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Weinstein AM. A brain imaging study of dopamine receptor D 2 availability in cannabis dependent users after recovery from cannabis-induced psychosis. Front Psychiatry 2023; 14:1230760. [PMID: 37965367 PMCID: PMC10641483 DOI: 10.3389/fpsyt.2023.1230760] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/29/2023] [Accepted: 10/11/2023] [Indexed: 11/16/2023] Open
Abstract
There is increased risk of psychosis associated with cannabis use disorder and the interaction of THC with dopamine neurotransmission is complex. It is important to investigate the recovery from cannabis-induced psychosis and its effects on the brain's dopamine neurotransmission. This study was to evaluate dopamine receptor D2 availability in the striatum (caudate/putamen) in recently abstinent cannabis dependent users after recovery from psychosis in comparison with abstinent MDMA "ecstasy" abusers and healthy control participants. Participants were eight abstinent ex cannabis-dependent users who were treated for cannabis-induced psychosis with anti-psychotic medication and psychosocial support for 4 months in an inpatient treatment center for drug users. They were compared with nine abstinent ex MDMA "ecstasy" abusers who received medication and psycho-social treatment for 4 months at the same treatment facility and eight healthy control participants. All participants were scanned with bolus and constant infusion of [123I] Iodobenzamide (IBZM) in Single Photon Computed Tomography (SPECT). Cannabis abstinent users who were treated for cannabis-induced psychotic episodes showed no difference in dopamine D2 receptor availability in the caudate compared with abstinent MDMA "ecstasy" abusers and healthy control participants. This finding indicates minimal effects of cannabis-induced psychosis on dopamine reward mechanisms. There is evidence for reduced D2 receptor availability measures in the right putamen (uncorrected) which may indicate a residual effect of anti-psychotic medication.
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Affiliation(s)
- Aviv M. Weinstein
- Department of Psychology and Behavioral Science, Ariel University, Ariel, Israel
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2
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Sundar V, Ramasamy T, Doke M, Samikkannu T. Psychostimulants influence oxidative stress and redox signatures: the role of DNA methylation. Redox Rep 2022; 27:53-59. [PMID: 35227168 PMCID: PMC8890556 DOI: 10.1080/13510002.2022.2043224] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/28/2022] Open
Abstract
Objective: Psychostimulant use induces oxidative stress and alters redox imbalance, influencing epigenetic signatures in the central nervous system (CNS). Among the various epigenetic changes, DNA methylation is directly linked to oxidative stress metabolism via critical redox intermediates such as NAD+, S-adenosylmethionine (SAM), and 2-oxoglutarate. Fluctuations in these intermediates directly influence epigenetic signatures, which leads to detectable alterations in gene expression and protein modification. This review focuses on recent advances in the impact of psychostimulant use on redox-imbalance-induced DNA methylation to develop novel epigenetics-based early interventions. Methods: This review is based on collective research data obtained from the PubMed, Science Direct, and Medline databases. The keywords used in the electronic search in these databases were redox, substance use disorder, psychostimulants, DNA methylation, and neurological diseases. Results: Instability in DNA methylation levels and redox expression effects are reported in various behavioral models stimulated by psychostimulants and opioids, indicating the widespread involvement of epigenetic changes in DNA methylation signatures in neurological disorders. Discussion: This review summarizes the need for more studies and experimental evaluations of DNA-methylation-based strategies that may help to understand the association between psychostimulant use and oxidative stress or redox-linked metabolic recalibration influencing neuronal impairments.
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Affiliation(s)
- Vaishnavi Sundar
- Department of Pharmaceutical Sciences, Irma Lerma Rangel College of Pharmacy, Texas A&M University, Kingsville, Texas, USA
| | - Tamizhselvi Ramasamy
- Department of Pharmaceutical Sciences, Irma Lerma Rangel College of Pharmacy, Texas A&M University, Kingsville, Texas, USA
- School of Biosciences and Technology, Vellore Institute of Technology, Vellore, India
| | - Mayur Doke
- Department of Pharmaceutical Sciences, Irma Lerma Rangel College of Pharmacy, Texas A&M University, Kingsville, Texas, USA
| | - Thangavel Samikkannu
- Department of Pharmaceutical Sciences, Irma Lerma Rangel College of Pharmacy, Texas A&M University, Kingsville, Texas, USA
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Sideli L, Trotta G, Spinazzola E, La Cascia C, Di Forti M. Adverse effects of heavy cannabis use: even plants can harm the brain. Pain 2021; 162:S97-S104. [PMID: 32804835 PMCID: PMC8216111 DOI: 10.1097/j.pain.0000000000001963] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/06/2020] [Revised: 06/08/2020] [Accepted: 06/12/2020] [Indexed: 12/03/2022]
Affiliation(s)
- Lucia Sideli
- Department of Psychosis Studies, Institute of Psychiatry, Psychology and Neurosceince, King's College London, De Crespigny Park, Denmark Hill, London, United Kingdom
| | - Giulia Trotta
- Department of Psychosis Studies, Institute of Psychiatry, Psychology and Neurosceince, King's College London, De Crespigny Park, Denmark Hill, London, United Kingdom
| | - Edoardo Spinazzola
- Department of Psychosis Studies, Institute of Psychiatry, Psychology and Neurosceince, King's College London, De Crespigny Park, Denmark Hill, London, United Kingdom
- Department of Neuroscience, Mental Health, and Sensory Organs (NeSMOS), Faculty of Medicine and Psychology, Sapienza University, Rome, Italy
| | - Caterina La Cascia
- Department of Biomedicine, Neuroscience and Advanced Diagnostic, Palermo University, Palermo, Italy
| | - Marta Di Forti
- Social, Genetic and Developmental Psychiatry Centre, Institute of Psychiatry, Psychology and Neuroscience, King's College London, London, United Kingdom
- National Institute for Health Research (NIHR) Mental Health Biomedical Research Centre at South London and Maudsley NHS Foundation Trust and King's College London, London, United Kingdom
- South London and Maudsley NHS Mental Health Foundation Trust, London, United Kingdom
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4
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Blest‐Hopley G, O'Neill A, Wilson R, Giampietro V, Lythgoe D, Egerton A, Bhattacharyya S. Adolescent-onset heavy cannabis use associated with significantly reduced glial but not neuronal markers and glutamate levels in the hippocampus. Addict Biol 2020; 25:e12827. [PMID: 31478302 DOI: 10.1111/adb.12827] [Citation(s) in RCA: 9] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/22/2019] [Revised: 08/14/2019] [Accepted: 08/15/2019] [Indexed: 12/18/2022]
Abstract
Cannabis use has been associated with adverse mental health outcomes, the neurochemical underpinnings of which are poorly understood. Although preclinical evidence suggests glutamatergic dysfunction following cannabis exposure in several brain regions including the hippocampus, evidence from human studies have been inconsistent. We investigated the effect of persistent cannabis use on the brain levels of N-acetyl aspartate (NAA) and myoinositol, the metabolite markers of neurons and glia, the site of the main central cannabinoid CB1 receptor, and the levels of glutamate, the neurotransmitter directly affected by CB1 modulation. We investigated cannabis users (CUs) who started using during adolescence, the period of greatest vulnerability to cannabis effects and focused on the hippocampus, where type 1 cannabinoid receptors (CBR1) are expressed in high density and have been linked to altered glutamatergic neurotransmission. Twenty-two adolescent-onset CUs and 21 nonusing controls (NU), completed proton magnetic resonance spectroscopy, to measure hippocampal metabolite concentrations. Glutamate, NAA, and myoinositol levels were compared between CU and NU using separate analyses of covariance. CU had significantly lower myoinositol but not glutamate or NAA levels in the hippocampus compared with NU. Myoinositol levels in CU positively correlated with glutamate levels, whereas this association was absent in NU. Altered myoinositol levels may be a marker of glia dysfunction and is consistent with experimental preclinical evidence that cannabinoid-induced glial dysfunction may underlie cannabinoid-induced memory impairments. Future studies using appropriate imaging techniques such as positron emission tomography should investigate whether glial dysfunction associated with cannabis use underlies hippocampal dysfunction and memory impairment in CUs.
