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Sainz-Cort A, Martín-Islas M, Jimenez-Garrido D, López-Navarro M, Oña G, Muñoz-Marron E, Heredia L, Gil-Pérez M, Torrente M, Vicens P, Bouso JC. Validation of the Spanish version of the multifaceted empathy test: comparison between cannabis use effects and controls in social cognition. Int Clin Psychopharmacol 2024:00004850-990000000-00144. [PMID: 38935429 DOI: 10.1097/yic.0000000000000544] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 06/28/2024]
Abstract
OBJECTIVE While social cognition is shown to be impaired in several mental disorders, the effects of cannabis on social cognition are still not clear. Past studies have used the multifaceted empathy test (MET) to study social cognition. This study aims to test the validity of the MET Spanish version and to evaluate the effects of cannabis use on social cognition. METHODS In total 116 participants from a Cannabis Social Club (CSC) completed the MET and the reading the mind in the eyes test (RMET) under the effects of cannabis and were compared to 86 university students (control group). Internal consistency and convergent validity were assessed. Cognitive empathy (CE) and emotional empathy (EE) were tested in both groups. RESULTS The MET CE scale shows low internal consistency, while the EE scale shows high internal consistency. Items showed similar difficulty for both groups. Cannabis users showed deficient overall emotional recognition, with reduced scores associated with positive stimuli. Overall scores for EE were similar for both groups, but the experimental group scored lower with negative stimuli when compared to controls. CONCLUSION This study validates the MET Spanish version for its use in future studies. Results confirmed deficient emotional recognition in cannabis users and a dampened reaction to negative stimuli for the first time.
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Affiliation(s)
- Alberto Sainz-Cort
- Faculty of Health Sciences, Universitat Oberta de Catalunya (UOC)
- International Center for Ethnobotanical Education, Research and Service (ICEERS), Barcelona, Spain
| | - Marta Martín-Islas
- International Center for Ethnobotanical Education, Research and Service (ICEERS), Barcelona, Spain
| | - Daniel Jimenez-Garrido
- International Center for Ethnobotanical Education, Research and Service (ICEERS), Barcelona, Spain
| | - Miriam López-Navarro
- Neurobiology Research Unit, Copenhagen University Hospital Rigshospitalet, Copenhagen, Denmark
| | - Genís Oña
- International Center for Ethnobotanical Education, Research and Service (ICEERS), Barcelona, Spain
- Medical Anthropology Research Center (MARC), Universitat Rovira i Virgili
| | | | - Luis Heredia
- Department of Psychology, Universitat Rovira i Virgili, CRAMC (Research Center for Behavior Assessment), Tarragona
- Laboratory of Toxicology and Environmental Health, School of Medicine, Universitat Rovira i Virgili, Reus, Spain
- Department of Research Methods and Diagnosis in Education (MIDE), Universidad Internacional de la Rioja, Logroño
- Department of Psychology, Universitat Rovira i Virgili, Tarragona, Spain
| | - Mercè Gil-Pérez
- Department of Psychology, Universitat Rovira i Virgili, Tarragona, Spain
| | - Margarita Torrente
- Department of Psychology, Universitat Rovira i Virgili, CRAMC (Research Center for Behavior Assessment), Tarragona
- Laboratory of Toxicology and Environmental Health, School of Medicine, Universitat Rovira i Virgili, Reus, Spain
- Department of Psychology, Universitat Rovira i Virgili, Tarragona, Spain
| | - Paloma Vicens
- Department of Psychology, Universitat Rovira i Virgili, CRAMC (Research Center for Behavior Assessment), Tarragona
- Laboratory of Toxicology and Environmental Health, School of Medicine, Universitat Rovira i Virgili, Reus, Spain
- Department of Psychology, Universitat Rovira i Virgili, Tarragona, Spain
| | - José Carlos Bouso
- International Center for Ethnobotanical Education, Research and Service (ICEERS), Barcelona, Spain
- Medical Anthropology Research Center (MARC), Universitat Rovira i Virgili
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Rosário BDA, Lemes JA, de Lima MP, Ribeiro DA, Viana MDB. Subjective, behavioral and neurobiological effects of cannabis and cannabinoids in social anxiety. Rev Neurosci 2024; 35:197-211. [PMID: 37812748 DOI: 10.1515/revneuro-2023-0078] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/19/2023] [Accepted: 09/23/2023] [Indexed: 10/11/2023]
Abstract
Social anxiety disorder (SAD) is a debilitating disorder, characterized by fear and anxiety in social situations. Evidence suggests that the levels of SAD are rising, in particularly after the COVID-19 pandemic. Serotonin and noradrenaline reuptake inhibitors and cognitive-behavioral therapy are effective treatments for SAD. Nevertheless, a significant number of patients do not respond well to these therapeutic options. During the last years, Cannabis and cannabinoid-containing products have been investigated for the treatment of different neuropsychiatric disorders. Nevertheless, their efficacy for the treatment of anxiety disorders is still a matter of debate. The purpose of this review was to investigate subjective, behavioral, and neurobiological effects of Cannabis and cannabinoids in social anxiety and SAD. A search in the PubMed database for articles published between the years of 2003-2023 was conducted. One hundred and seventeen (117) original studies were identified. After the exclusion criteria, eighteen (18) studies were selected. The studies investigated the effects of the cannabinoids Δ9-tetrahydrocannabinol (THC) and cannabidiol (CBD) in patients or healthy volunteers submitted to tasks that assessed social anxiety. Results showed that CBD decreases social anxiety, producing an inverted U-shaped curve, with anxiety measurements being reduced at intermediate doses administered orally (300-600 mg), but not at lower or higher doses. THC either reduces (lower doses, 6-7.5 mg) or increases (higher doses) social anxiety measurements. CBD attenuates the anxiogenic effects of THC. The effects of THC and CBD in anxiety are associated to the modulation of fronto-limbic regions. Further clinical trials, conducted with male and female patients and larger cohorts are still necessary to consolidate these results.
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Affiliation(s)
| | - Jéssica Alves Lemes
- Departamento de Biociências, Universidade Federal de São Paulo (UNIFESP), Santos, São Paulo, Brasil
| | - Maria Paula de Lima
- Departamento de Biociências, Universidade Federal de São Paulo (UNIFESP), Santos, São Paulo, Brasil
| | - Daniel Araki Ribeiro
- Departamento de Biociências, Universidade Federal de São Paulo (UNIFESP), Santos, São Paulo, Brasil
| | - Milena de Barros Viana
- Departamento de Biociências, Universidade Federal de São Paulo (UNIFESP), Santos, São Paulo, Brasil
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Sainz-Cort A, Jimenez-Garrido D, Muñoz-Marron E, Viejo-Sobera R, Heeroma J, Bouso JC. The Effects of Cannabidiol and δ-9-Tetrahydrocannabinol in Social Cognition: A Naturalistic Controlled Study. Cannabis Cannabinoid Res 2024; 9:230-240. [PMID: 35881851 DOI: 10.1089/can.2022.0037] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/13/2022] Open
Abstract
Background: Social cognition abilities such as empathy and the Theory of Mind (ToM) have been shown to be impaired in neuropsychiatric conditions such as psychotic, autistic, and bipolar disorders. The endocannabinoid system (ECS) seems to play a role in social behavior and emotional processing while it also seems to play a role in those neuropsychiatric conditions showing social cognition impairments. Main plant cannabinoids delta-9-tetrahydrocannabinol (THC) and cannabidiol (CBD) modulate the ECS and, due to their opposite effects, have been proposed as both cause and treatment for neuropsychiatric-related disorders such as schizophrenia, anxiety, or post-traumatic stress disorder (PTSD). The aim of this study was to test the effects of THC and CBD on social cognition abilities in chronic cannabis users. Method: Eighteen members from a cannabis social club were tested for social cognition effects under the effects of different full spectrum cannabis extracts containing either THC, CBD, THC+CBD, or placebo in a naturalistic randomized double-blind crossover placebo-controlled study. Results: Results showed that participants under the effects of THC showed lower cognitive empathy when compared with the effects of CBD but not when those were compared with THC+CBD or placebo. Also, participants showed higher cognitive ToM under the effects of CBD when compared with the effects of placebo, but not when those were compared with THC or THC+CBD. However, we did not find differences on the emotional scales for empathy or ToM. Conclusions: This study provides evidence for the interaction between the effects of THC and CBD and social cognition abilities in a naturalistic environment, which can be of special interest for the clinical practice of medical cannabis on neuropsychiatric disorders. We show for the first time that CBD can improve ToM abilities in chronic cannabis users. Our results might help to understand the role of the ECS in social cognition, and their association with psychiatric and neurodevelopmental disorders such as schizophrenia or autism. Finally, we demonstrate how reliable methodologies can be implemented in naturalistic environments to collect valid ecological evidence outside classic laboratory settings.
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Affiliation(s)
- Alberto Sainz-Cort
- Faculty of Health Sciences, Universitat Oberta de Catalunya (UOC), Barcelona, Spain
- International Center of Ethnobotanic Education, Research and Service (ICEERS), Barcelona, Spain
- GH Medical, Amsterdam, The Netherlands
| | - Daniel Jimenez-Garrido
- International Center of Ethnobotanic Education, Research and Service (ICEERS), Barcelona, Spain
| | - Elena Muñoz-Marron
- Faculty of Health Sciences, Universitat Oberta de Catalunya (UOC), Barcelona, Spain
| | - Raquel Viejo-Sobera
- Faculty of Health Sciences, Universitat Oberta de Catalunya (UOC), Barcelona, Spain
| | | | - Jose Carlos Bouso
- International Center of Ethnobotanic Education, Research and Service (ICEERS), Barcelona, Spain
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Spohrs J, Kühnle V, Mikusky D, Sanhüter N, Macchia A, Nickel S, Abler B. Plasma Endocannabinoid Levels in Patients with Borderline Personality Disorder and Healthy Controls. Int J Mol Sci 2023; 24:17452. [PMID: 38139281 PMCID: PMC10743563 DOI: 10.3390/ijms242417452] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/24/2023] [Revised: 11/30/2023] [Accepted: 12/07/2023] [Indexed: 12/24/2023] Open
Abstract
Borderline personality disorder (BPD) is a highly prevalent psychiatric disorder and presents a complex therapeutic challenge due to limited treatment modalities. Recent focus has converged on the endocannabinoid system (ECS) as a prospective modulator of psychopathological processes in BPD. To address this hypothesis, we analysed plasma endocannabinoid concentrations, specifically anandamide (AEA) and 2-arachidonoylglycerol (2-AG), in a cohort of 49 female BPD patients and 32 matched healthy controls (HC). Additionally, we examined the effect of the FAAH polymorphism rs324420 and correlates with psychopathology. The results indicate heightened AEA levels and, by trend, augmented 2-AG levels within the patient group, as compared to the HC group. Significant between group differences in AEA levels were evident in the CC genotype (FAAH_rs324420) but not in A-allele carriers while the commonly observed difference in AEA levels between A-allele carriers as compared to the CC genotype was not evident in patients. An effect of genotype was found with higher ratings of depression (Beck's depression inventory, BDI-II) in the CC genotype compared to A-allele carriers (FAAH_rs32442), particularly in the patients. Significant alterations in AEA (and by trend in 2-AG) in patients with BPD may relate to compensatory ECS activity. The finding that the effect is most pronounced in CC homozygotes, might point towards a countermeasure to balance physiologically lower baseline AEA levels. The findings warrant further research to develop potentially beneficial psychopharmacological therapies.
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Affiliation(s)
- Jennifer Spohrs
- Department for Child and Adolescent Psychiatry and Psychotherapy, Ulm University Medical Centre, 89075 Ulm, Germany;
- Department of Psychiatry, Psychotherapy and Psychotraumatology, Military Medical Centre, 89081 Ulm, Germany
| | - Valentin Kühnle
- Department of Psychiatry and Psychotherapy III, Ulm University Medical Centre, 89075 Ulm, Germany; (V.K.); (D.M.); (N.S.); (A.M.); (S.N.)
| | - David Mikusky
- Department of Psychiatry and Psychotherapy III, Ulm University Medical Centre, 89075 Ulm, Germany; (V.K.); (D.M.); (N.S.); (A.M.); (S.N.)
| | - Niklas Sanhüter
- Department of Psychiatry and Psychotherapy III, Ulm University Medical Centre, 89075 Ulm, Germany; (V.K.); (D.M.); (N.S.); (A.M.); (S.N.)
| | - Ana Macchia
- Department of Psychiatry and Psychotherapy III, Ulm University Medical Centre, 89075 Ulm, Germany; (V.K.); (D.M.); (N.S.); (A.M.); (S.N.)
| | - Sandra Nickel
- Department of Psychiatry and Psychotherapy III, Ulm University Medical Centre, 89075 Ulm, Germany; (V.K.); (D.M.); (N.S.); (A.M.); (S.N.)
| | - Birgit Abler
- Department of Psychiatry and Psychotherapy III, Ulm University Medical Centre, 89075 Ulm, Germany; (V.K.); (D.M.); (N.S.); (A.M.); (S.N.)
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Muzumdar N, Jackson KM, Buckman JF, Spaeth AM, Sokolovsky AW, Pawlak AP, White HR. Dose-dependent Relationships of Same-day and Typical Substance Use to Sleep Duration in College Cannabis and Alcohol Users: A Multilevel Modeling Approach Using Daily Diary Data. CANNABIS (ALBUQUERQUE, N.M.) 2023; 6:49-63. [PMID: 38035172 PMCID: PMC10683747 DOI: 10.26828/cannabis/2023/000179] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Indexed: 12/02/2023]
Abstract
This study characterized how quantities of cannabis and alcohol use affect sleep. Single-day and typical cannabis and alcohol use patterns were considered to assess acute-chronic use interactions. Linear and non-linear associations assessed dose-dependence. College students (n=337; 52% female) provided 11,417 days of data, with up to five time points per day. Daily self-reported sleep duration, cannabis use quantity, and alcohol use quantity were subjected to linear mixed modeling to capture linear and curvilinear associations between single-day and typical use on same-night and typical sleep. Sleep duration (difference between bedtime and waketime) was the outcome. Quantity of cannabis used each day andtypical quantity used across all days were predictors in the cannabis models. Parallel single-day and typical alcohol variables were predictors in the alcohol models. Follow-up analyses excluded days with alcohol-cannabis co-use. Main effects of single-day and typical cannabis quantity on sleep duration were observed when all cannabis-use days were modeled. Higher than typical doses of single-day and typical cannabis were associated with longer sleep durations, but only to a point; at the highest doses, cannabis shortened sleep. A main effect of single-day alcohol quantity and two interactions (single-day use with both linear and curvilinear typical use) on sleep duration were observed when all alcohol-use days were modeled. Greater alcohol consumption on a given day led to shorter same-night sleep, but typically heavier drinkers required higher doses than typically lighter drinkers to experience these adverse effects. Follow-up models suggested alcohol co-use may contribute to the purported sleep-promoting effects of cannabis.
