Drug Induced Psychosis or Schizophrenia?

Abstract

EditorialCannabis, cocaine, amphetamines and derivative substances so as hallucinogens and other drugs with psychotomimetic properties has reached an extensive misuse often producing psychotic reactions similar to primary psychotic disease like schizophrenia. In particular cannabis and cocaine use by young people has been increased during these years, and the age of first use is dramatically decreased [1,2]. However, cannabis, or marijuana, is the most common illegal substances used in the most of the countries, including UK and USA. About 20% of young people now report its use every week or heavy use (use on major than 100 occasions). The use of such substances has dramatically increased particularly during early adolescence, when the brains go through a developing phase and can be especially sensitive to environmental exposures. Experimental studies and surveys of users show strong evidence that cannabis intoxication can initially produce temporary effects, usually mild, but also psychotic and affective symptoms and with time it can induce a chronic psychopathological picture that can persist, or can occur independently of acute intoxication effects [3].On the other hand cannabis is on sale, at present, in a more potent form and synthetic compounds, also known as "new psychoactive substances" increasing globally and the phenomena may be under valuated. Synthetic cannabinoids (SCs) result among the most new psychoactive substances used. They are usually purchased as marijuana-like drugs, marketed as herbal blends and considered risk-free by the inexperienced users. Furthermore, contrary to Δ9-tetrahydrocannabinol, SCs may lead more frequently to severe health consequences like tachycardia, anxiety, hallucinations, including violent behaviour and psychosis. Reports suggest that SCs may either exacerbate previously chronic psychotic symptoms at least in sensible individuals or trigger new-onset psychosis in individuals with no previous history of psychosis [4,5].As a whole, preclinical data seem to support the hypothesis that adolescent exposure to cannabinoids might represent a great risk for the development of psychotic-like symptoms in adulthood since it interferes with maturational events occurring in the adolescent brain. This can leads to alterations affecting brain connectivity and functionality similar to those present in schizophrenic patients. The most likely mechanism underlying these effects involves the disruption of maturational events within the endocannabinoid system. Indeed, the impairment of the endocannabinoid system maturation might have an impact on the correct neuronal evolution peculiar of the adolescent brain leading to altered adult brain functionality and behavior.In particular cannabis derivatives produce their CNS effect through activation of the endocannabinoid (eCB) system, a recently discovered signaling system comprising the cannabinoid CB1 and CB2 receptors, their intrinsic lipid ligands, endocannabinoids (eCBs), such as the Narachidonoylethanolamide (anandamide, AEA) and the 2-ar...