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Affiliation(s)
- Grace Blest‐Hopley
- Department of Psychosis Studies, Institute of Psychiatry, Psychology and Neuroscience King's College London London UK
| | - Aisling O'Neill
- Department of Psychosis Studies, Institute of Psychiatry, Psychology and Neuroscience King's College London London UK
| | - Robin Wilson
- Department of Psychosis Studies, Institute of Psychiatry, Psychology and Neuroscience King's College London London UK
| | - Vincent Giampietro
- Department of Neuroimaging, Institute of Psychiatry, Psychology and Neuroscience King's College London London UK
| | - David Lythgoe
- Department of Neuroimaging, Institute of Psychiatry, Psychology and Neuroscience King's College London London UK
| | - Alice Egerton
- Department of Psychosis Studies, Institute of Psychiatry, Psychology and Neuroscience King's College London London UK
| | - Sagnik Bhattacharyya
- Department of Psychosis Studies, Institute of Psychiatry, Psychology and Neuroscience King's College London London UK
- South London and Maudsley NHS Foundation Trust London UK
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5
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Kynurenines and the Endocannabinoid System in Schizophrenia: Common Points and Potential Interactions. Molecules 2019; 24:molecules24203709. [PMID: 31619006 PMCID: PMC6832375 DOI: 10.3390/molecules24203709] [Citation(s) in RCA: 15] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/30/2019] [Revised: 10/09/2019] [Accepted: 10/14/2019] [Indexed: 12/15/2022] Open
Abstract
Schizophrenia, which affects around 1% of the world’s population, has been described as a complex set of symptoms triggered by multiple factors. However, the exact background mechanisms remain to be explored, whereas therapeutic agents with excellent effectivity and safety profiles have yet to be developed. Kynurenines and the endocannabinoid system (ECS) play significant roles in both the development and manifestation of schizophrenia, which have been extensively studied and reviewed previously. Accordingly, kynurenines and the ECS share multiple features and mechanisms in schizophrenia, which have yet to be reviewed. Thus, the present study focuses on the main common points and potential interactions between kynurenines and the ECS in schizophrenia, which include (i) the regulation of glutamatergic/dopaminergic/γ-aminobutyric acidergic neurotransmission, (ii) their presence in astrocytes, and (iii) their role in inflammatory mechanisms. Additionally, promising pharmaceutical approaches involving the kynurenine pathway and the ECS will be reviewed herein.
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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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Abstract
The main goal of our study was to investigate the association between psychotic-like experiences, aberrant salience, and cannabis use in a nonclinical sample of Belgian students. The participants were asked to complete a self-report questionnaire on cannabis use. The Community Assessment of Psychic Experiences and the Aberrant Salience Inventory were used to assess psychotic-like experiences and aberrant salience. The final sample was of 257 students. Cannabis users showed significantly higher Aberrant Salience Inventory score and, concerning the Community Assessment of Psychic Experiences, higher total, positive, and negative dimension scores. Years of cannabis use and frequency of use showed a positive correlation with Aberrant Salience Inventory score. Our results support the evidence that cannabis use is associated with an increased rate of psychotic experiences in individuals without a clinical form of psychosis. Future studies are required to better investigate the meaning of the association between cannabis use, psychotic-like experiences, and aberrant salience.
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8
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Ingebretson AE, Hearing MC, Huffington ED, Thomas MJ. Endogenous dopamine and endocannabinoid signaling mediate cocaine-induced reversal of AMPAR synaptic potentiation in the nucleus accumbens shell. Neuropharmacology 2018; 131:154-165. [PMID: 29225042 DOI: 10.1016/j.neuropharm.2017.12.011] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/05/2017] [Revised: 11/28/2017] [Accepted: 12/05/2017] [Indexed: 12/14/2022]
Abstract
Repeated exposure to drugs of abuse alters the structure and function of neural circuits mediating reward, generating maladaptive plasticity in circuits critical for motivated behavior. Within meso-corticolimbic dopamine circuitry, repeated exposure to cocaine induces progressive alterations in AMPAR-mediated glutamatergic synaptic transmission. During a 10-14 day period of abstinence from cocaine, AMPAR signaling is potentiated at synapses on nucleus accumbens (NAc) medium spiny neurons (MSNs), promoting a state of heightened synaptic excitability. Re-exposure to cocaine during abstinence, however, rapidly reverses and depotentiates enhanced AMPAR signaling. To understand how re-exposure to cocaine alters AMPAR synaptic transmission, we investigated the roles of dopamine and endocannabinoid (eCB) signaling in modifying synaptic strength in the NAc shell. Using patch-clamp recordings from NAc slices prepared after 10-14 days of abstinence from repeated cocaine, we found that AMPAR-mediated depotentiation is rapidly induced in the NAc shell within 20 min of cocaine re-exposure ex vivo, and persists for up to five days before synapses return to levels of potentiation observed during abstinence. In cocaine-treated animals, global dopamine receptor activation was both necessary and sufficient for the cocaine-evoked depotentiation of AMPAR synaptic function. Additionally, we identified that CB1 receptors are engaged by endogenous endocannabinoids (eCBs) during re-exposure to cocaine ex vivo. Overall, these results indicate the central role that dopamine and eCB signaling mechanisms play in modulating cocaine-induced AMPAR plasticity in the NAc shell.
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Affiliation(s)
- Anna E Ingebretson
- Department of Neuroscience, University of Minnesota, 321 Church St. S.E., Minneapolis, MN, 55455, USA
| | - Matthew C Hearing
- Department of Neuroscience, University of Minnesota, 321 Church St. S.E., Minneapolis, MN, 55455, USA; Department of Biomedical Sciences, Marquette University, Milwaukee, WI, 53233, USA
| | - Ethan D Huffington
- Department of Neuroscience, University of Minnesota, 321 Church St. S.E., Minneapolis, MN, 55455, USA
| | - Mark J Thomas
- Department of Neuroscience, University of Minnesota, 321 Church St. S.E., Minneapolis, MN, 55455, USA; Department of Psychology, University of Minnesota, 75 E River Road, Minneapolis, MN 55455, USA.
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Frissen A, van Os J, Peeters S, Gronenschild E, Marcelis M. Evidence that reduced gray matter volume in psychotic disorder is associated with exposure to environmental risk factors. Psychiatry Res Neuroimaging 2018; 271:100-110. [PMID: 29174764 DOI: 10.1016/j.pscychresns.2017.11.004] [Citation(s) in RCA: 15] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/16/2017] [Revised: 10/26/2017] [Accepted: 11/10/2017] [Indexed: 10/18/2022]
Abstract
The aim of this study was to examine whether cannabis use, childhood trauma and urban upbringing are associated with total gray matter volume (GMV) in individuals with (risk for) psychotic disorder and whether this is sex-specific. T1-weighted MRI scans were acquired from 89 patients with a psychotic disorder, 95 healthy siblings of patients with psychotic disorder and 87 controls. Multilevel random regression analyses were used to examine main effects and interactions between group, sex and environmental factors in models of GMV. The three-way interaction between group, sex and cannabis (χ2 =12.43, p<0.01), as well as developmental urbanicity (χ2 = 6.29, p = 0.01) were significant, indicating that cannabis use and developmental urbanicity were associated with lower GMV in the male patient group (cannabis: B= -32.54, p < 0.01; developmental urbanicity: B= -10.23, p=0.03). For childhood trauma, the two-way interaction with group was significant (χ2 = 5.74, p = 0.02), indicating that childhood trauma was associated with reduced GMV in the patient group (B=-9.79, p=0.01). The findings suggest that reduction of GMV in psychotic disorder may be the outcome of differential sensitivity to environmental risks, particularly in male patients.
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Affiliation(s)
- Aleida Frissen
- Department of Psychiatry and Neuropsychology, Maastricht University, The Netherlands
| | - Jim van Os
- Department of Psychiatry and Neuropsychology, Maastricht University, The Netherlands; King's College London, King's Health Partners, Department of Psychosis Studies, Institute of Psychiatry, London, United Kingdom
| | - Sanne Peeters
- Department of Psychiatry and Neuropsychology, Maastricht University, The Netherlands
| | - Ed Gronenschild
- Department of Psychiatry and Neuropsychology, Maastricht University, The Netherlands
| | - Machteld Marcelis
- Department of Psychiatry and Neuropsychology, Maastricht University, The Netherlands; Institute for Mental Health Care Eindhoven (GGzE), Eindhoven, The Netherlands.
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Perdikaris P, Tsarouchi M, Fanarioti E, Natsaridis E, Mitsacos A, Giompres P. Long lasting effects of chronic WIN55,212-2 treatment on mesostriatal dopaminergic and cannabinoid systems in the rat brain. Neuropharmacology 2017; 129:1-15. [PMID: 29113897 DOI: 10.1016/j.neuropharm.2017.11.005] [Citation(s) in RCA: 12] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/21/2017] [Revised: 10/16/2017] [Accepted: 11/03/2017] [Indexed: 01/14/2023]
Abstract
Cannabinoid administration modulates dopamine transmission via an indirect, multisynaptic mechanism that includes the activation of cannabinoid type-1 receptor (CB1R). The present study evaluated in rodents, the effects of acute and chronic (20 days) WIN55,212-2 administration, a non-selective CB1R agonist, on dopamine uptake and synthesis in the mesolimbic and nigrostriatal dopaminergic pathways and associate them to its effects on the endocannabinoid system. The effect of spontaneous withdrawal, after different abstinence periods (7 days, 20 days), was also assessed. Acute and chronic administration of WIN55,212-2 decreased dopamine transporter (DAT) binding and mRNA levels, as well as tyrosine hydroxylase (TH) mRNA expression in the substantia nigra (SN) and ventral tegmental area (VTA). In the striatum, chronic WIN55,212-2 administration led to decreased protein expression of DAT and TH, whereas no alterations were observed after acute administration, suggesting a diminished dopamine uptake and synthesis after chronic agonist treatment. Furthermore, after chronic agonist treatment, we observed reduced CB1R binding and mRNA levels in SN and striatum, providing evidence for a possible regulatory role of the endocannabinoid system on dopaminergic function. Seven days after WIN55,212-2 cessation, we observed a rebound increase in mRNA, binding and total protein levels of DAT and TH in VTA, SN and striatum proposing the existence of a biphasic expression pattern, which was also observed in CB1R binding levels. Within the 20-day period of abstinence, TH mRNA and protein levels and CB1R binding levels remain increased. The above results indicate that chronic CB1R agonist treatment induces long-lasting control of the mesostriatal dopaminergic activity.