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Affiliation(s)
- Neel Muzumdar
- Department of Kinesiology and Health, Rutgers University – New Brunswick
- Center for Alcohol and Substance Use Studies, Rutgers University – New Brunswick
| | - Kristina M. Jackson
- Center for Alcohol and Addiction Studies, Brown University, School of Public Health
| | - Jennifer F. Buckman
- Department of Kinesiology and Health, Rutgers University – New Brunswick
- Center for Alcohol and Substance Use Studies, Rutgers University – New Brunswick
| | - Andrea M. Spaeth
- Department of Kinesiology and Health, Rutgers University – New Brunswick
| | | | - Anthony P. Pawlak
- Center for Alcohol and Substance Use Studies, Rutgers University – New Brunswick
| | - Helene R. White
- Center for Alcohol and Substance Use Studies, Rutgers University – New Brunswick
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6
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Fasakin OW, Oboh G, Ademosun AO, Lawal AO. The modulatory effects of alkaloid extracts of Cannabis sativa, Datura stramonium, Nicotiana tabacum and male Carica papaya on neurotransmitter, neurotrophic and neuroinflammatory systems linked to anxiety and depression. Inflammopharmacology 2022; 30:2447-2476. [PMID: 35665872 DOI: 10.1007/s10787-022-01006-x] [Citation(s) in RCA: 6] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/29/2022] [Accepted: 05/08/2022] [Indexed: 01/03/2023]
Abstract
This study investigated the modulatory effects of alkaloid extracts of Cannabis sativa (CSAE), Datura stramonium (DSAE), Nicotiana tabacum (NTAE) and male Carica papaya (CMAE) on neurotransmitter, neurotrophic and neuro-inflammatory systems linked to anxiety and depression. Male Wistar rats were orally administered the alkaloid extracts in doses of 5, 50, 500, and 2000 mg/kg for 90 days. On day 91, neurobehavioural studies were evaluated, rats were sacrificed, brain hippocampus removed and tissue homogenate prepared. Biochemical, cytokine and neurotransmitter metabolisms were estimated in the hippocampus. Expressions of genes linked to anxiety and depression were evaluated by RT-qPCR. Results showed CSAE, NTAE and CMAE act as anxiolytic and antidepressant agents by depleting TNF-α, IL-1β and reactive oxygen species concentrations, and monoamine oxidase, angiotensin 1-converting enzyme and acetylcholinesterase activities while elevating IL-10 and dopamine concentrations and glutamate dehydrogenase activity at doses of 5, 50 and 500. Same doses of CSAE, NTAE and CMAE also depleted the gene expressions of GSK3β, JNK, NF-ĸB, and Nesfatin-1 while increasing expressions of CREB, BDNF, serotonin and Nrf2. However, administration of DSAE and 2000 mg/kg CSAE, NTAE and CMAE had adverse modulatory effects on the neurochemical concentrations and activities as well as the gene expressions of the evaluated neurotransmitter, neurotrophic and inflammatory systems. In conclusion, the study established the sub-chronic instrumentalization potential of CSAE, CMAE, and NTAE for anxiolytic and anti-depressive moods, though their use may be associated with dependence and addiction, which may result in more detrimental effects than any therapeutic potential they may proffer.
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Affiliation(s)
- Olamide Wilson Fasakin
- Department of Biochemistry, School of Life Sciences, Federal University of Technology, P.M.B. 704, Akure, 340001, Nigeria
| | - Ganiyu Oboh
- Department of Biochemistry, School of Life Sciences, Federal University of Technology, P.M.B. 704, Akure, 340001, Nigeria.
| | - Ayokunle Olubode Ademosun
- Department of Biochemistry, School of Life Sciences, Federal University of Technology, P.M.B. 704, Akure, 340001, Nigeria
| | - Akeem O Lawal
- Department of Biochemistry, School of Life Sciences, Federal University of Technology, P.M.B. 704, Akure, 340001, Nigeria
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The association between cannabis use and facial emotion recognition in schizophrenia, siblings, and healthy controls: Results from the EUGEI study. Eur Neuropsychopharmacol 2022; 63:47-59. [PMID: 36055075 DOI: 10.1016/j.euroneuro.2022.08.003] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/07/2022] [Revised: 08/12/2022] [Accepted: 08/16/2022] [Indexed: 11/23/2022]
Abstract
Schizophrenia is frequently accompanied with social cognitive disturbances. Cannabis represents one established environmental factor associated with the onset and progression of schizophrenia. The present cross-sectional study aimed to investigate the association of facial emotion recognition (FER) performance with cannabis use in 2039 patients with schizophrenia, 2141 siblings, and 2049 healthy controls (HC). FER performance was measured using the Degraded Facial Affect Recognition Task (DFAR). Better FER performance as indicated by higher DFAR-total scores was associated with lifetime regular cannabis use in schizophrenia (B = 1.36, 95% CI 0.02 to 2.69), siblings (B = 2.17, 95% CI 0.79 to 3.56), and HC (B = 3.10, 95% CI 1.14 to 5.06). No associations were found between DFAR-total and current cannabis use. Patients with schizophrenia who started to use cannabis after the age of 16 showed better FER performance than patients who started earlier (B = 2.50, 95% CI 0.15 to 4.84) and non-users (B = 3.72, 95 CI 1.96 to 5.49). Better FER performance was found also in siblings who started to use cannabis after 16 compared to non-users (B = 2.37, 95% CI 0.58 to 4.16), while HC using cannabis performed better than non-users at DFAR-total regardless of the age at onset. Our findings suggest that lifetime regular cannabis use may be associated with better FER regardless of the psychosis risk, but that FER might be moderated by age at first use in people with higher genetic risk. Longitudinal studies may clarify whether there is a cause-and-effect relationship between cannabis use and FER performance in psychotic and non-psychotic samples.
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Gunasekera B, Davies C, Blest-Hopley G, Veronese M, Ramsey NF, Bossong MG, Radua J, Bhattacharyya S. Task-independent acute effects of delta-9-tetrahydrocannabinol on human brain function and its relationship with cannabinoid receptor gene expression: A neuroimaging meta-regression analysis. Neurosci Biobehav Rev 2022; 140:104801. [PMID: 35914625 DOI: 10.1016/j.neubiorev.2022.104801] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/07/2022] [Revised: 06/07/2022] [Accepted: 07/26/2022] [Indexed: 11/20/2022]
Abstract
The neurobiological mechanisms underlying the effects of delta-9-tetrahydrocannabinol (THC) remain unclear. Here, we examined the spatial acute effect of THC on human regional brain activation or blood flow (hereafter called 'activation signal') in a 'core' network of brain regions from 372 participants, tested using a within-subject repeated measures design under experimental conditions. We also investigated whether the neuromodulatory effects of THC are related to the local expression of the cannabinoid-type-1 (CB1R) and type-2 (CB2R) receptors. Finally, we investigated the dose-response relationship between THC and key brain substrates. These meta-analytic findings shed new light on the localisation of the effects of THC in the human brain, suggesting that THC has neuromodulatory effects in regions central to many cognitive tasks and processes, related to dose, with greater effects in regions with higher levels of CB1R expression.
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Affiliation(s)
- Brandon Gunasekera
- Department of Psychosis Studies, Institute of Psychiatry, Psychology and Neuroscience, King's College London, UK
| | - Cathy Davies
- Department of Psychosis Studies, Institute of Psychiatry, Psychology and Neuroscience, King's College London, UK
| | - Grace Blest-Hopley
- Department of Psychosis Studies, Institute of Psychiatry, Psychology and Neuroscience, King's College London, UK
| | - Mattia Veronese
- Department of Neuroimaging, Centre for Neuroimaging Sciences, King's College London, UK; Department of Information Engineering, University of Padua, Italy
| | - Nick F Ramsey
- Department of Neurology and Neurosurgery, UMC Utrecht Brain Center, Utrecht University, Utrecht, the Netherlands
| | - Matthijs G Bossong
- Department of Psychiatry, UMC Utrecht Brain Center, Utrecht University, Utrecht, the Netherlands
| | - Joaquim Radua
- Department of Psychosis Studies, Institute of Psychiatry, Psychology and Neuroscience, King's College London, UK; Institut d'Investigacions Biomèdiques August Pi i Sunyer (IDIBAPS), CIBERSAM, Barcelona, Spain; Department of Clinical Neuroscience, Karolinska Institutet, Stockholm, Sweden
| | - Sagnik Bhattacharyya
- Department of Psychosis Studies, Institute of Psychiatry, Psychology and Neuroscience, King's College London, UK.
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Associations between cannabis use, cannabis use disorder, and mood disorders: longitudinal, genetic, and neurocognitive evidence. Psychopharmacology (Berl) 2022; 239:1231-1249. [PMID: 34741634 PMCID: PMC9520129 DOI: 10.1007/s00213-021-06001-8] [Citation(s) in RCA: 14] [Impact Index Per Article: 7.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/21/2020] [Accepted: 10/11/2021] [Indexed: 12/16/2022]
Abstract
RATIONALE Cannabis use among people with mood disorders increased in recent years. While comorbidity between cannabis use, cannabis use disorder (CUD), and mood disorders is high, the underlying mechanisms remain unclear. OBJECTIVES We aimed to evaluate (1) the epidemiological evidence for an association between cannabis use, CUD, and mood disorders; (2) prospective longitudinal, genetic, and neurocognitive evidence of underlying mechanisms; and (3) prognosis and treatment options for individuals with CUD and mood disorders. METHODS Narrative review of existing literature is identified through PubMed searches, reviews, and meta-analyses. Evidence was reviewed separately for depression, bipolar disorder, and suicide. RESULTS Current evidence is limited and mixed but suggestive of a bidirectional relationship between cannabis use, CUD, and the onset of depression. The evidence more consistently points to cannabis use preceding onset of bipolar disorder. Shared neurocognitive mechanisms and underlying genetic and environmental risk factors appear to explain part of the association. However, cannabis use itself may also influence the development of mood disorders, while others may initiate cannabis use to self-medicate symptoms. Comorbid cannabis use and CUD are associated with worse prognosis for depression and bipolar disorder including increased suicidal behaviors. Evidence for targeted treatments is limited. CONCLUSIONS The current evidence base is limited by the lack of well-controlled prospective longitudinal studies and clinical studies including comorbid individuals. Future studies in humans examining the causal pathways and potential mechanisms of the association between cannabis use, CUD, and mood disorder comorbidity are crucial for optimizing harm reduction and treatment strategies.
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Sullivan RM, Maple KE, Wallace AL, Thomas AM, Lisdahl KM. Examining Inhibitory Affective Processing Within the Rostral Anterior Cingulate Cortex Among Abstinent Cannabis-Using Adolescents and Young Adults. Front Psychiatry 2022; 13:851118. [PMID: 35418882 PMCID: PMC8995473 DOI: 10.3389/fpsyt.2022.851118] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/09/2022] [Accepted: 02/28/2022] [Indexed: 12/24/2022] Open
Abstract
Cannabis use has been associated with deficits in self-regulation, including inhibitory control. Cannabis users have previously exhibited both structural and functional deficits in the rostral anterior cingulate cortex (rACC), a region involved in self-regulation of emotional response and inhibitory control. The present study aimed to examine whether abstinent cannabis users demonstrated abnormal functional activation and connectivity of the bilateral rACC during an emotional inhibitory processing task, and whether gender moderated these relationships. Cannabis-using (N = 34) and non-using (N = 32) participants ages 16-25 underwent at least 2-weeks of monitored substance use abstinence (excluding tobacco) and fMRI scanning while completing a Go/No-go task using fearful and calm emotional faces as non-targets. Multiple linear regression and ANCOVA were used to determine if cannabis group status was related to rACC activation and context-dependent functional connectivity, and whether gender moderated these relationships. Results showed decreased bilateral rACC activation in cannabis users during fearful response inhibition, although groups did not show any context-dependent connectivity differences between the left or right rACC during calm or fearful inhibition. Gender findings revealed that cannabis-using females compared to males did show aberrant connectivity between the right rACC and right cerebellum. These results are consistent with literature demonstrating aberrant structural and functional rACC findings and suggest that chronic cannabis use may disrupt typical rACC development-even after abstinence-potentially conferring risk for later development of mood disorders. Marginal gender-specific connectivity findings bolster continued findings regarding female vulnerability to effects of cannabis on cognition and affect. Findings should be assessed in longitudinal studies to determine causality and timing effects.
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Affiliation(s)
| | | | | | | | - Krista M. Lisdahl
- Department of Psychology, University of Wisconsin-Milwaukee, Milwaukee, WI, United States
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Ho W, Kolla NJ. The endocannabinoid system in borderline personality disorder and antisocial personality disorder: A scoping review. BEHAVIORAL SCIENCES & THE LAW 2022; 40:331-350. [PMID: 35575169 DOI: 10.1002/bsl.2576] [Citation(s) in RCA: 4] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 11/07/2021] [Revised: 02/06/2022] [Accepted: 03/31/2022] [Indexed: 06/15/2023]
Abstract
Individuals with borderline personality disorder (BPD) or antisocial personality disorder (ASPD) are overrepresented in forensic settings. Yet, despite the burden these disorders place on healthcare and criminal justice systems, there remains a lack of evidence-based pharmacological treatments. Epidemiological data have shown that comorbid cannabis use disorders are common in BPD and ASPD. ∆9 -Tetrahydrocannabinol, the primary psychoactive constituent of cannabis, is an exogenous cannabinoid that stimulates the endocannabinoid system (ECS). Hence, an investigation of the ECS in these conditions is warranted. This scoping review screened 105 records and summarized the extant research on the ECS in ASPD (n = 69) and BPD (n = 61) participants. Preliminary results suggest that alterations of the ECS may be present in these disorders. Although research examining the ECS in personality disorders is still in its infancy, more research is warranted given initial positive findings.
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Affiliation(s)
- Wilson Ho
- Faculty of Medicine, University of Toronto, Toronto, ON, Canada
- Brain Health Imaging Centre, Centre for Addiction and Mental Health, Toronto, ON, Canada
| | - Nathan J Kolla
- Faculty of Medicine, University of Toronto, Toronto, ON, Canada
- Brain Health Imaging Centre, Centre for Addiction and Mental Health, Toronto, ON, Canada
- Department of Psychiatry, University of Toronto, Toronto, ON, Canada
- Waypoint Centre for Mental Health Care, Penetanguishene, ON, Canada
- Waypoint/University of Toronto Research Chair in Forensic Mental Health Science, Penetanguishene, ON, Canada
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12
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Aloi J, McCusker MC, Lew BJ, Schantell M, Eastman JA, Frenzel MR, Wilson TW. Altered amygdala-cortical connectivity in individuals with Cannabis use disorder. J Psychopharmacol 2021; 35:1365-1374. [PMID: 34730052 PMCID: PMC9659472 DOI: 10.1177/02698811211054163] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/16/2022]
Abstract
BACKGROUND Cannabis is one of the most commonly used substances in the United States. Prior literature using task-based functional magnetic resonance imaging (fMRI) has identified that individuals with Cannabis use disorder (CUD) show impairments in emotion processing circuitry. However, whether the functional networks involving these regions are also altered in CUD remains poorly understood. AIMS Investigate changes in resting-state functional connectivity (rsFC) in regions related to emotional processing in CUD. METHODS Sixty-two participants completed resting-state fMRI, including 21 with CUD, 20 with histories of illicit substance use but no current CUD diagnosis, and 21 with no history of illicit substance use. Whole-brain seed-based connectivity analyses were performed and one-way analyses of covariance (ANCOVAs) were conducted to detect group differences in the bilateral amygdalae, hippocampi, and the anterior and posterior cingulate cortices. RESULTS The CUD group exhibited significant reductions in rsFC between the amygdala and the cuneus, paracentral lobule, and supplementary motor area, and between the cingulate cortices and the occipital and temporal lobes. There were no significant group differences in hippocampal functional connectivity. In addition, CUD symptom counts based on the Structured Clinical Interview for DSM-5 (SCID) and the Cannabis Use Disorders Identification Test (CUDIT) significantly correlated with multiple connectivity metrics. CONCLUSION These data expand on emerging literature indicating that CUD is associated with dysfunction in the neural circuits underlying emotion processing. Dysfunction in emotion processing circuits may play a role in the behavioral impairments seen in emotion processing tasks in individuals with CUD, and the severity of CUD symptoms appears to be directly related to the degree of dysfunction in these circuits.
