

(196 citation statements)

References 81 publications

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“…It appears that both psychotic episodes and cannabis use during a time when the brain has not fully developed can have detrimental effects in the long term [88]. Cannabis use may also contribute to or precipitate the onset of the illness and can predict adverse outcomes, including higher relapse rates, longer hospital admissions, more severe positive symptoms, and treatment resistance [89]. This illustrates the diathesis-stress-support model of schizophrenia in which biogenetic and psychosocial factors interact in a vulnerability-stress model [90-92].…”

Section: Discussionmentioning

confidence: 99%

Dandy-Walker Malformation-Like Condition Revealed by Refractory Schizophrenia: A Case Report and Literature Review

et al. 2018

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Introduction: Dandy-Walker malformation is a rare congenital malformation involving cystic dilatation of the fourth ventricle, enlarged posterior fossa, complete or partial agenesis of the cerebellar vermis, elevated tentorium cerebelli, and hydrocephalus. Previous research highlighted a possible role for the cerebellum in schizophrenia as well as the contribution of underlying brain malformations to treatment resistance. Here, we present a case of a Dandy-Walker malformation-like condition revealed by a refractory schizophrenia in a 24-year-old male patient. We also conduct a literature review of all previously published case reports or case series of co-occurring posterior fossa abnormalities and schizophrenia or psychosis using a PubMed search query to better understand the potential link between these two disorders. Case Presentation: A 9-month hospital stay was needed to address the treatment-resistant psychotic symptoms, and the patient continued to experience moderate symptoms despite the prescription of various antipsychotic and antidepressant medications. After an irregular initial medical follow-up, the patient is currently treated with 350 mg daily clozapine and 20 mg daily prazepam and still exhibits moderate anxiety without delirious thoughts, however allowing him to re-enroll at the university. Regarding the literature, 24 cases published between 1996 and 2017 were identified, reviewed and compared to the present case report. Discussion: This case report and literature review further illuminates the pathophysiology of psychotic disorders including the potential role of the cerebellum, reinforces the importance of a multidisciplinary approach for the neurological and psychiatric management of patients with schizophrenia, and highlights optimal pharmacological management strategies for treatment-resistant schizophrenia.

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Section: Discussionmentioning

confidence: 99%

Dandy-Walker Malformation-Like Condition Revealed by Refractory Schizophrenia: A Case Report and Literature Review

et al. 2018

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“…A recent meta-analysis found that patients who continue to use cannabis are more likely to relapse than their non-using counterparts 45 . Moreover, continued use of high potency cannabis appears to be more harmful to patients with psychosis than use of cannabis with lower THC and a relatively high proportion of CBD 46 .…”

Section: Psychosismentioning

confidence: 99%

Can we make cannabis safer?

Englund

Freeman

Murray

et al. 2017

The Lancet Psychiatry

139

120

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“…At follow-up, the odds of continued cannabis use were halved. The findings suggest that, given the established toxic effect of continued cannabis use on the course of schizophrenia, 16 more effective intervention strategies are required to decrease cannabis use in patients with FEP.…”

Section: Clinical Pointsmentioning

confidence: 98%

“…This question was examined by Schoeler et al 16 in a systematic review and meta-analysis. These authors identified 24 relevant studies of patients with existing psychosis (pooled N = 16,565) who were followed for at least 6 months.…”

Section: Cannabis Use Continues To Compromise Outcomes After Onset Ofmentioning

confidence: 99%

Cannabis and Neuropsychiatry, 2: The Longitudinal Risk of Psychosis as an Adverse Outcome

Andrade

2016

J. Clin. Psychiatry

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Continued versus discontinued cannabis use in patients with psychosis: a systematic review and meta-analysis

Cited by 276 publications

References 81 publications

Dandy-Walker Malformation-Like Condition Revealed by Refractory Schizophrenia: A Case Report and Literature Review

Dandy-Walker Malformation-Like Condition Revealed by Refractory Schizophrenia: A Case Report and Literature Review

Can we make cannabis safer?

Cannabis and Neuropsychiatry, 2: The Longitudinal Risk of Psychosis as an Adverse Outcome

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