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Affiliation(s)
- Panagiotis Perdikaris
- Laboratory of Human and Animal Physiology, Department of Biology, University of Patras, Patras, Greece
| | - Martha Tsarouchi
- Laboratory of Human and Animal Physiology, Department of Biology, University of Patras, Patras, Greece
| | - Eleni Fanarioti
- Laboratory of Human and Animal Physiology, Department of Biology, University of Patras, Patras, Greece
| | - Evangelos Natsaridis
- Laboratory of Human and Animal Physiology, Department of Biology, University of Patras, Patras, Greece
| | - Ada Mitsacos
- Laboratory of Physiology, Department of Medicine, University of Patras, Patras, Greece
| | - Panagiotis Giompres
- Laboratory of Human and Animal Physiology, Department of Biology, University of Patras, Patras, Greece.
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Cannabidiol Counteracts Amphetamine-Induced Neuronal and Behavioral Sensitization of the Mesolimbic Dopamine Pathway through a Novel mTOR/p70S6 Kinase Signaling Pathway. J Neurosci 2017; 36:5160-9. [PMID: 27147666 DOI: 10.1523/jneurosci.3387-15.2016] [Citation(s) in RCA: 95] [Impact Index Per Article: 13.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/08/2015] [Accepted: 02/25/2016] [Indexed: 12/13/2022] Open
Abstract
UNLABELLED Schizophrenia-related psychosis is associated with disturbances in mesolimbic dopamine (DA) transmission, characterized by hyperdopaminergic activity in the mesolimbic pathway. Currently, the only clinically effective treatment for schizophrenia involves the use of antipsychotic medications that block DA receptor transmission. However, these medications produce serious side effects leading to poor compliance and treatment outcomes. Emerging evidence points to the involvement of a specific phytochemical component of marijuana called cannabidiol (CBD), which possesses promising therapeutic properties for the treatment of schizophrenia-related psychoses. However, the neuronal and molecular mechanisms through which CBD may exert these effects are entirely unknown. We used amphetamine (AMPH)-induced sensitization and sensorimotor gating in rats, two preclinical procedures relevant to schizophrenia-related psychopathology, combined with in vivo single-unit neuronal electrophysiology recordings in the ventral tegmental area, and molecular analyses to characterize the actions of CBD directly in the nucleus accumbens shell (NASh), a brain region that is the current target of most effective antipsychotics. We demonstrate that Intra-NASh CBD attenuates AMPH-induced sensitization, both in terms of DAergic neuronal activity measured in the ventral tegmental area and psychotomimetic behavioral analyses. We further report that CBD controls downstream phosphorylation of the mTOR/p70S6 kinase signaling pathways directly within the NASh. Our findings demonstrate a novel mechanism for the putative antipsychotic-like properties of CBD in the mesolimbic circuitry. We identify the molecular signaling pathways through which CBD may functionally reduce schizophrenia-like neuropsychopathology. SIGNIFICANCE STATEMENT The cannabis-derived phytochemical, cannabidiol (CBD), has been shown to have pharmacotherapeutic efficacy for the treatment of schizophrenia. However, the mechanisms by which CBD may produce antipsychotic effects are entirely unknown. Using preclinical behavioral procedures combined with molecular analyses and in vivo neuronal electrophysiology, our findings identify a functional role for the nucleus accumbens as a critical brain region whereby CBD can produce effects similar to antipsychotic medications by triggering molecular signaling pathways associated with the effects of classic antipsychotic medications. Specifically, we report that CBD can attenuate both behavioral and dopaminergic neuronal correlates of mesolimbic dopaminergic sensitization, via a direct interaction with mTOR/p70S6 kinase signaling within the mesolimbic pathway.
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12
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Morales-Muñoz I, Martínez-Gras I, Ponce G, de la Cruz J, Lora D, Rodríguez-Jiménez R, Jurado-Barba R, Navarrete F, García-Gutiérrez MS, Manzanares J, Rubio G. Psychological symptomatology and impaired prepulse inhibition of the startle reflex are associated with cannabis-induced psychosis. J Psychopharmacol 2017. [PMID: 28648138 DOI: 10.1177/0269881117711920] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 01/18/2023]
Abstract
BACKGROUND Cannabis-induced psychotic disorder (CIPD) is a psychiatric disorder induced by cannabis consumption. The psychological and psychophysiological features of this disorder are still unknown. We aimed to examine the psychological, personality and psychophysiological features of patients with CIPD. This study is an analytical extension of our previously published data, which previously found prepulse inhibition (PPI) deficits in the CIPD group used in this current paper. METHODS We used a sample of 45 patients with CIPD. After 9 months of follow up, these patients were assessed with a Symptom Checklist-90-R (SCL-90-R) questionnaire of psychopathology, with the Eysenck Personality Questionnaire, and with a psychophysiological paradigm of inhibition of the startle reflex (PPI). These results were compared with a group of patients with schizophrenia and cannabis abuse (SCHZ) ( n = 54); patients with cannabis dependence (CD) ( n = 21); and healthy controls ( n = 50). RESULTS CIPD patients obtained significant higher scores in the SCL-90-R subscale of neuroticism. These patients showed PPI percentages similar to SCHZ patients within early attentional levels (30 ms). The variables with greater correlation, and that appeared in the CIPD group were interpersonal sensitivity, depression and phobia. CONCLUSIONS Neurotic symptomatology and difficulties in inhibition of the startle reflex might be risk factors for developing CIPD.
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Affiliation(s)
- Isabel Morales-Muñoz
- 1 Department of Health, National Institute for Health and Welfare (THL), Helsinki, Finland.,2 Research Institute 12-i, Madrid, Spain
| | - Isabel Martínez-Gras
- 2 Research Institute 12-i, Madrid, Spain.,3 Hospital Universitario 12 de Octubre, Madrid, Spain.,4 Department of Psychiatry, Complutense University of Madrid, Madrid, Spain.,5 Red temática de Investigación cooperativa en salud (RETIS-Trastornos adictivos), Instituto Carlos III, MICINN and FEDER, Madrid, Spain
| | - Guillermo Ponce
- 2 Research Institute 12-i, Madrid, Spain.,3 Hospital Universitario 12 de Octubre, Madrid, Spain.,4 Department of Psychiatry, Complutense University of Madrid, Madrid, Spain.,5 Red temática de Investigación cooperativa en salud (RETIS-Trastornos adictivos), Instituto Carlos III, MICINN and FEDER, Madrid, Spain
| | - Javier de la Cruz
- 2 Research Institute 12-i, Madrid, Spain.,3 Hospital Universitario 12 de Octubre, Madrid, Spain
| | - David Lora
- 6 Clinical Research Unit (i+12), Hospital Universitario 12 de Octubre, Madrid, Spain.,7 CIBER de Epidemiología y Salud Pública (CIBERESP), Madrid, Spain
| | - Roberto Rodríguez-Jiménez
- 2 Research Institute 12-i, Madrid, Spain.,3 Hospital Universitario 12 de Octubre, Madrid, Spain.,4 Department of Psychiatry, Complutense University of Madrid, Madrid, Spain.,8 Biomedical Research Center Network for Mental Health (CIBERSAM), Madrid, Spain
| | - Rosa Jurado-Barba
- 2 Research Institute 12-i, Madrid, Spain.,3 Hospital Universitario 12 de Octubre, Madrid, Spain.,8 Biomedical Research Center Network for Mental Health (CIBERSAM), Madrid, Spain
| | - Francisco Navarrete
- 5 Red temática de Investigación cooperativa en salud (RETIS-Trastornos adictivos), Instituto Carlos III, MICINN and FEDER, Madrid, Spain.,9 Institute for Neurosciences, Miguel Hernández University-CSIC, Alicante, Spain
| | - María Salud García-Gutiérrez
- 5 Red temática de Investigación cooperativa en salud (RETIS-Trastornos adictivos), Instituto Carlos III, MICINN and FEDER, Madrid, Spain.,9 Institute for Neurosciences, Miguel Hernández University-CSIC, Alicante, Spain
| | - Jorge Manzanares
- 5 Red temática de Investigación cooperativa en salud (RETIS-Trastornos adictivos), Instituto Carlos III, MICINN and FEDER, Madrid, Spain.,9 Institute for Neurosciences, Miguel Hernández University-CSIC, Alicante, Spain
| | - Gabriel Rubio
- 2 Research Institute 12-i, Madrid, Spain.,3 Hospital Universitario 12 de Octubre, Madrid, Spain.,4 Department of Psychiatry, Complutense University of Madrid, Madrid, Spain.,5 Red temática de Investigación cooperativa en salud (RETIS-Trastornos adictivos), Instituto Carlos III, MICINN and FEDER, Madrid, Spain
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13
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McHugh MJ, McGorry PD, Yung AR, Lin A, Wood SJ, Hartmann JA, Nelson B. Cannabis-induced attenuated psychotic symptoms: implications for prognosis in young people at ultra-high risk for psychosis. Psychol Med 2017; 47:616-626. [PMID: 27821204 DOI: 10.1017/s0033291716002671] [Citation(s) in RCA: 33] [Impact Index Per Article: 4.7] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/06/2022]
Abstract
BACKGROUND Cannabis use shows a robust dose-dependent relationship with psychosis risk among the general population. Despite this, it has been difficult to link cannabis use with risk for transitioning to a psychotic disorder among individuals at ultra-high risk (UHR) for psychosis. The present study examined UHR transition risk as a function of cannabis use characteristics which vary substantially between individuals including age of first use, cannabis abuse severity and a history of cannabis-induced attenuated psychotic symptoms (APS). METHOD Participants were 190 UHR individuals (76 males) recruited at entry to treatment between 2000 and 2006. They completed a comprehensive baseline assessment including a survey of cannabis use characteristics during the period of heaviest use. Outcome was transition to a psychotic disorder, with mean time to follow-up of 5.0 years (range 2.4-8.7 years). RESULTS A history of cannabis abuse was reported in 58% of the sample. Of these, 26% reported a history of cannabis-induced APS. These individuals were 4.90 (95% confidence interval 1.93-12.44) times more likely to transition to a psychotic disorder (p = 0.001). Greater severity of cannabis abuse also predicted transition to psychosis (p = 0.036). However, this effect was mediated by higher abuse severity among individuals with a history of cannabis-induced APS. CONCLUSIONS Findings suggest that cannabis use poses risk in a subpopulation of UHR individuals who manifest cannabis-induced APS. Whether this reflects underlying genetic vulnerability requires further study. Nevertheless, findings reveal an important early marker of risk with potentially significant prognostic utility for UHR individuals.