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Affiliation(s)
- Joseph Aloi
- Institute for Human Neuroscience, Boys Town National Research Hospital, Omaha, NE,College of Medicine, University of Nebraska Medical Center, Omaha, NE,Department of Psychiatry, Indiana University School of Medicine, Indianapolis, IN
| | - Marie C. McCusker
- Institute for Human Neuroscience, Boys Town National Research Hospital, Omaha, NE
| | - Brandon J. Lew
- Institute for Human Neuroscience, Boys Town National Research Hospital, Omaha, NE,College of Medicine, University of Nebraska Medical Center, Omaha, NE
| | - Mikki Schantell
- Institute for Human Neuroscience, Boys Town National Research Hospital, Omaha, NE,College of Medicine, University of Nebraska Medical Center, Omaha, NE
| | - Jacob A. Eastman
- Institute for Human Neuroscience, Boys Town National Research Hospital, Omaha, NE
| | - Michaela R. Frenzel
- Institute for Human Neuroscience, Boys Town National Research Hospital, Omaha, NE
| | - Tony W. Wilson
- Institute for Human Neuroscience, Boys Town National Research Hospital, Omaha, NE,College of Medicine, University of Nebraska Medical Center, Omaha, NE
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13
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Van Hedger K, Mayo LM, Bershad AK, Madray R, de Wit H. Effects of Acute Drug Administration on Emotion: A Review of Pharmacological MRI Studies. CURRENT ADDICTION REPORTS 2021; 8:181-193. [PMID: 34631363 DOI: 10.1007/s40429-021-00362-y] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/21/2022]
Abstract
Purpose of review Many drug users claim to use drugs to cope with negative emotions, which may, in turn, result in persistent emotional blunting or anhedonia even when they are not using drugs. The purpose of this review is to describe the ways acute administration of psychoactive drugs impacts brain regions during emotion-related tasks, as a first step in understanding how drugs influence emotion processing in the brain. Recent findings Drugs have varying effects on neural responses to emotional stimuli. In general, alcohol, analgesics, and psychedelics reduce neural reactivity to negative emotional stimuli in the amygdala and other brain regions. Other drugs produce mixed effects: Stimulants such as caffeine and modafinil increase brain activation while viewing emotional stimuli, whereas MDMA decreases activation during presentation of negative images. The effects of cannabinoids (cannabidiol and THC) are mixed. There are also inconsistent findings on the associations between neural responses to emotional stimuli and subjective drug effects. Summary Consistent with the notion that individuals might use drugs non-medically to diminish the experience of negative emotions, several drugs of abuse decrease neural responses to negative stimuli in limbic brain regions. These neural actions may underlie the reported 'emotional blunting' of drugs, which may contribute to drug-seeking behavior. Future work is needed to examine these limbic responses in relation to self-reports of changes in affect, both during acute administration and after extended drug use.
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Affiliation(s)
| | - Leah M Mayo
- Center for Social and Affective Neuroscience, Linköping University, Linköping, Sweden
| | - Anya K Bershad
- Department of Psychiatry and Biobehavioral Sciences, University of California Los Angeles, Los Angeles, CA, USA
| | - Racheal Madray
- Undergraduate Program in Neuroscience, Western University, London, ON, Canada
| | - Harriet de Wit
- Department of Psychiatry and Behavioral Neuroscience, University of Chicago, Chicago, IL, USA
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14
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Glodosky NC, Cuttler C, McLaughlin RJ. A review of the effects of acute and chronic cannabinoid exposure on the stress response. Front Neuroendocrinol 2021; 63:100945. [PMID: 34461155 PMCID: PMC8605997 DOI: 10.1016/j.yfrne.2021.100945] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/01/2021] [Revised: 07/28/2021] [Accepted: 08/24/2021] [Indexed: 10/20/2022]
Abstract
While cannabis has been used for centuries for its stress-alleviating properties, the effects of acute and chronic cannabinoid exposure on responses to stress remain poorly understood. This review provides an overview of studies that measured stress-related endpoints following acute or chronic cannabinoid exposure in humans and animals. Acute cannabinoid exposure increases basal concentrations of stress hormones in rodents and humans and has dose-dependent effects on stress reactivity in humans and anxiety-like behavior in rodents. Chronic cannabis exposure is associated with dampened stress reactivity, a blunted cortisol awakening response (CAR), and flattened diurnal cortisol slope in humans. Sex differences in these effects remain underexamined, with limited evidence for sex differences in effects of cannabinoids on stress reactivity in rodents. Future research is needed to better understand sex differences in the effects of cannabis on the stress response, as well as downstream impacts on mental health and stress-related disorders.
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Affiliation(s)
| | - Carrie Cuttler
- Department of Psychology, Washington State University, Pullman, WA, USA.
| | - Ryan J McLaughlin
- Department of Psychology, Washington State University, Pullman, WA, USA; Department of Integrative Physiology and Neuroscience, Washington State University, Pullman, WA, USA
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15
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Gunasekera B, Davies C, Martin-Santos R, Bhattacharyya S. The Yin and Yang of Cannabis: A Systematic Review of Human Neuroimaging Evidence of the Differential Effects of Δ 9-Tetrahydrocannabinol and Cannabidiol. BIOLOGICAL PSYCHIATRY. COGNITIVE NEUROSCIENCE AND NEUROIMAGING 2021; 6:636-645. [PMID: 33414100 DOI: 10.1016/j.bpsc.2020.10.007] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 07/13/2020] [Revised: 09/14/2020] [Accepted: 10/19/2020] [Indexed: 12/23/2022]
Abstract
Cannabidiol (CBD) and Δ9-tetrahydrocannabinol (THC) have been the most investigated cannabinoids at the human and preclinical levels, although the neurobiological mechanisms underlying their effects remain unclear. Human experimental evidence complemented by observational studies suggests that THC may have psychotogenic effects while CBD may have antipsychotic effects. However, whether their effects on brain function are consistent with their opposing behavioral effects remains unclear. To address this, here we synthesize neuroimaging evidence investigating the acute effects of THC and CBD on human brain function using a range of neuroimaging techniques, with an aim to identify the key brain substrates where THC and CBD have opposing effects. After a systematic search, a review of the available studies indicated marked heterogeneity. However, an overall pattern of opposite effect profiles of the two cannabinoids was evident with some degree of consistency, primarily attributed to the head-to-head challenge studies of THC and CBD. While head-to-head comparisons are relatively few, collectively the evidence suggests that opposite effects of THC and CBD may be present in the striatum, parahippocampus, anterior cingulate/medial prefrontal cortex, and amygdala, with opposite effects less consistently identified in other regions. Broadly, THC seems to increase brain activation and blood flow, whereas CBD seems to decrease brain activation and blood flow. Given the sparse evidence, there is a particular need to understand the mechanisms underlying their opposite behavioral effects because it may not only offer insights into the underlying pathophysiological mechanisms of psychotic disorders but also suggest potentially novel targets and biomarkers for drug discovery.
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Affiliation(s)
- Brandon Gunasekera
- Department of Psychosis Studies, Institute of Psychiatry, Psychology and Neuroscience, King's College London, United Kingdom
| | - Cathy Davies
- Department of Psychosis Studies, Institute of Psychiatry, Psychology and Neuroscience, King's College London, United Kingdom
| | - Rocio Martin-Santos
- Department of Medicine, Institute of Neuroscience, University of Barcelona, Spain
| | - Sagnik Bhattacharyya
- Department of Psychosis Studies, Institute of Psychiatry, Psychology and Neuroscience, King's College London, United Kingdom.
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16
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A systematic review of neuroimaging and acute cannabis exposure in age-of-risk for psychosis. Transl Psychiatry 2021; 11:217. [PMID: 33850098 PMCID: PMC8044224 DOI: 10.1038/s41398-021-01295-w] [Citation(s) in RCA: 10] [Impact Index Per Article: 3.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/03/2020] [Revised: 01/06/2021] [Accepted: 02/05/2021] [Indexed: 01/14/2023] Open
Abstract
Acute exposure to cannabis has been associated with an array of cognitive alterations, increased risk for neuropsychiatric illness, and other neuropsychiatric sequelae including the emergence of acute psychotic symptoms. However, the brain alterations associating cannabis use and these behavioral and clinical phenotypes remains disputed. To this end, neuroimaging can be a powerful technique to non-invasively study the impact of cannabis exposure on brain structure and function in both humans and animal models. While chronic exposure studies provide insight into how use may be related to long-term outcomes, acute exposure may reveal interesting information regarding the immediate impact of use and abuse on brain circuits. Understanding these alterations could reveal the connection with symptom dimensions in neuropsychiatric disorders and, more specifically with psychosis. The purpose of the present review is to: 1) provide an update on the findings of pharmacological neuroimaging studies examining the effects of administered cannabinoids and 2) focus the discussion on studies that examine the sensitive window for the emergence of psychosis. Current literature indicates that cannabis exposure has varied effects on the brain, with the principal compounds in cannabis (delta-9-tetrahydrocannabinol and cannabidiol) altering activity across different brain regions. Importantly, we also discovered critical gaps in the literature, particularly regarding sex-dependent responses and long-term effects of chronic exposure. Certain networks often characterized as dysregulated in psychosis, like the default mode network and limbic system, were also impacted by THC exposure, identifying areas of particular interest for future work investigating the potential relationship between the two.
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17
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Mahedy L, Wootton R, Suddell S, Skirrow C, Field M, Heron J, Hickman M, Munafò MR. Testing the association between tobacco and cannabis use and cognitive functioning: Findings from an observational and Mendelian randomization study. Drug Alcohol Depend 2021; 221:108591. [PMID: 33618197 PMCID: PMC8047806 DOI: 10.1016/j.drugalcdep.2021.108591] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/19/2020] [Revised: 12/17/2020] [Accepted: 01/17/2021] [Indexed: 01/08/2023]
Abstract
BACKGROUND Although studies have examined the association between tobacco and cannabis use in adolescence with subsequent cognitive functioning, study designs are usually not able to distinguish correlation from causation. METHODS Separate patterns of tobacco and cannabis use were derived using longitudinal latent class analysis based on measures assessed on five occasions from age 13-18 in a large UK population cohort (Avon Longitudinal Study of Parents and Children). Cognitive functioning measures comprised of working memory, response inhibition, and emotion recognition assessed at 24 years of age. Mendelian randomization was used to examine the possible causal relationship between smoking initiation, lifetime cannabis use and cognitive functioning. RESULTS We found evidence of a relationship between tobacco and cannabis use and diminished cognitive functioning for each of the outcomes in the observational analyses. There was evidence to suggest that late-onset regular tobacco smokers (b=-0.29, 95 %CI=-0.45 to -0.13), early-onset regular tobacco smokers (b=-0.45, 95 %CI=-0.84 to -0.05), and early-onset regular cannabis users (b=-0.62, 95 %CI=-0.93 to -0.31) showed poorer working memory. Early-onset regular tobacco smokers (b = 0.18, 95 %CI = 0.07 to 0.28), and early-onset regular cannabis users (b = 0.30, 95 %CI = 0.08 to 0.52) displayed poorer ability to inhibit responses. Late-onset regular (b=-0.02, 95 %CI=-0.03 to - 0.00), and early-onset regular tobacco smokers (b=-0.04, 95 %CI=-0.08 to -0.01) showed poorer ability to recognise emotions. Mendelian randomization analyses were imprecise and did not provide additional support for the observational results. CONCLUSION There was some evidence to suggest that adolescent tobacco and cannabis use were associated with deficits in working memory, response inhibition and emotion recognition. Better powered genetic studies are required to determine whether these associations are causal.
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Affiliation(s)
- Liam Mahedy
- School of Psychological Science, University of Bristol, Bristol, BS8 1TU, UK; MRC Integrative Epidemiology Unit, University of Bristol, Bristol, UK; National Institute for Health Research Biomedical Research Centre at the University Hospitals Bristol NHS Foundation Trust and the University of Bristol, Bristol, UK.
| | - Robyn Wootton
- School of Psychological Science, University of Bristol, Bristol, BS8 1TU, UK; MRC Integrative Epidemiology Unit, University of Bristol, Bristol, UK; National Institute for Health Research Biomedical Research Centre at the University Hospitals Bristol NHS Foundation Trust and the University of Bristol, Bristol, UK.
| | - Steph Suddell
- School of Psychological Science, University of Bristol, Bristol, BS8 1TU, UK; MRC Integrative Epidemiology Unit, University of Bristol, Bristol, UK; National Institute for Health Research Biomedical Research Centre at the University Hospitals Bristol NHS Foundation Trust and the University of Bristol, Bristol, UK.
| | - Caroline Skirrow
- School of Psychological Science, University of Bristol, Bristol, BS8 1TU, UK; Cambridge Cognition, Cambridge, UK.
| | - Matt Field
- Department of Psychology, University of Sheffield, Sheffield, S1 2LT, UK.
| | - Jon Heron
- Population Health Sciences, Bristol Medical School, University of Bristol, Bristol, BS8 2BN, UK.
| | - Matthew Hickman
- Population Health Sciences, Bristol Medical School, University of Bristol, Bristol, BS8 2BN, UK.
| | - Marcus R Munafò
- School of Psychological Science, University of Bristol, Bristol, BS8 1TU, UK; MRC Integrative Epidemiology Unit, University of Bristol, Bristol, UK; National Institute for Health Research Biomedical Research Centre at the University Hospitals Bristol NHS Foundation Trust and the University of Bristol, Bristol, UK.
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18
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Kayser RR, Haney M, Simpson HB. Human Laboratory Models of Cannabis Use: Applications for Clinical and Translational Psychiatry Research. Front Psychiatry 2021; 12:626150. [PMID: 33716825 PMCID: PMC7947318 DOI: 10.3389/fpsyt.2021.626150] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/05/2020] [Accepted: 02/03/2021] [Indexed: 11/13/2022] Open
Abstract
Cannabis is increasingly used by individuals with mental health diagnoses and often purported to treat anxiety and various other psychiatric symptoms. Yet support for using cannabis as a psychiatric treatment is currently limited by a lack of evidence from rigorous placebo-controlled studies. While regulatory hurdles and other barriers make clinical trials of cannabis challenging to conduct, addiction researchers have decades of experience studying cannabis use in human laboratory models. These include methods to control cannabis administration, to delineate clinical and mechanistic aspects of cannabis use, and to evaluate potential treatment applications for cannabis and its constituents. In this paper, we review these human laboratory procedures and describe how each can be applied to study cannabis use in patients with psychiatric disorders. Because anxiety disorders are among the most common psychiatric illnesses affecting American adults, and anxiety relief is also the most commonly-reported reason for medicinal cannabis use, we focus particularly on applying human laboratory models to study cannabis effects in individuals with anxiety and related disorders. Finally, we discuss how these methods can be integrated to study cannabis effects in other psychiatric conditions and guide future research in this area.