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Affiliation(s)
- M J McHugh
- Orygen,The National Centre for Excellence in Youth Mental Health,35 Poplar Road,Parkville,VIC 3052,Australia
| | - P D McGorry
- Orygen,The National Centre for Excellence in Youth Mental Health,35 Poplar Road,Parkville,VIC 3052,Australia
| | - A R Yung
- Institute of Brain, Behaviour and Mental Health,University of Manchester,Manchester,UK
| | - A Lin
- Telethon Kids Institute,University of Western Australia,WA 6008,Australia
| | - S J Wood
- Orygen,The National Centre for Excellence in Youth Mental Health,35 Poplar Road,Parkville,VIC 3052,Australia
| | - J A Hartmann
- Orygen,The National Centre for Excellence in Youth Mental Health,35 Poplar Road,Parkville,VIC 3052,Australia
| | - B Nelson
- Orygen,The National Centre for Excellence in Youth Mental Health,35 Poplar Road,Parkville,VIC 3052,Australia
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14
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Duman B, Sedes N, Baskak B. Additive Effects of Former Methylenedioxymethamphetamine and Cannabis Use on Subclinical Psychotic Symptoms. Noro Psikiyatr Ars 2017; 54:38-42. [PMID: 28566957 DOI: 10.5152/npa.2017.16964] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/23/2016] [Accepted: 04/15/2016] [Indexed: 01/07/2023] Open
Abstract
INTRODUCTION Methylenedioxymethamphetamine (MDMA) is an amphetamine-derived psychostimulant, usually known as "ecstasy." The long-term neuropsychological effects of MDMA are examined in several studies with conflicting results. The most common findings reported are depression, anxiety, and memory and attention deficits. In addition to acute psychotic reactions observed after MDMA use, serotonergic and dopaminergic toxicities may increase the psychosis risk in the long-term. Cannabis usage among MDMA users is very high. The aim of this study was, therefore, to examine the additive effects of cannabis and MDMA on subclinical psychotic symptoms (SPS). METHODS Here, 131 healthy controls (hC), 54 former cannabis and MDMA users (C&M), and 46 former cannabis users (C) were evaluated for SPS. The definition of former user was based on the Munich Composite International Diagnostic Interview. The SPS scores were assessed by using the Schizotypal Personality Questionnaire (SPQ). The relationship between substance-free periods and total MDMA exposure with SPS was also examined. RESULTS The C&M group had higher levels of SPS than both C and hC groups. This is true not only for the total SPQ scores but both positive and negative schizotypy scores as well as cognitive-perceptual, disorganized, and interpersonal schizotypy scores aligned hierarchically in the 3 study groups (C&M>C>hC). The total MDMA exposure was positively correlated and MDMA-free period was negatively correlated with the SPS score. CONCLUSION We found that the former use of cannabis and MDMA is associated with marked elevation in SPS. Moreover, the exposure amount of MDMA and MDMA-free periods are important determinants of SPS. The longer the cannabis and ecstasy free periods, the larger is the waning of SPS.
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Affiliation(s)
- Berker Duman
- Department of Psychiatry, Ankara University School of Medicine, Ankara, Turkey
| | - Nilay Sedes
- Department of Psychiatry, Ankara University School of Medicine, Ankara, Turkey
| | - Bora Baskak
- Department of Psychiatry, Ankara University School of Medicine, Ankara, Turkey
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15
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Frissen A, van Os J, Lieverse R, Habets P, Gronenschild E, Marcelis M. No Evidence of Association between Childhood Urban Environment and Cortical Thinning in Psychotic Disorder. PLoS One 2017; 12:e0166651. [PMID: 28045900 PMCID: PMC5207533 DOI: 10.1371/journal.pone.0166651] [Citation(s) in RCA: 10] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/12/2016] [Accepted: 11/01/2016] [Indexed: 12/23/2022] Open
Abstract
Background The alterations in cortical morphology, such as cortical thinning, observed in psychotic disorder, may be the outcome of interacting genetic and environmental effects. It has been suggested that urban upbringing may represent a proxy environmental effect impacting cortical thickness (CT). Therefore, the current study examined whether the association between group as a proxy genetic variable (patients with psychotic disorder [high genetic risk], healthy siblings of patients [intermediate risk] and healthy control subjects [average risk]) and CT was conditional on different levels of the childhood urban environment and whether this was sex-dependent. Methods T1-weighted MRI scans were acquired from 89 patients with a psychotic disorder, 95 non-psychotic siblings of patients with psychotic disorder and 87 healthy control subjects. Freesurfer software was used to measure CT. Developmental urban exposure was classified as low, medium, and high, reflecting the population density and the number of moves between birth and the 15th birthday, using data from the Dutch Central Bureau of Statistics and the equivalent database in Belgium. Multilevel regression analyses were used to examine the association between group, sex, and urban upbringing (as well as their interactions) and cortical CT as the dependent variable. Results CT was significantly smaller in the patient group compared to the controls (B = -0.043, p <0.001), but not in the siblings compared to the controls (B = -0.013, p = 0.31). There was no main effect of developmental urbanicity on CT (B = 0.001, p = 0.91). Neither the three-way group × urbanicity × sex interaction (χ2 = 3.73, p = 0.16), nor the two-way group × urbanicity interaction was significant (χ2 = 0.51, p = 0.77). Conclusion The negative association between (familial risk for) psychotic disorder and CT was not moderated by developmental urbanicity, suggesting that reduced CT is not the outcome of familial sensitivity to the proxy environmental factor ‘urban upbringing’.
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Affiliation(s)
- Aleida Frissen
- Department of Psychiatry and Psychology, Maastricht University, Maastricht, The Netherlands
| | - Jim van Os
- Department of Psychiatry and Psychology, Maastricht University, Maastricht, The Netherlands
- King’s College London, King’s Health Partners, Department of Psychosis Studies, Institute of Psychiatry, London, United Kingdom
| | - Ritsaert Lieverse
- Department of Psychiatry and Psychology, Maastricht University, Maastricht, The Netherlands
| | - Petra Habets
- Department of Psychiatry and Psychology, Maastricht University, Maastricht, The Netherlands
| | - Ed Gronenschild
- Department of Psychiatry and Psychology, Maastricht University, Maastricht, The Netherlands
| | - Machteld Marcelis
- Department of Psychiatry and Psychology, Maastricht University, Maastricht, The Netherlands
- Institute for Mental Health Care Eindhoven (GGzE), Eindhoven, The Netherlands
- * E-mail:
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16
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Mhalla A, Ben Mohamed B, Correll CU, Amamou B, Mechri A, Gaha L. Neurological soft signs in Tunisian patients with first-episode psychosis and relation with cannabis use. Ann Gen Psychiatry 2017; 16:30. [PMID: 28717382 PMCID: PMC5508788 DOI: 10.1186/s12991-017-0153-3] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/13/2016] [Accepted: 07/01/2017] [Indexed: 12/12/2022] Open
Abstract
BACKGROUND Neurological soft signs (NSS) are minor non-localizing neurological abnormalities that are conceptualized as neurodevelopmental markers that mediate the biological risk for psychosis. We aimed to explore the relationship between NSS and cannabis use, an environmental risk factor of psychosis. METHODS This was a cross-sectional study in consecutively admitted patients hospitalized for first-episode psychosis. NSS were assessed by the NSS scale (23 items exploring motor coordination, motor integrative function, sensory integration, involuntary movements or posture, quality of lateralization). Presence of NSS was defined as a NSS scale total score ≥9.5. Cannabis use was ascertained with the cannabis subsection in the Composite International Diagnostic Interview. RESULTS Among 61 first-episode psychosis patients (mean age = 28.9 ± 9.4 years; male = 86.9%, antipsychotic-naïve = 75.4%), the prevalence of current cannabis use was 14.8% (heavy use = 8.2%, occasional use = 6.6%). NSS were present in 83.6% of the sample (cannabis users = 66.7% versus cannabis non-users = 85.5%, p = 0.16). The mean total NSS score was 15.3 ± 6.7, with a significant lower total NSS score in cannabis users (11.2 ± 5.6 versus 16.0 ± 6.7, p = 0.048). Differences were strongest for the "motor coordination" (p = 0.06) and "involuntary movements" (p = 0.07) sub-scores. CONCLUSIONS This study demonstrated a negative association between cannabis use and NSS, especially regarding motor discoordination. This finding supports the hypothesis that a strong environmental risk factor, such as cannabis, may contribute to the onset of psychosis even in the presence of lower biological and genetic vulnerability, as reflected indirectly by lower NSS scores. Nevertheless, additional studies are needed that explore this interaction further in larger samples and considering additional neurobiological and environmental risk factors.
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Affiliation(s)
- Ahmed Mhalla
- Psychiatry Department, Fattouma Bourguiba Hospital, 5000 Monastir, Tunisia.,Faculty of Medicine of Monastir, University of Monastir, Monastir, Tunisia
| | - Bochra Ben Mohamed
- Psychiatry Department, Fattouma Bourguiba Hospital, 5000 Monastir, Tunisia.,Faculty of Medicine of Monastir, University of Monastir, Monastir, Tunisia
| | - Christoph U Correll
- Department of Psychiatry, The Zucker Hillside Hospital, Glen Oaks, NY USA.,Department of Psychiatry and Molecular Medicine, Hofstra Northwell School of Medicine, Hempstead, NY USA.,Center for Psychiatric Neuroscience, Feinstein Institute for Medical Research, Manhasset, NY USA
| | - Badii Amamou
- Psychiatry Department, Fattouma Bourguiba Hospital, 5000 Monastir, Tunisia.,Faculty of Medicine of Monastir, University of Monastir, Monastir, Tunisia
| | - Anouar Mechri
- Psychiatry Department, Fattouma Bourguiba Hospital, 5000 Monastir, Tunisia.,Faculty of Medicine of Monastir, University of Monastir, Monastir, Tunisia
| | - Lotfi Gaha
- Psychiatry Department, Fattouma Bourguiba Hospital, 5000 Monastir, Tunisia.,Faculty of Medicine of Monastir, University of Monastir, Monastir, Tunisia
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17
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Howes OD, McCutcheon R, Owen MJ, Murray RM. The Role of Genes, Stress, and Dopamine in the Development of Schizophrenia. Biol Psychiatry 2017; 81:9-20. [PMID: 27720198 PMCID: PMC5675052 DOI: 10.1016/j.biopsych.2016.07.014] [Citation(s) in RCA: 334] [Impact Index Per Article: 47.7] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/21/2015] [Revised: 07/08/2016] [Accepted: 07/10/2016] [Indexed: 02/06/2023]
Abstract
The dopamine hypothesis is the longest standing pathoetiologic theory of schizophrenia. Because it was initially based on indirect evidence and findings in patients with established schizophrenia, it was unclear what role dopamine played in the onset of the disorder. However, recent studies in people at risk of schizophrenia have found elevated striatal dopamine synthesis capacity and increased dopamine release to stress. Furthermore, striatal dopamine changes have been linked to altered cortical function during cognitive tasks, in line with preclinical evidence that a circuit involving cortical projections to the striatum and midbrain may underlie the striatal dopamine changes. Other studies have shown that a number of environmental risk factors for schizophrenia, such as social isolation and childhood trauma, also affect presynaptic dopaminergic function. Advances in preclinical work and genetics have begun to unravel the molecular architecture linking dopamine, psychosis, and psychosocial stress. Included among the many genes associated with risk of schizophrenia are the gene encoding the dopamine D2 receptor and those involved in the upstream regulation of dopaminergic synthesis, through glutamatergic and gamma-aminobutyric acidergic pathways. A number of these pathways are also linked to the stress response. We review these new lines of evidence and present a model of how genes and environmental factors may sensitize the dopamine system so that it is vulnerable to acute stress, leading to progressive dysregulation and the onset of psychosis. Finally, we consider the implications for rational drug development, in particular regionally selective dopaminergic modulation, and the potential of genetic factors to stratify patients.
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Affiliation(s)
- Oliver D Howes
- Psychosis Studies, King's College London, London, United Kingdom; MRC Clinical Sciences Centre, Imperial College Hammersmith Hospital, London, United Kingdom.
| | - Robert McCutcheon
- Psychosis Studies, King's College London, London, United Kingdom; MRC Clinical Sciences Centre, Imperial College Hammersmith Hospital, London, United Kingdom
| | - Michael J Owen
- MRC Centre for Neuropsychiatric Genetics and Genomics, and Neuroscience and Mental Health Research Institute, Cardiff University, Cardiff, Wales, United Kingdom
| | - Robin M Murray
- Psychosis Studies, King's College London, London, United Kingdom
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18
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Gage SH, Hickman M, Zammit S. Association Between Cannabis and Psychosis: Epidemiologic Evidence. Biol Psychiatry 2016; 79:549-56. [PMID: 26386480 DOI: 10.1016/j.biopsych.2015.08.001] [Citation(s) in RCA: 213] [Impact Index Per Article: 26.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/31/2015] [Revised: 07/22/2015] [Accepted: 08/04/2015] [Indexed: 11/28/2022]
Abstract
Associations between cannabis use and psychotic outcomes are consistently reported, but establishing causality from observational designs can be problematic. We review the evidence from longitudinal studies that have examined this relationship and discuss the epidemiologic evidence for and against interpreting the findings as causal. We also review the evidence identifying groups at particularly high risk of developing psychosis from using cannabis. Overall, evidence from epidemiologic studies provides strong enough evidence to warrant a public health message that cannabis use can increase the risk of psychotic disorders. However, further studies are required to determine the magnitude of this effect, to determine the effect of different strains of cannabis on risk, and to identify high-risk groups particularly susceptible to the effects of cannabis on psychosis. We also discuss complementary epidemiologic methods that can help address these questions.
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Affiliation(s)
- Suzanne H Gage
- Medical Research Council Integrative Epidemiology Unit, University of Bristol, Bristol, United Kingdom.
| | - Matthew Hickman
- School of Social and Community Medicine, University of Bristol, Bristol, United Kingdom
| | - Stanley Zammit
- School of Social and Community Medicine, University of Bristol, Bristol, United Kingdom
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19
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Colizzi M, McGuire P, Pertwee RG, Bhattacharyya S. Effect of cannabis on glutamate signalling in the brain: A systematic review of human and animal evidence. Neurosci Biobehav Rev 2016; 64:359-81. [PMID: 26987641 DOI: 10.1016/j.neubiorev.2016.03.010] [Citation(s) in RCA: 102] [Impact Index Per Article: 12.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/18/2016] [Revised: 03/09/2016] [Accepted: 03/11/2016] [Indexed: 01/04/2023]
Abstract
Use of cannabis or delta-9-tetrahydrocannabinol (Δ9-THC), its main psychoactive ingredient, is associated with psychotic symptoms or disorder. However, the neurochemical mechanism that may underlie this psychotomimetic effect is poorly understood. Although dopaminergic dysfunction is generally recognized as the final common pathway in psychosis, evidence of the effects of Δ9-THC or cannabis use on dopaminergic measures in the brain is equivocal. In fact, it is thought that cannabis or Δ9-THC may not act on dopamine firing directly but indirectly by altering glutamate neurotransmission. Here we systematically review all studies examining acute and chronic effects of cannabis or Δ9-THC on glutamate signalling in both animals and man. Limited research carried out in humans tends to support the evidence that chronic cannabis use reduces levels of glutamate-derived metabolites in both cortical and subcortical brain areas. Research in animals tends to consistently suggest that Δ9-THC depresses glutamate synaptic transmission via CB1 receptor activation, affecting glutamate release, inhibiting receptors and transporters function, reducing enzyme activity, and disrupting glutamate synaptic plasticity after prolonged exposure.