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Affiliation(s)
- Reilly R. Kayser
- Department of Psychiatry, Columbia University Vagelos College of Physicians and Surgeons, New York, NY, United States
- Research Foundation for Mental Hygiene, New York State Psychiatric Institute, New York, NY, United States
| | - Margaret Haney
- Department of Psychiatry, Columbia University Vagelos College of Physicians and Surgeons, New York, NY, United States
- Research Foundation for Mental Hygiene, New York State Psychiatric Institute, New York, NY, United States
| | - Helen Blair Simpson
- Department of Psychiatry, Columbia University Vagelos College of Physicians and Surgeons, New York, NY, United States
- Research Foundation for Mental Hygiene, New York State Psychiatric Institute, New York, NY, United States
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19
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Bourque J, Potvin S. Cannabis and Cognitive Functioning: From Acute to Residual Effects, From Randomized Controlled Trials to Prospective Designs. Front Psychiatry 2021; 12:596601. [PMID: 34177633 PMCID: PMC8222623 DOI: 10.3389/fpsyt.2021.596601] [Citation(s) in RCA: 11] [Impact Index Per Article: 3.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/19/2020] [Accepted: 05/17/2021] [Indexed: 12/30/2022] Open
Abstract
In recent years, several jurisdictions have revised their regulation policy toward both medical and recreational use of cannabis. These changes have elicited concerns regarding how legalization impacts academic achievement and work performance. This review evaluates the acute and long-term (residual) association between cannabis use and cognitive functioning that underlies poor academic and work performance. Relative to other reviews, this article focuses on cross-over randomized controlled trials and prospective designs given that they allow to test the impairing effects of cannabis exposure at the within-subject level. Acute cannabis cognitive effects are discussed separately for known confounding factors such as levels of delta-9-tetrahydrocannabinol (Δ9-THC), Δ9-THC:cannabidiol ratio, previous cannabis use and, comorbidity with psychosis-spectrum disorders. The cognitive residual effects of cannabis are detailed in relation to duration of abstinence, frequency of use, comorbidity with psychosis-spectrum disorders, types of cognitive domains assessed, and age of cannabis use initiation. Moreover, considering the fact that adequate longitudinal studies can make inferences about causality between cannabis use and impaired cognitive functioning when disentangling between-subject from within-subject variation, proofs for the three main non-mutually exclusive hypotheses about this relationship will be presented: i) the cognitive vulnerability hypothesis as part of the more general common antecedent hypothesis, ii) the concurrent cannabis impairing hypothesis, and iii) the neurotoxic hypothesis of cannabis. Current research provides evidence for mild to moderate acute cannabis effects on episodic and working memory, processing speed, and executive functions. Mild residual impairing effects were also observed in these exact same cognitive domains, suggesting that adverse effects following cannabis intoxication persist at least days or weeks following cannabis abstinence. Relative to adult-onset, adolescent-onset cannabis use seems to explain the dose-response relationship and is associated with longer lasting residual effects even in mild users (<weekly). The association between cannabis and cognition is likely explained by common antecedents, such that genetic and shared environment factors predispose individuals to both cannabis use and cognitive deficits, and to a lesser degree, neurotoxic effects.
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Affiliation(s)
- Josiane Bourque
- Department of Psychiatry, Perelman School of Medicine, University of Pennsylvania, Philadelphia, PA, United States
| | - Stéphane Potvin
- Department of Psychiatry and Addiction, Faculty of Medicine, University of Montreal, Montreal, QC, Canada.,Centre de Recherche de l'Institut Universitaire en Santé Mentale de Montréal, Montréal, QC, Canada
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20
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Tsuboi H, Sakakibara H, Matsunaga M, Tatsumi A, Yamakawa-Kobayashi K, Yoshida N, Shimoi K. Omega-3 Eicosapentaenoic Acid Is Related to Happiness and a Sense of Fulfillment-A Study among Female Nursing Workers. Nutrients 2020; 12:nu12113462. [PMID: 33187281 PMCID: PMC7696953 DOI: 10.3390/nu12113462] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/06/2020] [Revised: 10/29/2020] [Accepted: 11/05/2020] [Indexed: 12/02/2022] Open
Abstract
Background: Omega (ω) 3 fatty acid (FA) is a polyunsaturated FA (PUFA) that can modulate some mental statuses. However, most studies have not considered the functional differences between eicosapentaenoic acid (EPA) and docosahexaenoic acid (DHA). We investigated associations among happiness, a sense of fulfillment and serum ω3 PUFA levels. Methods: Participants were 133 female staff from a hospital and nursing homes. Happiness was measured using the Japanese version of the subjective happiness scale (SHS); a sense of fulfillment was assessed using a visual analogue scale. Serum FA concentrations were measured. A partial correlation test and a regression model were applied. Results: The SHS scores showed significantly positive correlations with a sense of fulfillment, DHA% and EPA% (p < 0.05, < 0.05 and < 0.005, respectively), after controlling for age, BMI, menopause, snacking habits and leisure-time physical activities. A sense of fulfillment was significantly negatively correlated with α-linoleic acid%, and positively correlated with DHA% and EPA% (p < 0.05, < 0.05 and < 0.005, respectively), after controlling for the confounders. A regression model showed that a sense of fulfillment, EPA, and not stopping menstruation explained happiness (standardised beta, B = 0.18, p < 0.05; B = 0.24, p < 0.01; and B = 0.32, and p < 0.05, respectively), whereas age, BMI and snacking habits could not. Simultaneously, a regression model could not explain the association between DHA and happiness. Conclusion: Happiness was related with serum EPA%, a sense of fulfillment, and premenopause.
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Affiliation(s)
- Hirohito Tsuboi
- Institute of Medical, Pharmaceutical & Health Sciences, Kanazawa University, Kanazawa 920-1192, Japan;
- Department of Neurology and Internal Psychosomatic Medicine, Bantane Hospital, Fujita Health University School of Medicine, Nagoya 454-8509, Japan;
- Correspondence:
| | - Hiroyuki Sakakibara
- Faculty of Agriculture, University of Miyazaki, Miyazaki 889-2192, Japan;
- School of Food and Nutritional Sciences, University of Shizuoka, Shizuoka 422-8526, Japan; (K.Y.-K.); (K.S.)
| | - Masahiro Matsunaga
- Department of Neurology and Internal Psychosomatic Medicine, Bantane Hospital, Fujita Health University School of Medicine, Nagoya 454-8509, Japan;
- Department of Health and Psychosocial Medicine, School of Medicine, Aichi Medical University, Nagakute 480-1195, Japan
| | - Asami Tatsumi
- Department of Nursing, University of Human Environments, Obu 474-0035, Japan;
| | - Kimiko Yamakawa-Kobayashi
- School of Food and Nutritional Sciences, University of Shizuoka, Shizuoka 422-8526, Japan; (K.Y.-K.); (K.S.)
| | - Naoko Yoshida
- Institute of Medical, Pharmaceutical & Health Sciences, Kanazawa University, Kanazawa 920-1192, Japan;
| | - Kayoko Shimoi
- School of Food and Nutritional Sciences, University of Shizuoka, Shizuoka 422-8526, Japan; (K.Y.-K.); (K.S.)
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21
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Davies C, Wilson R, Appiah-Kusi E, Blest-Hopley G, Brammer M, Perez J, Murray RM, Allen P, Bossong MG, McGuire P, Bhattacharyya S. A single dose of cannabidiol modulates medial temporal and striatal function during fear processing in people at clinical high risk for psychosis. Transl Psychiatry 2020; 10:311. [PMID: 32921794 PMCID: PMC7487274 DOI: 10.1038/s41398-020-0862-2] [Citation(s) in RCA: 21] [Impact Index Per Article: 5.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/02/2020] [Revised: 04/21/2020] [Accepted: 04/28/2020] [Indexed: 12/23/2022] Open
Abstract
Emotional dysregulation and anxiety are common in people at clinical high risk for psychosis (CHR) and are associated with altered neural responses to emotional stimuli in the striatum and medial temporal lobe. Using a randomised, double-blind, parallel-group design, 33 CHR patients were randomised to a single oral dose of CBD (600 mg) or placebo. Healthy controls (n = 19) were studied under identical conditions but did not receive any drug. Participants were scanned with functional magnetic resonance imaging (fMRI) during a fearful face-processing paradigm. Activation related to the CHR state and to the effects of CBD was examined using a region-of-interest approach. During fear processing, CHR participants receiving placebo (n = 15) showed greater activation than controls (n = 19) in the parahippocampal gyrus but less activation in the striatum. Within these regions, activation in the CHR group that received CBD (n = 15) was intermediate between that of the CHR placebo and control groups. These findings suggest that in CHR patients, CBD modulates brain function in regions implicated in psychosis risk and emotion processing. These findings are similar to those previously evident using a memory paradigm, suggesting that the effects of CBD on medial temporal and striatal function may be task independent.
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Affiliation(s)
- Cathy Davies
- grid.13097.3c0000 0001 2322 6764Department of Psychosis Studies, Institute of Psychiatry, Psychology & Neuroscience, King’s College London, London, UK
| | - Robin Wilson
- grid.13097.3c0000 0001 2322 6764Department of Psychosis Studies, Institute of Psychiatry, Psychology & Neuroscience, King’s College London, London, UK
| | - Elizabeth Appiah-Kusi
- grid.13097.3c0000 0001 2322 6764Department of Psychosis Studies, Institute of Psychiatry, Psychology & Neuroscience, King’s College London, London, UK
| | - Grace Blest-Hopley
- grid.13097.3c0000 0001 2322 6764Department of Psychosis Studies, Institute of Psychiatry, Psychology & Neuroscience, King’s College London, London, UK
| | - Michael Brammer
- grid.13097.3c0000 0001 2322 6764Department of Neuroimaging, Institute of Psychiatry, Psychology & Neuroscience, King’s College London, London, UK
| | - Jesus Perez
- grid.450563.10000 0004 0412 9303CAMEO Early Intervention Service, Cambridgeshire and Peterborough NHS Foundation Trust, Cambridge, UK
| | - Robin M. Murray
- grid.13097.3c0000 0001 2322 6764Department of Psychosis Studies, Institute of Psychiatry, Psychology & Neuroscience, King’s College London, London, UK
| | - Paul Allen
- grid.13097.3c0000 0001 2322 6764Department of Psychosis Studies, Institute of Psychiatry, Psychology & Neuroscience, King’s College London, London, UK ,grid.35349.380000 0001 0468 7274Department of Psychology, University of Roehampton, London, UK ,grid.416167.3Icahn School of Medicine, Mount Sinai Hospital, New York, NY USA
| | - Matthijs G. Bossong
- grid.5477.10000000120346234Department of Psychiatry, University Medical Center Utrecht Brain Center, Utrecht University, Utrecht, The Netherlands
| | - Philip McGuire
- grid.13097.3c0000 0001 2322 6764Department of Psychosis Studies, Institute of Psychiatry, Psychology & Neuroscience, King’s College London, London, UK ,grid.37640.360000 0000 9439 0839National Institute for Health Research (NIHR) Maudsley Biomedical Research Centre (BRC), South London and Maudsley NHS Foundation Trust, London, UK ,grid.37640.360000 0000 9439 0839Outreach And Support in South London (OASIS) Service, South London and Maudsley NHS Foundation Trust, London, UK
| | - Sagnik Bhattacharyya
- Department of Psychosis Studies, Institute of Psychiatry, Psychology & Neuroscience, King's College London, London, UK.
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22
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Scherma M, Muntoni AL, Riedel G, Fratta W, Fadda P. Cannabinoids and their therapeutic applications in mental disorders
. DIALOGUES IN CLINICAL NEUROSCIENCE 2020; 22:271-279. [PMID: 33162770 PMCID: PMC7605020 DOI: 10.31887/dcns.2020.22.3/pfadda] [Citation(s) in RCA: 10] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Subscribe] [Scholar Register] [Indexed: 12/20/2022]
Abstract
Mental disorders represent a significant public health burden worldwide due to their high prevalence, chronically disabling nature, and substantial impact on quality of life. Despite growing knowledge of the pathological mechanisms that underlie the development of these disorders, a high percentage of patients do not respond to first-line clinical treatments; thus, there is a strong need for alternative therapeutic approaches. During the past half-century, after the identification of the endocannabinoid system and its role in multiple physiological processes, both natural and synthetic cannabinoids have attracted considerable interest as putative medications in pathological conditions such as, but not exclusive to, mental disorders. Here, we provide a summary of cannabinoid effects in support of possible therapeutic applications for major depression, bipolar disorder, anxiety, posttraumatic stress disorder, and schizophrenia. Considering this evidence, highlighted benefits and risks of cannabinoid use in the management of these illnesses require further experimental study.
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Affiliation(s)
- Maria Scherma
- Department of Biomedical Sciences, Division of Neuroscience and Clinical Pharmacology, University of Cagliari, Italy
| | - Anna Lisa Muntoni
- Neuroscience Institute, National Research Council of Italy (CNR), Cagliari, Italy
| | - Gernot Riedel
- Institute of Medical Sciences, University of Aberdeen, Foresterhill, Aberdeen, Scotland, United Kingdom
| | - Walter Fratta
- Department of Biomedical Sciences, Division of Neuroscience and Clinical Pharmacology, University of Cagliari, Italy
| | - Paola Fadda
- Author affiliations: Department of Biomedical Sciences, Division of Neuroscience and Clinical Pharmacology, University of Cagliari, Italy; Neuroscience Institute, National Research Council of Italy (CNR), Cagliari, Italy; Institute of Medical Sciences, University of Aberdeen, Foresterhill, Aberdeen, Scotland, United Kingdom (Gernot Riedel); National Neuroscience Institute, Pisa, Italy
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23
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Rossi GN, Osório FL, Morgan CJA, Crippa JAS, Bouso JC, Rocha JM, Zuardi AW, Hallak JEC, Santos RGD. The effects of Cannabidiol (CBD) and Delta-9-Tetrahydrocannabinol (THC) on the recognition of emotions in facial expressions: A systematic review of randomized controlled trials. Neurosci Biobehav Rev 2020; 118:236-246. [PMID: 32745478 DOI: 10.1016/j.neubiorev.2020.07.034] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/16/2020] [Revised: 06/03/2020] [Accepted: 07/27/2020] [Indexed: 11/25/2022]
Abstract
Tetrahydrocannabinol (THC) and cannabidiol (CBD) are phytocannabinoids being linked with modulation of anxiety and depression. The recognition of emotions in facial expressions (REFE) is impaired in these disorders. Both drugs could modulate anxiety and mood by interfering with REFE. Thus, a systematic review of controlled trials assessing the effects of THC and CBD on REFE was performed. Ten studies describing seven distinct experiments were found (n = 170). THC (7.5-15 mg) did not alter REFE in three experiments, but reduced task performance in other three experiments. CBD did not alter REFE in two experiments, but improved task performance and counteracted the effects of THC in one experiment. THC (≥ 10 mg) and CBD (600 mg) showed opposite effects on brain activation, skin conductance, and anxiety measures with negative/threatening faces. The limited number of studies precludes firm conclusions on the effects of these substances on REFE. Further controlled trials are needed to elucidate the effects of THC and CBD on REFE. The PROSPERO ID for this study is CRD42019135085.