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Affiliation(s)
- Marco Colizzi
- Department of Psychosis Studies, Institute of Psychiatry, Psychology and Neuroscience, King's College London, London SE5 8AF, United Kingdom
| | - Philip McGuire
- Department of Psychosis Studies, Institute of Psychiatry, Psychology and Neuroscience, King's College London, London SE5 8AF, United Kingdom
| | - Roger G Pertwee
- Institute of Medical Sciences, University of Aberdeen, Aberdeen AB25 2ZD, United Kingdom
| | - Sagnik Bhattacharyya
- Department of Psychosis Studies, Institute of Psychiatry, Psychology and Neuroscience, King's College London, London SE5 8AF, United Kingdom.
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20
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Sami MB, Rabiner EA, Bhattacharyya S. Does cannabis affect dopaminergic signaling in the human brain? A systematic review of evidence to date. Eur Neuropsychopharmacol 2015; 25:1201-24. [PMID: 26068702 DOI: 10.1016/j.euroneuro.2015.03.011] [Citation(s) in RCA: 45] [Impact Index Per Article: 5.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/20/2014] [Revised: 02/23/2015] [Accepted: 03/22/2015] [Indexed: 12/21/2022]
Abstract
A significant body of epidemiological evidence has linked psychotic symptoms with both acute and chronic use of cannabis. Precisely how these effects of THC are mediated at the neurochemical level is unclear. While abnormalities in multiple pathways may lead to schizophrenia, an abnormality in dopamine neurotransmission is considered to be the final common abnormality. One would thus expect cannabis use to be associated with dopamine signaling alterations. This is the first systematic review of all studies, both observational as well as experimental, examining the acute as well as chronic effect of cannabis or its main psychoactive ingredient, THC, on the dopamine system in man. We aimed to review all studies conducted in man, with any reported neurochemical outcomes related to the dopamine system after cannabis, cannabinoid or endocannabinoid administration or use. We identified 25 studies reporting outcomes on over 568 participants, of which 244 participants belonged to the cannabis/cannabinoid exposure group. In man, there is as yet little direct evidence to suggest that cannabis use affects acute striatal dopamine release or affects chronic dopamine receptor status in healthy human volunteers. However some work has suggested that acute cannabis exposure increases dopamine release in striatal and pre-frontal areas in those genetically predisposed for, or at clinical high risk of psychosis. Furthermore, recent studies are suggesting that chronic cannabis use blunts dopamine synthesis and dopamine release capacity. Further well-designed studies are required to definitively delineate the effects of cannabis use on the dopaminergic system in man.
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Affiliation(s)
- Musa Basser Sami
- Kent and Medway Partnership, NHS Trust, UK; Department of Psychosis Studies, Institute of Psychiatry, Psychology & Neuroscience, King׳s College London, De Crespigny Park, London SE5 8AF, UK
| | - Eugenii A Rabiner
- Centre for Neuroimaging Sciences, Institute of Psychiatry, Psychology & Neuroscience, King׳s College London, UK; Imanova, Centre for Imaging Sciences, London, UK
| | - Sagnik Bhattacharyya
- Department of Psychosis Studies, Institute of Psychiatry, Psychology & Neuroscience, King׳s College London, De Crespigny Park, London SE5 8AF, UK.
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21
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Impey D, El-Marj N, Parks A, Choueiry J, Fisher D, Knott VJ. Mismatch negativity in tobacco-naïve cannabis users and its alteration with acute nicotine administration. Pharmacol Biochem Behav 2015; 136:73-81. [PMID: 26188167 DOI: 10.1016/j.pbb.2015.07.002] [Citation(s) in RCA: 7] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/21/2015] [Revised: 06/30/2015] [Accepted: 07/03/2015] [Indexed: 11/29/2022]
Abstract
Chronic cannabis use may interact with factors, such as age of onset of cannabis use, family history, and genetic factors, to elicit schizophrenia (SZ)-like symptoms, including sensory and cognitive deficits. However, evidence of a relationship between cannabis use and cognitive impairment is confounded by concomitant use of tobacco. The objective of this study was to compare tobacco-naïve cannabis users with individuals without a history of tobacco/cannabis use on the auditory mismatch negativity (MMN) event-related potential (ERP), a neural measure of auditory deviance detection which is diminished in SZ. An exploratory arm of the study, conducted within a randomized, double-blind, placebo controlled design, examined the acute effects of nicotine gum (6mg) on MMN in cannabis users. MMN was recorded in response to 5 deviant stimuli within an optimal MMN paradigm in 44 healthy, non-tobacco smoking volunteers aged 18-26. Cannabis users (n=21) started smoking cannabis prior to age 17, at least 1 joint per month. To examine the effects of chronicity, users were grouped into relatively heavy long-term (HLT; n=11) users and light short-term (LST; n=10) users. Impaired deviance detection was shown in cannabis users vs. nonusers as reflected by a smaller MMN to duration deviants. Chronicity of use was also associated with MMN alterations, as HLTs displayed a reduced duration and gap MMN vs. LSTs. Compared with placebo, nicotine treatment enhanced select MMN deviants in cannabis user subgroups. As deficits associated with early and persistent cannabis use are similar to those seen in SZ, these dose-dependant disturbances in early sensory processing with cannabis use may be one cognitive pathway which mediates an increased risk for SZ in vulnerable youth, and be influenced by concurrent cigarette smoking behavior.
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Affiliation(s)
- Danielle Impey
- University of Ottawa Institute of Mental Health Research, Ottawa, ON, Canada; School of Psychology, University of Ottawa, Ottawa, ON, Canada.
| | - Nicole El-Marj
- School of Psychology, University of Ottawa, Ottawa, ON, Canada
| | - Andrea Parks
- Department of Biomedical Science, University of Ottawa, Ottawa, ON, Canada
| | - Joelle Choueiry
- Department of Cellular and Molecular Medicine, Neuroscience Program, University of Ottawa, Ottawa, ON, Canada
| | - Derek Fisher
- Department of Psychology, Mount Saint Vincent University, Halifax, Nova Scotia, Canada
| | - Verner J Knott
- University of Ottawa Institute of Mental Health Research, Ottawa, ON, Canada; School of Psychology, University of Ottawa, Ottawa, ON, Canada; Department of Biomedical Science, University of Ottawa, Ottawa, ON, Canada; Department of Cellular and Molecular Medicine, Neuroscience Program, University of Ottawa, Ottawa, ON, Canada
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22
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Bhattacharyya S, Falkenberg I, Martin-Santos R, Atakan Z, Crippa JA, Giampietro V, Brammer M, McGuire P. Cannabinoid modulation of functional connectivity within regions processing attentional salience. Neuropsychopharmacology 2015; 40:1343-52. [PMID: 25249057 PMCID: PMC4397391 DOI: 10.1038/npp.2014.258] [Citation(s) in RCA: 88] [Impact Index Per Article: 9.8] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/08/2014] [Revised: 05/18/2014] [Accepted: 06/12/2014] [Indexed: 12/31/2022]
Abstract
There is now considerable evidence to support the hypothesis that psychotic symptoms are the result of abnormal salience attribution, and that the attribution of salience is largely mediated through the prefrontal cortex, the striatum, and the hippocampus. Although these areas show differential activation under the influence of delta-9-tetrahydrocannabinol (delta-9-THC) and cannabidiol (CBD), the two major derivatives of cannabis sativa, little is known about the effects of these cannabinoids on the functional connectivity between these regions. We investigated this in healthy occasional cannabis users by employing event-related functional magnetic resonance imaging (fMRI) following oral administration of delta-9-THC, CBD, or a placebo capsule. Employing a seed cluster-based functional connectivity analysis that involved using the average time series from each seed cluster for a whole-brain correlational analysis, we investigated the effect of drug condition on functional connectivity between the seed clusters and the rest of the brain during an oddball salience processing task. Relative to the placebo condition, delta-9-THC and CBD had opposite effects on the functional connectivity between the dorsal striatum, the prefrontal cortex, and the hippocampus. Delta-9-THC reduced fronto-striatal connectivity, which was related to its effect on task performance, whereas this connection was enhanced by CBD. Conversely, mediotemporal-prefrontal connectivity was enhanced by delta-9-THC and reduced by CBD. Our results suggest that the functional integration of brain regions involved in salience processing is differentially modulated by single doses of delta-9-THC and CBD and that this relates to the processing of salient stimuli.
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Affiliation(s)
- Sagnik Bhattacharyya
- Department of Psychosis Studies, King's College London, Institute of Psychiatry, London, UK,Department of Psychosis Studies, Psychosis Clinical Academic Group, King's College London, Institute of Psychiatry, 6th Floor, Main Building, PO Box 067, De Crespigny Park, London SE5 8AF, UK, Tel: +44 (0)20 78480955, Fax: +44 (0)20 78480976, E-mail:
| | - Irina Falkenberg
- Department of Psychosis Studies, King's College London, Institute of Psychiatry, London, UK,Department of Psychiatry and Psychotherapy, Philipps-University Marburg, Marburg, Germany
| | - Rocio Martin-Santos
- Instituto de Investigaciones Biomedicas August Pi i Sunyer (IDIBAPS), and Centro de Investigación Biomedica en Red en Salud Mental (CIBERSAM), Barcelona, Spain,Department of Psychiatry and Psychology, Hospital Clinic, University of Barcelona, Barcelona, Spain,INCT Translational Medicine (CNPq), Rio de Janeiro, Brazil
| | - Zerrin Atakan
- Department of Psychosis Studies, King's College London, Institute of Psychiatry, London, UK
| | - Jose A Crippa
- INCT Translational Medicine (CNPq), Rio de Janeiro, Brazil,Department of Neuroscience and Behavior, Ribeirão Preto Medical School, University of São Paulo, São Paulo, Brazil
| | - Vincent Giampietro
- Department of Neuroimaging, King's College London, Institute of Psychiatry, London, UK
| | - Mick Brammer
- Department of Neuroimaging, King's College London, Institute of Psychiatry, London, UK
| | - Philip McGuire
- Department of Psychosis Studies, King's College London, Institute of Psychiatry, London, UK
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23
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Abstract
Since its inception cannabis has been observed to be associated with various psycho-pathology. In this paper, the authors have reviewed the advancement made in this area over the last decade. The association between cannabis and schizophrenia has been researched more intensively. The controversy regarding the reliability, clinical utility, and the existence of a cannabis withdrawal syndrome has also been settled. Recent studies also buttressed the possibility of acute and chronic effect of cannabis on various cognitive functions. There has been a plethora of research regarding the treatment for cannabis use disorders. But the new and most interesting area of research is concentrated on the endocannabinoid system and its contribution in various psychiatric disorders.
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Affiliation(s)
- Abhishek Ghosh
- Department of Psychiatry, Drug De-addiction and Treatment Centre, Postgraduate Institute of Medical Education and Research, Chandigarh, India
| | - Debasish Basu
- Department of Psychiatry, Drug De-addiction and Treatment Centre, Postgraduate Institute of Medical Education and Research, Chandigarh, India
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van Amsterdam J, Brunt T, van den Brink W. The adverse health effects of synthetic cannabinoids with emphasis on psychosis-like effects. J Psychopharmacol 2015; 29:254-63. [PMID: 25586398 DOI: 10.1177/0269881114565142] [Citation(s) in RCA: 121] [Impact Index Per Article: 13.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/17/2022]
Abstract
Cannabis use is associated with an increased risk of psychosis in vulnerable individuals. Cannabis containing high levels of the partial cannabinoid receptor subtype 1 (CB1) agonist tetrahydrocannabinol (THC) is associated with the induction of psychosis in susceptible subjects and with the development of schizophrenia, whereas the use of cannabis variants with relatively high levels of cannabidiol (CBD) is associated with fewer psychotic experiences. Synthetic cannabinoid receptor agonists (SCRAs) are full agonists and often more potent than THC. Moreover, in contrast to natural cannabis, SCRAs preparations contain no CBD so that these drugs may have a higher psychosis-inducing potential than cannabis. This paper reviews the general toxicity profile and the adverse effects of SCRAs with special emphasis on their psychosis-inducing risk. The review shows that, compared with the use of natural cannabis, the use of SCRAs may cause more frequent and more severe unwanted negative effects, especially in younger, inexperienced users. Psychosis and psychosis-like conditions seem to occur relatively often following the use of SCRAs, presumably due to their high potency and the absence of CBD in the preparations. Studies on the relative risk of SCRAs compared with natural cannabis to induce or evoke psychosis are urgently needed.
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Affiliation(s)
- Jan van Amsterdam
- Amsterdam Institute for Addiction Research, Academic Medical Center, University of Amsterdam, Amsterdam, The Netherlands
| | - Tibor Brunt
- Trimbos Institute (Netherlands Institute of Mental Health and Addiction), Utrecht, The Netherlands
| | - Wim van den Brink
- Amsterdam Institute for Addiction Research, Academic Medical Center, University of Amsterdam, Amsterdam, The Netherlands
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Kvitland LR, Melle I, Aminoff SR, Demmo C, Lagerberg TV, Andreassen OA, Ringen PA. Continued cannabis use at one year follow up is associated with elevated mood and lower global functioning in bipolar I disorder. BMC Psychiatry 2015; 15:11. [PMID: 25651990 PMCID: PMC4323143 DOI: 10.1186/s12888-015-0389-x] [Citation(s) in RCA: 20] [Impact Index Per Article: 2.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/01/2014] [Accepted: 01/15/2015] [Indexed: 02/08/2023] Open
Abstract
BACKGROUND There is limited knowledge about how environmental factors affect the course of bipolar disorder (BD). Cannabis has been proposed as a potential risk factor for poorer course of illness, but the role of cannabis use has not been studied in a first treatment BD I sample. METHODS The present study examines the associations between course of illness in first treatment BD I and continued cannabis use, from baseline to one year follow up. Patients (N = 62) with first treatment DSM-IV BD I were included as part of the Thematically Organized Psychosis study (TOP), and completed interviews and self-report questionnaires at both baseline and follow up. Cannabis use within the last six months at baseline and use between baseline and follow up ("continued use") was recorded. RESULTS After controlling for confounders, continued cannabis use was significantly associated with elevated mood (YMRS) and inferior global functioning (GAF-F) at follow up. Elevated mood mediated the effect of cannabis use on global functioning. CONCLUSIONS These results suggest that cannabis use has clinical implications for the early course of BD by increasing mood level. More focus on reducing cannabis use in clinical settings seems to be useful for improving outcome in early phase of the disorder.
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Affiliation(s)
- Levi Roestad Kvitland
- NORMENT, KG Jebsen Center for Psychosis Research, Division of Mental Health and Addiction, Oslo University Hospital and Institute of Clinical Medicine, University of Oslo, Norway TOP Study, Building 49, Oslo University Hospital, Ullevål, Kirkeveien 166, PO Box 4956 Nydalen, 0424, Oslo, Norway.
| | - Ingrid Melle
- NORMENT, KG Jebsen Center for Psychosis Research, Division of Mental Health and Addiction, Oslo University Hospital and Institute of Clinical Medicine, University of Oslo, Norway TOP Study, Building 49, Oslo University Hospital, Ullevål, Kirkeveien 166, PO Box 4956 Nydalen, 0424, Oslo, Norway.
| | - Sofie Ragnhild Aminoff
- NORMENT, KG Jebsen Center for Psychosis Research, Division of Mental Health and Addiction, Oslo University Hospital and Institute of Clinical Medicine, University of Oslo, Norway TOP Study, Building 49, Oslo University Hospital, Ullevål, Kirkeveien 166, PO Box 4956 Nydalen, 0424, Oslo, Norway. .,Division of Mental Health Services, Department of Specialized Inpatient Treatment, Akershus University Hospital, Akershus, Norway.
| | - Christine Demmo
- NORMENT, KG Jebsen Center for Psychosis Research, Division of Mental Health and Addiction, Oslo University Hospital and Institute of Clinical Medicine, University of Oslo, Norway TOP Study, Building 49, Oslo University Hospital, Ullevål, Kirkeveien 166, PO Box 4956 Nydalen, 0424, Oslo, Norway.
| | - Trine Vik Lagerberg
- NORMENT, KG Jebsen Center for Psychosis Research, Division of Mental Health and Addiction, Oslo University Hospital and Institute of Clinical Medicine, University of Oslo, Norway TOP Study, Building 49, Oslo University Hospital, Ullevål, Kirkeveien 166, PO Box 4956 Nydalen, 0424, Oslo, Norway.
| | - Ole Andreas Andreassen
- NORMENT, KG Jebsen Center for Psychosis Research, Division of Mental Health and Addiction, Oslo University Hospital and Institute of Clinical Medicine, University of Oslo, Norway TOP Study, Building 49, Oslo University Hospital, Ullevål, Kirkeveien 166, PO Box 4956 Nydalen, 0424, Oslo, Norway.
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Abstract
Schizophrenia is a complex mental health disorder with positive, negative and cognitive symptom domains. Approximately one third of patients are resistant to currently available medication. New therapeutic targets and a better understanding of the basic biological processes that drive pathogenesis are needed in order to develop therapies that will improve quality of life for these patients. Several drugs that act on neurotransmitter systems in the brain have been suggested to model aspects of schizophrenia in animals and in man. In this paper, we selectively review findings from dopaminergic, glutamatergic, serotonergic, cannabinoid, GABA, cholinergic and kappa opioid pharmacological drug models to evaluate their similarity to schizophrenia. Understanding the interactions between these different neurotransmitter systems and their relationship with symptoms will be an important step towards building a coherent hypothesis for the pathogenesis of schizophrenia.