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Affiliation(s)
- Giordano Novak Rossi
- Department of Neuroscience and Behavior, Ribeirão Preto Medical School, University of São Paulo, SP, Brazil.
| | - Flávia L Osório
- Department of Neuroscience and Behavior, Ribeirão Preto Medical School, University of São Paulo, SP, Brazil; National Institute for Translational Medicine (INCT-TM), CNPq, Brazil.
| | - Celia J A Morgan
- Clinical Psychopharmacology Unit, University College London, London, UK; Psychopharmacology and Addiction Research Centre, University of Exeter, Exeter, UK.
| | - José Alexandre S Crippa
- Department of Neuroscience and Behavior, Ribeirão Preto Medical School, University of São Paulo, SP, Brazil; National Institute for Translational Medicine (INCT-TM), CNPq, Brazil.
| | - José Carlos Bouso
- ICEERS Foundation (International Center for Ethnobotanical Education, Research and Services), Barcelona, Spain.
| | - Juliana Mendes Rocha
- Department of Neuroscience and Behavior, Ribeirão Preto Medical School, University of São Paulo, SP, Brazil.
| | - Antônio W Zuardi
- Department of Neuroscience and Behavior, Ribeirão Preto Medical School, University of São Paulo, SP, Brazil; National Institute for Translational Medicine (INCT-TM), CNPq, Brazil.
| | - Jaime E C Hallak
- Department of Neuroscience and Behavior, Ribeirão Preto Medical School, University of São Paulo, SP, Brazil; National Institute for Translational Medicine (INCT-TM), CNPq, Brazil.
| | - Rafael G Dos Santos
- Department of Neuroscience and Behavior, Ribeirão Preto Medical School, University of São Paulo, SP, Brazil; National Institute for Translational Medicine (INCT-TM), CNPq, Brazil; ICEERS Foundation (International Center for Ethnobotanical Education, Research and Services), Barcelona, Spain.
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24
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Kroon E, Kuhns L, Cousijn J. The short-term and long-term effects of cannabis on cognition: recent advances in the field. Curr Opin Psychol 2020; 38:49-55. [PMID: 32823178 DOI: 10.1016/j.copsyc.2020.07.005] [Citation(s) in RCA: 16] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/23/2020] [Revised: 07/03/2020] [Accepted: 07/07/2020] [Indexed: 01/28/2023]
Abstract
The aim of this review is to discuss the most recent evidence for the short-term and long-term effects of cannabis on cognition. The evidence that cannabis intoxication is associated with short-term impairment across several basal cognitive domains, including learning and (episodic) memory, attentional control, and motor inhibition is increasing. However, evidence regarding the effects of long-term heavy cannabis use on cognition remains equivocal. Cannabis research suffers from difficulties in measuring cannabis exposure history, poor control over potential subacute effects, and heterogeneity in cognitive measures and sample composition. Multidisciplinary collaborations and investment in studies that help overcome these difficulties should be prioritized.
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Affiliation(s)
- Emese Kroon
- Neuroscience of Addiction (NofA) Lab, Department of Psychology, University of Amsterdam, Amsterdam, The Netherlands; The Amsterdam Brain and Cognition Center (ABC), University of Amsterdam, Amsterdam, The Netherlands.
| | - Lauren Kuhns
- Neuroscience of Addiction (NofA) Lab, Department of Psychology, University of Amsterdam, Amsterdam, The Netherlands; The Amsterdam Brain and Cognition Center (ABC), University of Amsterdam, Amsterdam, The Netherlands
| | - Janna Cousijn
- Neuroscience of Addiction (NofA) Lab, Department of Psychology, University of Amsterdam, Amsterdam, The Netherlands; The Amsterdam Brain and Cognition Center (ABC), University of Amsterdam, Amsterdam, The Netherlands
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25
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Hawes SW, Pacheco-Colón I, Ross JM, Gonzalez R. Adolescent Cannabis Use and Conduct Problems: The Mediating Influence of Callous-Unemotional Traits. Int J Ment Health Addict 2020; 18:613-627. [PMID: 32742245 PMCID: PMC7394462 DOI: 10.1007/s11469-018-9958-9] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/25/2022] Open
Abstract
Cannabis use has been linked to an increased risk of engaging in conduct problem behaviors. However, little existing research has considered intervening processes and shared risk factors that may contribute to this association. The current investigation examines whether callous-unemotional traits, which have shown associations with adolescent cannabis use and conduct problem development, may exhibit a mediating influence on this relationship. Using a longitudinal cohort of youth (n = 390) at increased risk for escalating in their use of cannabis, we found that baseline cannabis use (age~15) was associated with higher levels of trait-like conduct problems (ages~16 & 17), even after controlling for important autoregressive and cross-lagged effects, along with a number of other shared risk factors (e.g., co-occuring substance use, age, sex). Findings also revealed that callous-unemotional traits partially mediated this relationship, with the hypothesized model accounting for approximately one-third of the variance in the conduct problem outcome (R2=.34). These results indicate that callous-unemotional traits may play an important intermediary role in the association between cannabis use and the development of problem behaviors.
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Affiliation(s)
- Samuel W Hawes
- Center for Children and Families, Florida International University, Department of Psychology, 11200 S.W. 8 Street, AHC1 Rm 140, Miami, Florida 33199
| | - Ileana Pacheco-Colón
- Center for Children and Families, Florida International University, Department of Psychology, 11200 S.W. 8 Street, AHC1 Rm 140, Miami, Florida 33199
| | - J Megan Ross
- Center for Children and Families, Florida International University, Department of Psychology, 11200 S.W. 8 Street, AHC1 Rm 140, Miami, Florida 33199
| | - Raul Gonzalez
- Center for Children and Families, Florida International University, Department of Psychology, 11200 S.W. 8 Street, AHC1 Rm 140, Miami, Florida 33199
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26
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Forrester SY, Jahan N. Depression Onset in Long-term Adolescent Cannabinoid Use: A Neurobiological Review. Cureus 2020; 12:e7759. [PMID: 32455076 PMCID: PMC7243066 DOI: 10.7759/cureus.7759] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/21/2022] Open
Abstract
Escalating cannabis use may be linked to decreased motivation and anhedonia, which are symptoms of depression. Adolescent cannabis users with subthreshold depressive symptoms such as reduced motivation may be susceptible to the development of significant anhedonia in addition to impaired emotional development. The main issue regarding depression within the context of cannabis use is whether or not there is a neurobiological basis linking the two variables. A Medical Subject Headings (MeSH) function PubMed search using the keywords “cannabis, depression, adolescence, endocannabinoid, and temperament” returned 1,109 articles. Data were included from studies that satisfied the following criteria: (i) published within the last 10 years (older studies were included based on relevance), (ii) on adolescent subjects (animal or human), (iii) published in English, (iv) journal articles, systematic reviews, meta-analyses, clinical trials, observational studies (animal or human), (v) on subjects who had unipolar depression with no comorbidities, and (vi) on subjects who used cannabis [with no confounding variables such as the use of ethanol, nicotine, cocaine, lysergic acid diethylamide (LSD), and heroin; and no medical conditions such as comorbid psychosis, mania, or autism]. Depressive symptoms in cannabinoid users were a common co-occurrence partly explained by pleiotropic linkage of genetic locus identified on chromosome 11q23.1-q23.2 and comprises the gene sequence nuclear cell adhesion molecule 1-tetratricopeptide repeat domain 12-ankyrin repeat and kinase domain containing 1-dopamine receptor D2 (NCAM1-TTC12-ANKK1-DRD2). The relationship between the two is not invariant and is influenced by polymorphic DRD, endocannabinoid receptor (CNR), and 5-HT genes. Anhedonia seemed to be the most important symptom. Cannabinoid-induced long-term neuroplastic changes, particularly in the dorsal striatum, is a possible mechanism resulting in anhedonia and long-term effects on motivation.
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Affiliation(s)
- Shawn Y Forrester
- Psychiatry, California Institute of Behavioral Neurosciences and Psychology, Fairfield, USA
| | - Nusrat Jahan
- Internal Medicine, California Institute of Behavioral Neurosciences and Psychology, Fairfield, USA
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27
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Pinto JV, Saraf G, Frysch C, Vigo D, Keramatian K, Chakrabarty T, Lam RW, Kauer-Sant'Anna M, Yatham LN. [Not Available]. CANADIAN JOURNAL OF PSYCHIATRY. REVUE CANADIENNE DE PSYCHIATRIE 2020; 65:213-227. [PMID: 31830820 PMCID: PMC7385425 DOI: 10.1177/0706743719895195] [Citation(s) in RCA: 19] [Impact Index Per Article: 4.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 12/16/2022]
Abstract
Objective: To review the current evidence for efficacy of cannabidiol in the treatment of mood disorders. Methods: We systematically searched PubMed, Embase, Web of Science, PsychInfo, Scielo, ClinicalTrials.gov, and The Cochrane Central Register of Controlled Trials for studies published up to July 31, 2019. The inclusion criteria were clinical trials, observational studies, or case reports evaluating the effect of pure cannabidiol or cannabidiol mixed with other cannabinoids on mood symptoms related to either mood disorders or other health conditions. The review was reported in accordance with guidelines from Preferred Reporting Items for Systematic reviews and Meta-Analyses protocol. Results: Of the 924 records initially yielded by the search, 16 were included in the final sample. Among them, six were clinical studies that used cannabidiol to treat other health conditions but assessed mood symptoms as an additional outcome. Similarly, four tested cannabidiol blended with Δ-9-tetrahydrocannabinol in the treatment of general health conditions and assessed affective symptoms as secondary outcomes. Two were case reports testing cannabidiol. Four studies were observational studies that evaluated the cannabidiol use and its clinical correlates. However, there were no clinical trials investigating the efficacy of cannabidiol, specifically in mood disorders or assessing affective symptoms as the primary outcome. Although some articles point in the direction of benefits of cannabidiol to treat depressive symptoms, the methodology varied in several aspects and the level of evidence is not enough to support its indication as a treatment for mood disorders. Conclusions: There is a lack of evidence to recommend cannabidiol as a treatment for mood disorders. However, considering the preclinical and clinical evidence related to other diseases, cannabidiol might have a role as a treatment for mood disorders. Therefore, there is an urgent need for well-designed clinical trials investigating the efficacy of cannabidiol in mood disorders.
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Affiliation(s)
- Jairo Vinícius Pinto
- Department of Psychiatry, University of British Columbia, Vancouver, British Columbia, Canada.,Department of Psychiatry, Federal University of Rio Grande do Sul, Porto Alegre, Rio Grande do Sul, Brazil
| | - Gayatri Saraf
- Department of Psychiatry, University of British Columbia, Vancouver, British Columbia, Canada
| | - Christian Frysch
- Department of Psychiatry, University of British Columbia, Vancouver, British Columbia, Canada
| | - Daniel Vigo
- Department of Psychiatry, University of British Columbia, Vancouver, British Columbia, Canada
| | - Kamyar Keramatian
- Department of Psychiatry, University of British Columbia, Vancouver, British Columbia, Canada
| | - Trisha Chakrabarty
- Department of Psychiatry, University of British Columbia, Vancouver, British Columbia, Canada
| | - Raymond W Lam
- Department of Psychiatry, University of British Columbia, Vancouver, British Columbia, Canada
| | - Márcia Kauer-Sant'Anna
- Department of Psychiatry, Federal University of Rio Grande do Sul, Porto Alegre, Rio Grande do Sul, Brazil
| | - Lakshmi N Yatham
- Department of Psychiatry, University of British Columbia, Vancouver, British Columbia, Canada
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28
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Kroon E, Kuhns L, Hoch E, Cousijn J. Heavy cannabis use, dependence and the brain: a clinical perspective. Addiction 2020; 115:559-572. [PMID: 31408248 PMCID: PMC7027478 DOI: 10.1111/add.14776] [Citation(s) in RCA: 46] [Impact Index Per Article: 11.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/04/2019] [Revised: 07/15/2019] [Accepted: 08/07/2019] [Indexed: 12/28/2022]
Abstract
AIMS To summarize and evaluate our knowledge of the relationship between heavy cannabis use, cannabis use disorder (CUD) and the brain. METHODS Narrative review of relevant literature identified through existing systematic reviews, meta-analyses and a PubMed search. Epidemiology, clinical representations, potential causal mechanisms, assessments, treatment and prognosis are discussed. RESULTS Although causality is unclear, heavy and dependent cannabis use is consistently associated with a high prevalence of comorbid psychiatric disorders and learning and memory impairments that seem to recover after a period of abstinence. Evidence regarding other cognitive domains and neurological consequences, including cerebrovascular events, is limited and inconsistent. Abstinence after treatment is only achieved in a minority of cases; treatment targeted at reduction in use appears have some success. Potential moderators of the impact of CUD on the brain include age of onset, heaviness of use, CUD severity, the ratio of ∆9-tetrahydrocannabinol to cannabidiol and severity of comorbid disorders. CONCLUSIONS Current evidence of long-term effects of daily cannabis use and cannabis use disorder on brain-related outcomes is suggestive rather than conclusive, but use is associated with psychiatric morbidity and with cognitive impairments that recover after a period of abstinence.
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Affiliation(s)
- Emese Kroon
- Neuroscience of Addiction Lab, Department of PsychologyUniversity of AmsterdamAmsterdamthe Netherlands
- The Amsterdam Brain and Cognition Center (ABC)University of AmsterdamAmsterdamthe Netherlands
| | - Lauren Kuhns
- Neuroscience of Addiction Lab, Department of PsychologyUniversity of AmsterdamAmsterdamthe Netherlands
- The Amsterdam Brain and Cognition Center (ABC)University of AmsterdamAmsterdamthe Netherlands
| | - Eva Hoch
- Cannabinoid Research and Treatment Group, Department of Psychiatry and PsychotherapyUniversity Hospital, Ludwig Maximilan UniversityMunichGermany
- Division of Clinical Psychology and Psychological Treatment, Department of PsychologyLudwig Maximilian University MunichMunichGermany
| | - Janna Cousijn
- Neuroscience of Addiction Lab, Department of PsychologyUniversity of AmsterdamAmsterdamthe Netherlands
- The Amsterdam Brain and Cognition Center (ABC)University of AmsterdamAmsterdamthe Netherlands
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29
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Daniju Y, Bossong MG, Brandt K, Allen P. Do the effects of cannabis on the hippocampus and striatum increase risk for psychosis? Neurosci Biobehav Rev 2020; 112:324-335. [PMID: 32057817 DOI: 10.1016/j.neubiorev.2020.02.010] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/18/2019] [Revised: 01/17/2020] [Accepted: 02/10/2020] [Indexed: 11/19/2022]
Abstract
Cannabis use is associated with increased risk of psychotic symptoms and in a small number of cases it can lead to psychoses. This review examines the neurobiological mechanisms that mediate the link between cannabis use and psychosis risk. We use an established preclinical model of psychosis, the methylazoxymethanol acetate (MAM) rodent model, as a framework to examine if psychosis risk in some cannabis users is mediated by the effects of cannabis on the hippocampus, and this region's role in the regulation of mesolimbic dopamine. We also examine how cannabis affects excitatory neurotransmission known to regulate hippocampal neural activity and output. Whilst there is clear evidence that cannabis/cannabinoids can affect hippocampal and medial temporal lobe function and structure, the evidence that cannabis/cannabinoids increase striatal dopamine function is less robust. There is limited evidence that cannabis use affects cortical and striatal glutamate levels, but there are currently too few studies to draw firm conclusions. Future work is needed to test the MAM model in relation to cannabis using multimodal neuroimaging approaches.
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Affiliation(s)
- Y Daniju
- Department of Psychology, University of Roehampton, London, UK
| | - M G Bossong
- Department of Psychiatry, UMC Utrecht Brain Center, University Medical Center Utrecht, the Netherlands
| | - K Brandt
- Department of Psychology, University of Roehampton, London, UK
| | - P Allen
- Department of Psychology, University of Roehampton, London, UK; Department of Psychosis Studies, Institute of Psychiatry, Psychology and Neuroscience, King's College London, UK; Icahn School of Medicine at Mount Sinai Hospital, New York, USA.
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30
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Hindocha C, Cousijn J, Rall M, Bloomfield MAP. The Effectiveness of Cannabinoids in the Treatment of Posttraumatic Stress Disorder (PTSD): A Systematic Review. J Dual Diagn 2020; 16:120-139. [PMID: 31479625 DOI: 10.1080/15504263.2019.1652380] [Citation(s) in RCA: 22] [Impact Index Per Article: 5.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/12/2022]
Abstract
Objectives: Posttraumatic stress disorder (PTSD) is a potentially debilitating mental health problem. There has been a recent surge of interest regarding the use of cannabinoids in the treatment of PTSD. We therefore sought to systematically review and assess the quality of the clinical evidence of the effectiveness of cannabinoids for the treatment of PTSD. Method: We included all studies published until December 2018 where a patient has had PTSD diagnosed and had been prescribed or were using a cannabinoid for the purpose of reducing PTSD symptoms. Our primary outcome measure was the reduction in PTSD symptoms using a validated instrument. In the absence of randomized controlled trials, we included the next best available levels of evidence including observational and retrospective studies and case reports. We assessed risk of bias and quality using validated tools appropriate for the study design. Results: We included 10 studies in this review, of which only one study was a pilot randomized, double-blind, placebo-controlled, crossover clinical trial. Every identified study had medium to high risk of bias and was of low quality. We found that cannabinoids may decrease PTSD symptomology, in particular sleep disturbances and nightmares. Conclusions: Most studies to date are small and of low quality, with significant limitations to the study designs precluding any clinical recommendations about its use in routine clinical practice. Evidence that cannabinoids may help reduce global PTSD symptoms, sleep disturbances, and nightmares indicates that future well-controlled, randomized, double-blind clinical trials are highly warranted.PROSPERO registration number: 121646.
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Affiliation(s)
- C Hindocha
- Clinical Psychopharmacology Unit, University College London, London, United Kingdom.,Translational Psychiatry Research Group, Research Department of Mental Health Neuroscience, Division of Psychiatry, Faculty of Brain Sciences, University College London, London, United Kingdom.,NIHR University College London Hospitals Biomedical Research Centre, University College Hospital, London, United Kingdom
| | - J Cousijn
- Neuroscience of Addiction (NofA) Lab, Department of Psychology, University of Amsterdam, Amsterdam, The Netherlands
| | - M Rall
- Clinical Psychopharmacology Unit, University College London, London, United Kingdom.,Translational Psychiatry Research Group, Research Department of Mental Health Neuroscience, Division of Psychiatry, Faculty of Brain Sciences, University College London, London, United Kingdom
| | - M A P Bloomfield
- Clinical Psychopharmacology Unit, University College London, London, United Kingdom.,Translational Psychiatry Research Group, Research Department of Mental Health Neuroscience, Division of Psychiatry, Faculty of Brain Sciences, University College London, London, United Kingdom.,NIHR University College London Hospitals Biomedical Research Centre, University College Hospital, London, United Kingdom.,The Traumatic Stress Clinic, St Pancras Hospital, Camden and Islington NHS Foundation Trust, London, UK
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31
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Dellazizzo L, Potvin S, Athanassiou M, Dumais A. Violence and Cannabis Use: A Focused Review of a Forgotten Aspect in the Era of Liberalizing Cannabis. Front Psychiatry 2020; 11:567887. [PMID: 33192691 PMCID: PMC7525024 DOI: 10.3389/fpsyt.2020.567887] [Citation(s) in RCA: 20] [Impact Index Per Article: 5.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/30/2020] [Accepted: 08/27/2020] [Indexed: 01/07/2023] Open
Abstract
There has been a shift surrounding societal and legal perspectives on cannabis reflecting changing public attitudes towards the perceived safety and social acceptability of cannabis use. With cannabis liberalization internationally, the focus of most cannabis-related harms has been on effects with users themselves. Harm-to-others including injuries from violence have nevertheless been unfortunately largely overlooked. While studies remain heterogeneous, there is meta-analytical evidence pointing towards an association. The aims of this focused review are two-fold: (I) review the evidence from meta-analyses on the association between cannabis and violence; and (II) provide an overview of possible mechanisms relating cannabis use to violence. First, evidence from meta-analytical studies in youths, intimate partners, and individuals with severe mental disorders have shown that there is a global moderate association between cannabis use and violence, which is stronger in the latter more at-risk population. Preliminary data has even highlighted a potential dose-response relationship with larger effects in more frequent users. Although of importance, this subject has remained essentially forgotten as a public health concern. While literature remains inconclusive, data has suggested potential increases in cannabis use following liberalization policies. This may increase violent outcomes if the effect is directly related to the use of cannabis by means of its psychophysiological modifications. However, for the moment, the mechanisms associating cannabis use and violence remain to be clearly resolved. Considering the recency of policy changes on cannabis, further methodologically sound research using longitudinal designs should examine the effects that cannabis use may have on different forms of violence and the trends that emerge, while evaluating the effects of possible confounding factors (e.g. other substance use). In addition, as evidence-based research from meta-analyses have shown that cannabis use is associated with violence, measures must be taken to mitigate the risks.
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Affiliation(s)
- Laura Dellazizzo
- Research Center of the Institut Universitaire en Santé Mentale de Montréal, Montreal, QC, Canada.,Department of Psychiatry and Addictology, Faculty of Medicine, Université de Montréal, Montreal, QC, Canada
| | - Stéphane Potvin
- Research Center of the Institut Universitaire en Santé Mentale de Montréal, Montreal, QC, Canada.,Department of Psychiatry and Addictology, Faculty of Medicine, Université de Montréal, Montreal, QC, Canada
| | - Maria Athanassiou
- Research Center of the Institut Universitaire en Santé Mentale de Montréal, Montreal, QC, Canada.,Department of Psychiatry and Addictology, Faculty of Medicine, Université de Montréal, Montreal, QC, Canada
| | - Alexandre Dumais
- Research Center of the Institut Universitaire en Santé Mentale de Montréal, Montreal, QC, Canada.,Department of Psychiatry and Addictology, Faculty of Medicine, Université de Montréal, Montreal, QC, Canada.,Institut national de psychiatrie légale Philippe-Pinel, Montreal, QC, Canada
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32
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Cohen K, Mama Y, Rosca P, Pinhasov A, Weinstein A. Chronic Use of Synthetic Cannabinoids Is Associated With Impairment in Working Memory and Mental Flexibility. Front Psychiatry 2020; 11:602. [PMID: 32695029 PMCID: PMC7339911 DOI: 10.3389/fpsyt.2020.00602] [Citation(s) in RCA: 11] [Impact Index Per Article: 2.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/16/2019] [Accepted: 06/10/2020] [Indexed: 11/13/2022] Open
Abstract
BACKGROUND We have recently shown that chronic use of Synthetic Cannabinoids (SCs) has been associated with mood disorders and impairments in executive functions. There is also evidence indicating that chronic SC users have higher rates of comorbidity with depression and psychotic symptoms. Here, we investigate performance on executive function and emotional processing tasks in regular SC users and a measure of schizotypal traits. METHOD Thirty chronic SC users, 32 recreational cannabis users, and 32 non-using control participants, without history of mental disorder, or current substance abuse diagnosis (mean age 26 ± 4.27 years; 85 males, 9 females), were tested in addiction treatment centers in Israel. Computerized neurocognitive function tests; the N-back task, Go/No-Go task, Wisconsin Sorting Card-like Task (WSCT), and emotional face recognition task and questionnaires of depression, anxiety and schizotypal traits and symptoms were used. RESULTS SC users have performed worse than recreational cannabis users and non-cannabis users on the N-back working-memory task (lower accuracy) and the WSCT cognitive flexibility task. SC users showed greater schizotypal traits and symptoms compared with recreational cannabis users and non-user control participants. A positive association was found in cannabinoid-user groups between schizotypal traits and symptoms and cognitive and emotional processing measures. Finally, SC users have scored higher on depression and state-trait anxiety measures than recreational cannabis users or healthy control participants. CONCLUSIONS Repeated use of SCs is associated with impairment in executive functions and emotional processing. These alterations are associated with depression and schizotypal traits and symptoms. This adds to existing evidence on the long-term consequences of SC drugs and their risks for mental health.
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Affiliation(s)
- Koby Cohen
- Department of Behavioral Science, Ariel University, Ariel, Israel
| | - Yaniv Mama
- Department of Behavioral Science, Ariel University, Ariel, Israel
| | - Paola Rosca
- Ministry of Health (Israel), Jerusalem, Israel
| | - Albert Pinhasov
- Adelson School of Medicine, Ariel University, Ariel, Israel.,Department of Molecular Biology, Ariel University, Ariel, Israel
| | - Aviv Weinstein
- Department of Behavioral Science, Ariel University, Ariel, Israel
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33
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Shollenbarger S, Thomas AM, Wade NE, Gruber SA, Tapert SF, Filbey FM, Lisdahl KM. Intrinsic Frontolimbic Connectivity and Mood Symptoms in Young Adult Cannabis Users. Front Public Health 2019; 7:311. [PMID: 31737591 PMCID: PMC6838025 DOI: 10.3389/fpubh.2019.00311] [Citation(s) in RCA: 12] [Impact Index Per Article: 2.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/16/2018] [Accepted: 10/14/2019] [Indexed: 11/25/2022] Open
Abstract
Objective: The endocannbinoid system and cannabis exposure has been implicated in emotional processing. The current study examined whether regular cannabis users demonstrated abnormal intrinsic (a.k.a. resting state) frontolimbic connectivity compared to non-users. A secondary aim examined the relationship between cannabis group connectivity differences and self-reported mood and affect symptoms. Method: Participants included 79 cannabis-using and 80 non-using control emerging adults (ages of 18–30), balanced for gender, reading ability, and age. Standard multiple regressions were used to predict if cannabis group status was associated with frontolimbic connectivity after controlling for site, past month alcohol and nicotine use, and days of abstinence from cannabis. Results: After controlling for research site, past month alcohol and nicotine use, and days of abstinence from cannabis, cannabis users demonstrated significantly greater connectivity between left rACC and the following: right rACC (p = 0.001; corrected p = 0.05; f2 = 0.55), left amygdala (p = 0.03; corrected p = 0.47; f2 = 0.17), and left insula (p = 0.03; corrected p = 0.47; f2 = 0.16). Among cannabis users, greater bilateral rACC connectivity was significantly associated with greater subthreshold depressive symptoms (p = 0.02). Conclusions: Cannabis using young adults demonstrated greater connectivity within frontolimbic regions compared to controls. In cannabis users, greater bilateral rACC intrinsic connectivity was associated with greater levels of subthreshold depression symptoms. Current findings suggest that regular cannabis use during adolescence is associated with abnormal frontolimbic connectivity, especially in cognitive control and emotion regulation regions.
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Affiliation(s)
- Skyler Shollenbarger
- Psychology Department, University of Wisconsin-Milwaukee, Milwaukee, WI, United States
| | - Alicia M Thomas
- Psychology Department, University of Wisconsin-Milwaukee, Milwaukee, WI, United States
| | - Natasha E Wade
- Department of Psychiatry, University of California, San Diego, La Jolla, CA, United States
| | - Staci A Gruber
- Imaging Center, McLean Hospital, Belmont, MA, United States.,Department of Psychiatry, Harvard Medical School, Boston, MA, United States
| | - Susan F Tapert
- Department of Psychiatry, University of California, San Diego, La Jolla, CA, United States
| | - Francesca M Filbey
- Bert Moore Chair in BrainHealth, School of Behavioral and Brain Sciences, The University of Texas at Dallas, Dallas, TX, United States
| | - Krista M Lisdahl
- Psychology Department, University of Wisconsin-Milwaukee, Milwaukee, WI, United States
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Slawek D, Meenrajan SR, Alois MR, Comstock Barker P, Estores IM, Cook R. Medical Cannabis for the Primary Care Physician. J Prim Care Community Health 2019; 10:2150132719884838. [PMID: 31646929 PMCID: PMC6820188 DOI: 10.1177/2150132719884838] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/09/2023] Open
Abstract
Medical cannabis use is common in the United States and increasingly more socially acceptable. As more patients seek out and acquire medical cannabis, primary care physicians will be faced with a growing number of patients seeking information on the indications, efficacy, and safety of medical cannabis. We present a case of a patient with several chronic health conditions who asks her primary care provider whether she should try medical cannabis. We provide a review of the pharmacology of medical cannabis, the state of evidence regarding the efficacy of medical cannabis, variations in the types of medical cannabis, and safety monitoring considerations for the primary care physician.
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Affiliation(s)
- Deepika Slawek
- Albert Einstein College of Medicine/Montefiore Medical Center, Bronx, NY, USA
| | | | | | | | | | - Robert Cook
- Albert Einstein College of Medicine/Montefiore Medical Center, Bronx, NY, USA
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Baron EP. Medicinal Properties of Cannabinoids, Terpenes, and Flavonoids in Cannabis, and Benefits in Migraine, Headache, and Pain: An Update on Current Evidence and Cannabis Science. Headache 2019; 58:1139-1186. [PMID: 30152161 DOI: 10.1111/head.13345] [Citation(s) in RCA: 126] [Impact Index Per Article: 25.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/07/2018] [Accepted: 05/09/2018] [Indexed: 12/19/2022]
Abstract
BACKGROUND Comprehensive literature reviews of historical perspectives and evidence supporting cannabis/cannabinoids in the treatment of pain, including migraine and headache, with associated neurobiological mechanisms of pain modulation have been well described. Most of the existing literature reports on the cannabinoids Δ9 -tetrahydrocannabinol (THC) and cannabidiol (CBD), or cannabis in general. There are many cannabis strains that vary widely in the composition of cannabinoids, terpenes, flavonoids, and other compounds. These components work synergistically to produce wide variations in benefits, side effects, and strain characteristics. Knowledge of the individual medicinal properties of the cannabinoids, terpenes, and flavonoids is necessary to cross-breed strains to obtain optimal standardized synergistic compositions. This will enable targeting individual symptoms and/or diseases, including migraine, headache, and pain. OBJECTIVE Review the medical literature for the use of cannabis/cannabinoids in the treatment of migraine, headache, facial pain, and other chronic pain syndromes, and for supporting evidence of a potential role in combatting the opioid epidemic. Review the medical literature involving major and minor cannabinoids, primary and secondary terpenes, and flavonoids that underlie the synergistic entourage effects of cannabis. Summarize the individual medicinal benefits of these substances, including analgesic and anti-inflammatory properties. CONCLUSION There is accumulating evidence for various therapeutic benefits of cannabis/cannabinoids, especially in the treatment of pain, which may also apply to the treatment of migraine and headache. There is also supporting evidence that cannabis may assist in opioid detoxification and weaning, thus making it a potential weapon in battling the opioid epidemic. Cannabis science is a rapidly evolving medical sector and industry with increasingly regulated production standards. Further research is anticipated to optimize breeding of strain-specific synergistic ratios of cannabinoids, terpenes, and other phytochemicals for predictable user effects, characteristics, and improved symptom and disease-targeted therapies.
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Affiliation(s)
- Eric P Baron
- Department of Neurology, Center for Neurological Restoration - Headache and Chronic Pain Medicine, Cleveland Clinic Neurological Institute, Cleveland, OH, 44195, USA
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Norris C, Szkudlarek HJ, Pereira B, Rushlow W, Laviolette SR. The Bivalent Rewarding and Aversive properties of Δ 9-tetrahydrocannabinol are Mediated Through Dissociable Opioid Receptor Substrates and Neuronal Modulation Mechanisms in Distinct Striatal Sub-Regions. Sci Rep 2019; 9:9760. [PMID: 31278333 PMCID: PMC6611878 DOI: 10.1038/s41598-019-46215-7] [Citation(s) in RCA: 17] [Impact Index Per Article: 3.4] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/28/2019] [Accepted: 06/17/2019] [Indexed: 11/09/2022] Open
Abstract
The primary psychoactive compound in cannabis, Δ9-tetrahydrocannabinol (THC), is capable of producing bivalent rewarding and aversive affective states through interactions with the mesolimbic system. However, the precise mechanisms underlying the dissociable effects of THC are not currently understood. In the present study, we identify anatomically dissociable effects of THC within the rat nucleus accumbens (NAc), using an integrative combination of behavioral pharmacology and in vivo neuronal electrophysiology. We report that the rewarding vs. aversive stimulus properties of THC are both anatomically and pharmacologically dissociable within distinct anterior vs. posterior sub-regions of the NAc. While the rewarding effects of THC were dependent upon local μ-opioid receptor signaling, the aversive effects of THC were processed via a κ-opioid receptor substrate. Behaviorally, THC in the posterior NASh induced deficits in social reward and cognition whereas THC in the anterior NAc, potentiated opioid-related reward salience. In vivo neuronal recordings demonstrated that THC decreased medium spiny neuron (MSN) activity in the anterior NAc and increased the power of gamma (γ) oscillations. In contrast, THC increased MSN activity states in the posterior NASh and decreased γ-oscillation power. These findings reveal critical new insights into the bi-directional neuronal and pharmacological mechanisms controlling the dissociable effects of THC in mesolimbic-mediated affective processing.
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Affiliation(s)
- Christopher Norris
- Addiction Research Group, Schulich School of Medicine & Dentistry, University of Western Ontario, London, Ontario, N6A 5C1, Canada.
- Dept. of Anatomy & Cell Biology, Schulich School of Medicine & Dentistry, University of Western Ontario, London, Ontario, N6A 5C1, Canada.
| | - Hanna J Szkudlarek
- Addiction Research Group, Schulich School of Medicine & Dentistry, University of Western Ontario, London, Ontario, N6A 5C1, Canada
- Dept. of Anatomy & Cell Biology, Schulich School of Medicine & Dentistry, University of Western Ontario, London, Ontario, N6A 5C1, Canada
| | - Brian Pereira
- Addiction Research Group, Schulich School of Medicine & Dentistry, University of Western Ontario, London, Ontario, N6A 5C1, Canada
- Dept. of Anatomy & Cell Biology, Schulich School of Medicine & Dentistry, University of Western Ontario, London, Ontario, N6A 5C1, Canada
| | - Walter Rushlow
- Addiction Research Group, Schulich School of Medicine & Dentistry, University of Western Ontario, London, Ontario, N6A 5C1, Canada
- Dept. of Anatomy & Cell Biology, Schulich School of Medicine & Dentistry, University of Western Ontario, London, Ontario, N6A 5C1, Canada
- Dept. of Psychiatry, Schulich School of Medicine & Dentistry, University of Western Ontario, London, Ontario, N6A 5C1, Canada
| | - Steven R Laviolette
- Addiction Research Group, Schulich School of Medicine & Dentistry, University of Western Ontario, London, Ontario, N6A 5C1, Canada
- Dept. of Anatomy & Cell Biology, Schulich School of Medicine & Dentistry, University of Western Ontario, London, Ontario, N6A 5C1, Canada
- Dept. of Psychiatry, Schulich School of Medicine & Dentistry, University of Western Ontario, London, Ontario, N6A 5C1, Canada
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The prevalence and clinical correlates of cannabis use and cannabis use disorder among patients with bipolar disorder: A systematic review with meta-analysis and meta-regression. Neurosci Biobehav Rev 2019; 101:78-84. [PMID: 30974123 DOI: 10.1016/j.neubiorev.2019.04.004] [Citation(s) in RCA: 40] [Impact Index Per Article: 8.0] [Reference Citation Analysis] [Abstract] [Key Words] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/03/2019] [Revised: 04/04/2019] [Accepted: 04/08/2019] [Indexed: 12/13/2022]
Abstract
Bipolar disorder (BD) is commonly associated with comorbidities, especially substance use disorders. In light of this, the present review aimed to investigate the prevalence and clinical correlates of cannabis use in BD. Studies evaluating the prevalence of cannabis use among patients with BD and studies reporting a dichotomous sample of patients with cannabis use compared to those without the use were included. Meta-analyses using random-effects models were performed, and sources of heterogeneity were explored using meta-regression. The search resulted in 2918 publications, of which 53 were included. The prevalence of cannabis use was 24% (95%CI:18-29; k = 35; n = 51,756). Cannabis use was significantly associated with being younger, male, and single; having fewer years of education and an earlier onset of affective symptoms; and lifetime psychotic symptoms, suicide attempts, and use of tobacco, alcohol, and other substances. In conclusion, cannabis use present in almost one-quarter of patients with BD and is associated with factors that are highly relevant for both clinical practice and public health.
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Abstract
BACKGROUND Although alterations in medial temporal lobe structures have been previously associated with use of cannabis, one of the most widely used illicit drugs, whether such alterations are a cause or effect of cannabis use has been unclear. METHODS In this cross-sectional observational study involving 404 twins/siblings, we have compared cortical thickness and surface area between groups of gender-matched sibling-pairs (concordant cannabis unexposed, concordant exposed and discordant for cannabis exposure) using permutation tests after controlling for potential confounds. Bi-variate polygenic model was used to assess the genetic and environmental contributions underlying cortical morphological phenotypes and frequency of cannabis use. RESULTS Cortical thickness of the right entorhinal cortex was significantly lower in the concordant exposed siblings compared to both discordant unexposed and discordant exposed groups [false discovery rate (FDR)-corrected, q < 0.05]. The association between the right entorhinal cortex thickness and frequency of cannabis use is due to the contribution of significant shared additive genetic (ρg = -0.19 ± 0.08; p = 0.02) factors but not unique environment (ρe = 0.05 ± 0.09; p = 0.53). Significantly lower surface area of the right entorhinal cortex in discordant exposed group compared with the discordant unexposed group furnishes preliminary evidence in support of causal effect of cannabis use (FDR-corrected, q < 0.05). However, bi-variate polygenic model-based analysis did not show any significant effect. CONCLUSIONS Shared genetic liability may underlie the association between cannabis exposure and thinner right entorhinal cortex. Prospective longitudinal studies are necessary to definitively disentangle the cause-effect relationships of cannabis use.
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Affiliation(s)
- Subhadip Paul
- Institute of Psychiatry,Psychology & Neuroscience,King's College London,UK
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The endocannabinoid system in mental disorders: Evidence from human brain studies. Biochem Pharmacol 2018; 157:97-107. [DOI: 10.1016/j.bcp.2018.07.009] [Citation(s) in RCA: 38] [Impact Index Per Article: 6.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/29/2018] [Accepted: 07/12/2018] [Indexed: 02/06/2023]
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40
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Bloomfield MAP, Hindocha C, Green SF, Wall MB, Lees R, Petrilli K, Costello H, Ogunbiyi MO, Bossong MG, Freeman TP. The neuropsychopharmacology of cannabis: A review of human imaging studies. Pharmacol Ther 2018; 195:132-161. [PMID: 30347211 PMCID: PMC6416743 DOI: 10.1016/j.pharmthera.2018.10.006] [Citation(s) in RCA: 132] [Impact Index Per Article: 22.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/31/2022]
Abstract
The laws governing cannabis are evolving worldwide and associated with changing patterns of use. The main psychoactive drug in cannabis is Δ9-tetrahydrocannabinol (THC), a partial agonist at the endocannabinoid CB1 receptor. Acutely, cannabis and THC produce a range of effects on several neurocognitive and pharmacological systems. These include effects on executive, emotional, reward and memory processing via direct interactions with the endocannabinoid system and indirect effects on the glutamatergic, GABAergic and dopaminergic systems. Cannabidiol, a non-intoxicating cannabinoid found in some forms of cannabis, may offset some of these acute effects. Heavy repeated cannabis use, particularly during adolescence, has been associated with adverse effects on these systems, which increase the risk of mental illnesses including addiction and psychosis. Here, we provide a comprehensive state of the art review on the acute and chronic neuropsychopharmacology of cannabis by synthesizing the available neuroimaging research in humans. We describe the effects of drug exposure during development, implications for understanding psychosis and cannabis use disorder, and methodological considerations. Greater understanding of the precise mechanisms underlying the effects of cannabis may also give rise to new treatment targets.
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Affiliation(s)
- Michael A P Bloomfield
- Translational Psychiatry Research Group, Research Department of Mental Health Neuroscience, Division of Psychiatry, Faculty of Brain Sciences, University College London, United Kingdom; Clinical Psychopharmacology Unit, Research Department of Clinical, Educational and Health Psychology, Faculty of Brain Sciences, University College London, United Kingdom; Psychiatric Imaging Group, MRC London Institute of Medical Sciences, Hammersmith Hospital, London, United Kingdom; NIHR University College London Hospitals Biomedical Research Centre, University College Hospital, London, United Kingdom; Institute of Clinical Sciences, Faculty of Medicine, Imperial College London, United Kingdom.
| | - Chandni Hindocha
- Translational Psychiatry Research Group, Research Department of Mental Health Neuroscience, Division of Psychiatry, Faculty of Brain Sciences, University College London, United Kingdom; Clinical Psychopharmacology Unit, Research Department of Clinical, Educational and Health Psychology, Faculty of Brain Sciences, University College London, United Kingdom; NIHR University College London Hospitals Biomedical Research Centre, University College Hospital, London, United Kingdom
| | - Sebastian F Green
- Translational Psychiatry Research Group, Research Department of Mental Health Neuroscience, Division of Psychiatry, Faculty of Brain Sciences, University College London, United Kingdom
| | - Matthew B Wall
- Clinical Psychopharmacology Unit, Research Department of Clinical, Educational and Health Psychology, Faculty of Brain Sciences, University College London, United Kingdom; Centre for Neuropsychopharmacology, Division of Brain Sciences, Faculty of Medicine, Imperial College London, United Kingdom; Invicro UK, Hammersmith Hospital, London, United Kingdom
| | - Rachel Lees
- Translational Psychiatry Research Group, Research Department of Mental Health Neuroscience, Division of Psychiatry, Faculty of Brain Sciences, University College London, United Kingdom; Clinical Psychopharmacology Unit, Research Department of Clinical, Educational and Health Psychology, Faculty of Brain Sciences, University College London, United Kingdom; Institute of Cognitive Neuroscience, Faculty of Brain Sciences, University College London, United Kingdom
| | - Katherine Petrilli
- Translational Psychiatry Research Group, Research Department of Mental Health Neuroscience, Division of Psychiatry, Faculty of Brain Sciences, University College London, United Kingdom; Clinical Psychopharmacology Unit, Research Department of Clinical, Educational and Health Psychology, Faculty of Brain Sciences, University College London, United Kingdom; Institute of Cognitive Neuroscience, Faculty of Brain Sciences, University College London, United Kingdom
| | - Harry Costello
- Translational Psychiatry Research Group, Research Department of Mental Health Neuroscience, Division of Psychiatry, Faculty of Brain Sciences, University College London, United Kingdom
| | - M Olabisi Ogunbiyi
- Translational Psychiatry Research Group, Research Department of Mental Health Neuroscience, Division of Psychiatry, Faculty of Brain Sciences, University College London, United Kingdom
| | - Matthijs G Bossong
- Department of Psychiatry, Brain Center Rudolf Magnus, University Medical Center Utrecht, the Netherlands
| | - Tom P Freeman
- Translational Psychiatry Research Group, Research Department of Mental Health Neuroscience, Division of Psychiatry, Faculty of Brain Sciences, University College London, United Kingdom; Clinical Psychopharmacology Unit, Research Department of Clinical, Educational and Health Psychology, Faculty of Brain Sciences, University College London, United Kingdom; Department of Psychology, University of Bath, United Kingdom; National Addiction Centre, Institute of Psychiatry, Psychology & Neuroscience, King's College London, United Kingdom
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Scherma M, Masia P, Deidda M, Fratta W, Tanda G, Fadda P. New Perspectives on the Use of Cannabis in the Treatment of Psychiatric Disorders. MEDICINES (BASEL, SWITZERLAND) 2018; 5:E107. [PMID: 30279403 PMCID: PMC6313625 DOI: 10.3390/medicines5040107] [Citation(s) in RCA: 24] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 08/07/2018] [Revised: 09/26/2018] [Accepted: 09/30/2018] [Indexed: 12/11/2022]
Abstract
Following the discovery of the endocannabinoid system and its potential as a therapeutic target for various pathological conditions, growing interest led researchers to investigate the role of cannabis and its derivatives for medical purposes. The compounds Δ9-tetrahydrocannabinol and cannabidiol are the most abundant phytocannabinoids found in cannabis extracts, as well as the most studied. The present review aims to provide an overview of the current evidence for their beneficial effects in treating psychiatric disorders, including schizophrenia, anxiety, and depression. Nevertheless, further investigations are required to clarify many pending issues, especially those relative to the assessment of benefits and risks when using cannabis for therapeutic purposes, thereby also helping national and federal jurisdictions to remain updated.
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Affiliation(s)
- Maria Scherma
- Department of Biomedical Sciences, Division of Neuroscience and Clinical Pharmacology, University of Cagliari, 09042 Monserrato, Italy.
| | - Paolo Masia
- Department of Biomedical Sciences, Division of Neuroscience and Clinical Pharmacology, University of Cagliari, 09042 Monserrato, Italy.
| | - Matteo Deidda
- Department of Biomedical Sciences, Division of Neuroscience and Clinical Pharmacology, University of Cagliari, 09042 Monserrato, Italy.
| | - Walter Fratta
- Department of Biomedical Sciences, Division of Neuroscience and Clinical Pharmacology, University of Cagliari, 09042 Monserrato, Italy.
| | - Gianluigi Tanda
- Medication Development program, NIDA-IRP, NIH/DHHS, NIDA suite 3301, Baltimore, MD 21224, USA.
| | - Paola Fadda
- Department of Biomedical Sciences, Division of Neuroscience and Clinical Pharmacology, University of Cagliari, 09042 Monserrato, Italy.
- Centre of Excellence "Neurobiology of Dependence", University of Cagliari, 09042 Monserrato, Italy.
- CNR Institute of Neuroscience ⁻ Cagliari, National Research Council, 09042 Monserrato, Italy.
- National Institute of Neuroscience (INN), University of Cagliari, 09042 Monserrato, Italy.
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Circulating endocannabinoids and affect regulation in human subjects. Psychoneuroendocrinology 2018; 92:66-71. [PMID: 29627714 DOI: 10.1016/j.psyneuen.2018.03.009] [Citation(s) in RCA: 20] [Impact Index Per Article: 3.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/12/2017] [Revised: 03/15/2018] [Accepted: 03/15/2018] [Indexed: 12/31/2022]
Abstract
The endocannabinoid (EC) system influences a wide variety of neurobiological processes including affect and emotionality as well as other neuropsychiatric functions. In this study we examined the relationship of circulating endocannabinoids [anandamide (AEA) and 2-arachidonoylglycerol (2-AG)] with affect and emotionality in 175 individuals with (n = 115) and without (n = 60) mood, anxiety, and/or personality disorders. Circulating AEA levels displayed a modest, though statistically significant, inverse relationship with a composite measure of affect regulation (β = - 0.264, p = 0.009), due to its relationship with affect intensity (β = - 0.225, p = 0.021) across all study participants. Neither AEA nor 2-AG level differed as a function of any syndromal/personality disorder and neither correlated significantly with state depression or state anxiety scores. These data suggest that circulating levels endocannabinoids may play a role in emotionality across individuals regardless of defined psychiatric disorder.
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45
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Altered orbitofrontal activity and dorsal striatal connectivity during emotion processing in dependent marijuana users after 28 days of abstinence. Psychopharmacology (Berl) 2018; 235:849-859. [PMID: 29197984 DOI: 10.1007/s00213-017-4803-6] [Citation(s) in RCA: 30] [Impact Index Per Article: 5.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/14/2017] [Accepted: 11/26/2017] [Indexed: 12/28/2022]
Abstract
RATIONALE Intact cognitive and emotional functioning is vital for the long-term success of addiction treatment strategies. Accumulating evidence suggests an association between chronic marijuana use and lasting alterations in cognitive brain function. Despite initial evidence for altered emotion processing in dependent marijuana users after short abstinence periods, adaptations in the domain of emotion processing after longer abstinence remain to be determined. OBJECTIVE AND METHODS Using task-based and resting state fMRI, the present study investigated emotion processing in 19 dependent marijuana users and 18 matched non-using controls after an abstinence period of > 28 days. RESULTS Relative to the control subjects, negative emotional stimuli elicited increased medial orbitofrontal cortex (mOFC) activity and stronger mOFC-dorsal striatal and mOFC-amygdala functional coupling in dependent marijuana users (p < 0.022, FWE-corrected). Furthermore, mOFC-dorsal striatal functional connectivity was increased at rest in marijuana users (p < 0.03, FWE-corrected). Yet, processing of positive stimuli and subjective ratings of valence and arousal were comparable in both groups. CONCLUSIONS Together, the present findings provide the first evidence for persisting emotion processing alterations in dependent marijuana users. Alterations might reflect long-term neural adaptations as a consequence of chronic marijuana use or predisposing risk factors for the development of marijuana dependence.
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Bhattacharyya S, Egerton A, Kim E, Rosso L, Riano Barros D, Hammers A, Brammer M, Turkheimer FE, Howes OD, McGuire P. Acute induction of anxiety in humans by delta-9-tetrahydrocannabinol related to amygdalar cannabinoid-1 (CB1) receptors. Sci Rep 2017; 7:15025. [PMID: 29101333 PMCID: PMC5670208 DOI: 10.1038/s41598-017-14203-4] [Citation(s) in RCA: 46] [Impact Index Per Article: 6.6] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/17/2017] [Accepted: 10/04/2017] [Indexed: 12/19/2022] Open
Abstract
Use of Cannabis, the most widely used illicit drug worldwide, is associated with acute anxiety, and anxiety disorders following regular use. The precise neural and receptor basis of these effects have not been tested in man. Employing a combination of functional MRI (fMRI) and positron emission tomography (PET), we investigated whether the effects of delta-9-tetrahydrocannabinol (delta-9-THC), the main psychoactive ingredient of cannabis, on anxiety and on amygdala response while processing fearful stimuli were related to local availability of its main central molecular target, cannabinoid-1 (CB1) receptors in man. Fourteen healthy males were studied with fMRI twice, one month apart, following an oral dose of either delta-9-THC (10 mg) or placebo, while they performed a fear-processing task. Baseline availability of the CB1 receptor was studied using PET with [11C]MePPEP, a CB1 inverse agonist radioligand. Relative to the placebo condition, delta-9-THC induced anxiety and modulated right amygdala activation while processing fear. Both these effects were positively correlated with CB1 receptor availability in the right amygdala. These results suggest that the acute effects of cannabis on anxiety in males are mediated by the modulation of amygdalar function by delta-9-THC and the extent of these effects are related to local availability of CB1 receptors.
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Affiliation(s)
- Sagnik Bhattacharyya
- Department of Psychosis Studies, King's College London, Institute of Psychiatry, Psychology & Neuroscience, De Crespigny Park, London, SE5 8AF, UK.
| | - Alice Egerton
- Department of Psychosis Studies, King's College London, Institute of Psychiatry, Psychology & Neuroscience, De Crespigny Park, London, SE5 8AF, UK
| | - Euitae Kim
- Department of Psychiatry, Seoul National University College of Medicine, Seoul, Republic of Korea
| | - Lula Rosso
- Medical Research Council Clinical Sciences Centre, Hammersmith Hospital, London, UK
| | | | - Alexander Hammers
- King's College London & Guy's and St Thomas' PET Centre, School of Biomedical Engineering and Imaging Sciences, Faculty of Life Sciences and Medicine, King's College London, 4th floor Lambeth Wing, St Thomas' Hospital, Westminster Bridge Road, London, SE1 7EH, UK
| | - Michael Brammer
- Department of Neuroimaging, Centre for Neuroimaging Sciences, PO Box 089, King's College London, Institute of Psychiatry, Psychology & Neuroscience, De Crespigny Park, London, SE5 8AF, UK
| | - Federico E Turkheimer
- Department of Neuroimaging, Centre for Neuroimaging Sciences, PO Box 089, King's College London, Institute of Psychiatry, Psychology & Neuroscience, De Crespigny Park, London, SE5 8AF, UK
| | - Oliver D Howes
- Department of Psychosis Studies, King's College London, Institute of Psychiatry, Psychology & Neuroscience, De Crespigny Park, London, SE5 8AF, UK
- Medical Research Council Clinical Sciences Centre, Hammersmith Hospital, London, UK
| | - Philip McGuire
- Department of Psychosis Studies, King's College London, Institute of Psychiatry, Psychology & Neuroscience, De Crespigny Park, London, SE5 8AF, UK
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Turna J, Patterson B, Van Ameringen M. Is cannabis treatment for anxiety, mood, and related disorders ready for prime time? Depress Anxiety 2017. [PMID: 28636769 DOI: 10.1002/da.22664] [Citation(s) in RCA: 59] [Impact Index Per Article: 8.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/31/2022] Open
Abstract
Anxiety and related disorders are the most common mental conditions affecting the North American population. Despite their established efficacy, first-line antidepressant treatments are associated with significant side effects, leading many afflicted individuals to seek alternative treatments. Cannabis is commonly viewed as a natural alternative for a variety of medical and mental health conditions. Currently, anxiety ranks among the top five medical symptoms for which North Americans report using medical marijuana. However, upon careful review of the extant treatment literature, the anxiolytic effects of cannabis in clinical populations are surprisingly not well-documented. The effects of cannabis on anxiety and mood symptoms have been examined in healthy populations and in several small studies of synthetic cannabinoid agents but there are currently no studies which have examined the effects of the cannabis plant on anxiety and related disorders. In light of the rapidly shifting landscape regarding the legalization of cannabis for medical and recreational purposes, it is important to highlight the significant disconnect between the scientific literature, public opinion, and related policies. The aim of this article is to provide a comprehensive review of the current cannabis treatment literature, and to identify the potential for cannabis to be used as a therapeutic intervention for anxiety, mood, and related disorders. Searches of five electronic databases were conducted (PubMed, MEDLINE, Web of Science, PsychINFO, and Google Scholar), with the most recent in February 2017. The effects of cannabis on healthy populations and clinical psychiatric samples will be discussed, focusing primarily on anxiety and mood disorders.
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Affiliation(s)
- Jasmine Turna
- MacAnxiety Research Centre, McMaster University, Hamilton, ON, Canada.,MiNDS Neuroscience Graduate Program, McMaster University, Hamilton, ON, Canada
| | - Beth Patterson
- MacAnxiety Research Centre, McMaster University, Hamilton, ON, Canada.,Department of Psychiatry and Behavioural Neurosciences, McMaster University, Hamilton, ON, Canada
| | - Michael Van Ameringen
- MacAnxiety Research Centre, McMaster University, Hamilton, ON, Canada.,Department of Psychiatry and Behavioural Neurosciences, McMaster University, Hamilton, ON, Canada.,Hamilton Health Sciences, Hamilton, ON, Canada
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48
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Childs E, Lutz JA, de Wit H. Dose-related effects of delta-9-THC on emotional responses to acute psychosocial stress. Drug Alcohol Depend 2017; 177:136-144. [PMID: 28599212 PMCID: PMC6349031 DOI: 10.1016/j.drugalcdep.2017.03.030] [Citation(s) in RCA: 72] [Impact Index Per Article: 10.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/01/2016] [Revised: 03/20/2017] [Accepted: 03/21/2017] [Indexed: 02/08/2023]
Abstract
OBJECTIVES Cannabis smokers often report that they use the drug to relax or to relieve emotional stress. However, few clinical studies have shown evidence of the stress-relieving effects of cannabis or cannabinoid agonists. In this study, we sought to assess the influence of delta-9-tetrahydrocannabinol (THC), a main active ingredient of cannabis, upon emotional responses to an acute psychosocial stressor among healthy young adults. METHODS Healthy volunteers (N=42) participated in two experimental sessions, one with psychosocial stress (Trier Social Stress Test, TSST) and another with a non-stressful task, after receiving 0 (N=13), 7.5mg (N=14) or 12.5mg (N=15) oral THC. Capsules were administered under randomized, double blind conditions, 2.5h before the tasks began. We measured subjective mood and drug effects, vital signs and salivary cortisol before and at repeated times after the capsule and tasks. Subjects also appraised the tasks, before and after completion. RESULTS In comparison to placebo, 7.5mg THC significantly reduced self-reported subjective distress after the TSST and attenuated post-task appraisals of the TSST as threatening and challenging. By contrast, 12.5mg THC increased negative mood overall i.e., both before and throughout the tasks, and pre-task ratings of the TSST as threatening and challenging. It also impaired TSST performance and attenuated blood pressure reactivity to the stressor. CONCLUSIONS Our findings suggest that a low dose of THC produces subjective stress-relieving effects in line with those commonly reported among cannabis users, but that higher doses may non-specifically increase negative mood.
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Affiliation(s)
- Emma Childs
- The University of Chicago, Department of Psychiatry Behavioral Neuroscience, 5841 S. Maryland Ave., MC3077, Chicago IL 60637, United States.
| | | | - Harriet de Wit
- Department of Psychiatry and Behavioral Neuroscience, The University of Chicago, 5841 S. Maryland Ave., MC3077, Chicago, Illinois 60637
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49
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Murray RM, Englund A, Abi-Dargham A, Lewis DA, Di Forti M, Davies C, Sherif M, McGuire P, D'Souza DC. Cannabis-associated psychosis: Neural substrate and clinical impact. Neuropharmacology 2017. [PMID: 28634109 DOI: 10.1016/j.neuropharm.2017.06.018] [Citation(s) in RCA: 105] [Impact Index Per Article: 15.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/25/2022]
Abstract
Prospective epidemiological studies have consistently demonstrated that cannabis use is associated with an increased subsequent risk of both psychotic symptoms and schizophrenia-like psychoses. Early onset of use, daily use of high-potency cannabis, and synthetic cannabinoids carry the greatest risk. The risk-increasing effects are not explained by shared genetic predisposition between schizophrenia and cannabis use. Experimental studies in healthy humans show that cannabis and its active ingredient, delta-9-tetrahydrocannabinol (THC), can produce transient, dose-dependent, psychotic symptoms, as well as an array of psychosis-relevant behavioral, cognitive and psychophysiological effects; the psychotogenic effects can be ameliorated by cannabidiol (CBD). Findings from structural imaging studies in cannabis users have been inconsistent but functional MRI studies have linked the psychotomimetic and cognitive effects of THC to activation in brain regions implicated in psychosis. Human PET studies have shown that acute administration of THC weakly releases dopamine in the striatum but that chronic users are characterised by low striatal dopamine. We are beginning to understand how cannabis use impacts on the endocannabinoid system but there is much still to learn about the biological mechanisms underlying how cannabis increases risk of psychosis. This article is part of the Special Issue entitled "A New Dawn in Cannabinoid Neurobiology".
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Affiliation(s)
- R M Murray
- Institute of Psychiatry, Psychology, and Neuroscience, King's College, London, UK.
| | - A Englund
- Institute of Psychiatry, Psychology, and Neuroscience, King's College, London, UK
| | - A Abi-Dargham
- Department of Psychiatry, School of Medicine, Stony Brook University, New York, USA
| | - D A Lewis
- Department of Psychiatry, University of Pittsburg, PA, USA
| | - M Di Forti
- Institute of Psychiatry, Psychology, and Neuroscience, King's College, London, UK
| | - C Davies
- Institute of Psychiatry, Psychology, and Neuroscience, King's College, London, UK
| | - M Sherif
- Department of Psychiatry, Yale University School of Medicine, CT, USA
| | - P McGuire
- Institute of Psychiatry, Psychology, and Neuroscience, King's College, London, UK
| | - D C D'Souza
- Department of Psychiatry, Yale University School of Medicine, CT, USA
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50
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Allendorfer JB, Szaflarski JP. Neuroimaging studies towards understanding the central effects of pharmacological cannabis products on patients with epilepsy. Epilepsy Behav 2017; 70:349-354. [PMID: 28109780 DOI: 10.1016/j.yebeh.2016.11.020] [Citation(s) in RCA: 13] [Impact Index Per Article: 1.9] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/31/2016] [Revised: 11/11/2016] [Accepted: 11/14/2016] [Indexed: 02/04/2023]
Abstract
Recent interest for the use of cannabis-derived products as therapeutic agents in the treatment of epilepsies has necessitated a reevaluation of their effects on brain and behavior. Overall, prolonged cannabis use is thought to result in functional and structural brain alterations. These effects may be dependent on a number of factors: e.g., which phytocannabinoid is used (e.g., cannabidiol (CBD) vs. tetrahyrocannabinol (THC)), the frequency of use (occasional vs. heavy), and at what age (prenatal, childhood, adulthood) the use began. However, due to the fact that there are over seven hundred constituents that make up the Cannabis sativa plant, it is difficult to determine which compound or combination of compounds is responsible for specific effects when studying recreational users. Therefore, this review focuses only on the functional MRI studies investigating the effects of specific pharmacological preparations of cannabis compounds, specifically THC, tetrahydrocannabivarin (THCV), and CBD, on brain function in healthy individuals and persons with epilepsy with references to non-epilepsy studies only to underline the gaps in research that need to be filled before cannabis-derived products are considered for a wide use in the treatment of epilepsy. This article is part of a Special Issue entitled "Cannabinoids and Epilepsy".
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Affiliation(s)
- Jane B Allendorfer
- Department of Neurology, University of Alabama at Birmingham, Birmingham, AL, USA.
| | - Jerzy P Szaflarski
- Department of Neurology, University of Alabama at Birmingham, Birmingham, AL, USA
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