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Affiliation(s)
- Hannah Steeds
- Imperial College London, Division of Brain Sciences, Du Cane Road, London W12 0NN, UK
| | | | - James M Stone
- King's College London, Institute of Psychiatry Psychology and Neuroscience, De Crespigny Park, London SE5 8AF, UK, Imperial College London, Division of Brain Sciences, Du Cane Road, London W12 0NN, UK
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Cannabis and creativity: highly potent cannabis impairs divergent thinking in regular cannabis users. Psychopharmacology (Berl) 2015; 232:1123-34. [PMID: 25288512 PMCID: PMC4336648 DOI: 10.1007/s00213-014-3749-1] [Citation(s) in RCA: 36] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/09/2014] [Accepted: 09/15/2014] [Indexed: 01/10/2023]
Abstract
RATIONALE Cannabis users often claim that cannabis has the potential to enhance their creativity. Research suggests that aspects of creative performance might be improved when intoxicated with cannabis; however, the evidence is not conclusive. OBJECTIVE The aim of this study was to investigate the acute effects of cannabis on creativity. METHODS We examined the effects of administering a low (5.5 mg delta-9-tetrahydrocannabinol [THC]) or high (22 mg THC) dose of vaporized cannabis vs. placebo on creativity tasks tapping into divergent (Alternate Uses Task) and convergent (Remote Associates Task) thinking, in a population of regular cannabis users. The study used a randomized, double-blind, between-groups design. RESULTS Participants in the high-dose group (n = 18) displayed significantly worse performance on the divergent thinking task, compared to individuals in both the low-dose (n = 18) and placebo (n = 18) groups. CONCLUSIONS The findings suggest that cannabis with low potency does not have any impact on creativity, while highly potent cannabis actually impairs divergent thinking.
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Helle S, Gjestad R, Johnsen E, Kroken RA, Jørgensen HA, Løberg EM. Cognitive changes in patients with acute phase psychosis--effects of illicit drug use. Psychiatry Res 2014; 220:818-24. [PMID: 25240944 DOI: 10.1016/j.psychres.2014.08.062] [Citation(s) in RCA: 8] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/12/2013] [Revised: 08/27/2014] [Accepted: 08/28/2014] [Indexed: 11/26/2022]
Abstract
Illicit drug use may influence cognition in non-affective psychosis. Previous studies have shown better cognition in psychosis with illicit drug use as compared to psychosis only. Possibly, illicit drug using patients have more transient drug-related cognitive deficits. Thus, the aim of the present study was to examine cognitive change the first weeks after admission to a psychiatric emergency ward, expecting more cognitive improvement at follow-up in the illicit drug group as compared to psychosis only. Patients with acute non-affective psychosis with (26%) and without illicit drug use were examined at baseline (n=123) and follow-up (n=67), with alternative forms of the Repeatable Battery for the Assessment of Neuropsychological Status. Latent Growth Curve models, controlling for cognition at baseline and age differences between the groups, were used to analyze cognitive change. The illicit drug using patients showed the largest improvement in cognition, especially among the youngest patients. Younger patients with non-affective psychosis and illicit drug use showed more cognitive improvement the first weeks after acute psychosis as compared to psychosis only. This suggests that the illicit drug users constitute a sub-group with less stable cognitive deficits and less cognitive vulnerability.
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Affiliation(s)
- Siri Helle
- Division of Psychiatry, Haukeland University Hospital, Sandviksleitet 1, N-5035 Bergen, Norway.
| | - Rolf Gjestad
- Division of Psychiatry, Haukeland University Hospital, Sandviksleitet 1, N-5035 Bergen, Norway
| | - Erik Johnsen
- Division of Psychiatry, Haukeland University Hospital, Sandviksleitet 1, N-5035 Bergen, Norway; Department of Clinical Medicine, University of Bergen, Norway
| | - Rune Andreas Kroken
- Division of Psychiatry, Haukeland University Hospital, Sandviksleitet 1, N-5035 Bergen, Norway
| | | | - Else-Marie Løberg
- Division of Psychiatry, Haukeland University Hospital, Sandviksleitet 1, N-5035 Bergen, Norway; Department of Clinical Psychology, University of Bergen, Norway
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Rolland B, Jardri R. Cortico-accumbens circuitry in schizophrenia: merely a "reward system"? Schizophr Res 2014; 160:233-4. [PMID: 25458864 DOI: 10.1016/j.schres.2014.10.009] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/02/2014] [Accepted: 10/08/2014] [Indexed: 11/25/2022]
Affiliation(s)
- Benjamin Rolland
- Department of Addiction Medicine, CHRU Lille, Lille, France; Department of Pharmacology, EA1046, Univ Lille 2, Lille, France
| | - Renaud Jardri
- Department of Child and Adolescent Psychiatry, CHRU Lille, Lille, France; SCA-Lab, PSYChiC team, Lille University, Lille, France.
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Maremmani AGI, Rugani F, Bacciardi S, Rovai L, Massimetti E, Gazzarrini D, Dell'Osso L, Maremmani I. Differentiating between the course of illness in bipolar 1 and chronic-psychotic heroin-dependent patients at their first agonist opioid treatment. J Addict Dis 2014; 34:43-54. [PMID: 25424434 DOI: 10.1080/10550887.2014.975608] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/24/2022]
Abstract
In an effort to inquiry the "self-medication hypothesis" in heroin-dependent patients suffering from chronic psychosis and bipolar disorder, a naturalistic comparative cohort study was designed with the aim of comparing, according to the presence of dual diagnosis, the clinical characteristics of heroin-dependent patients presenting for their first agonist opioid treatment. The main finding was that addictive (heroin) illness was more severe in bipolar 1 patients and less severe in chronic psychotic patients when compared with heroin-dependent patients without dual diagnoses. In the case of chronic psychotic patients, these differences do not allow us to exclude a therapeutic heroin use, at least at the beginning of their toxicomanic career, with limited progression of their addictive disease. This occurrence seems to be excluded for bipolar 1 heroin-dependent patients, who come to their first agonist opioid treatment with a more severe addictive disease.
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Affiliation(s)
- Angelo Giovanni Icro Maremmani
- a Vincent P. Dole Dual Diagnosis Unit, Department of Neurosciences , Santa Chiara University Hospital, University of Pisa , Italy
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Løberg EM, Helle S, Nygård M, Berle JØ, Kroken RA, Johnsen E. The Cannabis Pathway to Non-Affective Psychosis may Reflect Less Neurobiological Vulnerability. Front Psychiatry 2014; 5:159. [PMID: 25477825 PMCID: PMC4235385 DOI: 10.3389/fpsyt.2014.00159] [Citation(s) in RCA: 12] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/08/2014] [Accepted: 10/24/2014] [Indexed: 12/19/2022] Open
Abstract
There is a high prevalence of cannabis use reported in non-affective psychosis. Early prospective longitudinal studies conclude that cannabis use is a risk factor for psychosis, and neurochemical studies on cannabis have suggested potential mechanisms for this effect. Recent advances in the field of neuroscience and genetics may have important implications for our understanding of this relationship. Importantly, we need to better understand the vulnerability × cannabis interaction to shed light on the mediators of cannabis as a risk factor for psychosis. Thus, the present study reviews recent literature on several variables relevant for understanding the relationship between cannabis and psychosis, including age of onset, cognition, brain functioning, family history, genetics, and neurological soft signs (NSS) in non-affective psychosis. Compared with non-using non-affective psychosis, the present review shows that there seem to be fewer stable cognitive deficits in patients with cannabis use and psychosis, in addition to fewer NSS and possibly more normalized brain functioning, indicating less neurobiological vulnerability for psychosis. There are, however, some familiar and genetic vulnerabilities present in the cannabis psychosis group, which may influence the cannabis pathway to psychosis by increasing sensitivity to cannabis. Furthermore, an earlier age of onset suggests a different pathway to psychosis in the cannabis-using patients. Two alternative vulnerability models are presented to integrate these seemingly paradoxical findings.
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Affiliation(s)
- Else-Marie Løberg
- Division of Psychiatry, Haukeland University Hospital, Bergen, Norway
- Department of Clinical Psychology, University of Bergen, Bergen, Norway
| | - Siri Helle
- Division of Psychiatry, Haukeland University Hospital, Bergen, Norway
| | - Merethe Nygård
- Laboratory of Clinical Biochemistry, Haukeland University Hospital, Bergen, Norway
| | - Jan Øystein Berle
- Division of Psychiatry, Haukeland University Hospital, Bergen, Norway
| | - Rune A. Kroken
- Division of Psychiatry, Haukeland University Hospital, Bergen, Norway
| | - Erik Johnsen
- Division of Psychiatry, Haukeland University Hospital, Bergen, Norway
- Department of Clinical Medicine, University of Bergen, Bergen, Norway
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Herzig DA, Nutt DJ, Mohr C. Alcohol and Relatively Pure Cannabis Use, but Not Schizotypy, are Associated with Cognitive Attenuations. Front Psychiatry 2014; 5:133. [PMID: 25324787 PMCID: PMC4178377 DOI: 10.3389/fpsyt.2014.00133] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/31/2014] [Accepted: 09/09/2014] [Indexed: 12/28/2022] Open
Abstract
Elevated schizotypy relates to similar cognitive attenuations as seen in psychosis and cannabis/polydrug use. Also, in schizotypal populations cannabis and polydrug (including licit drug) use are enhanced. These cognitive attenuations may therefore either be a behavioral marker of psychotic (-like) symptoms or the consequence of enhanced drug use in schizotypal populations. To elucidate this, we investigated the link between cognitive attenuation and cannabis use in largely pure cannabis users (35) and non-using controls (48), accounting for the potential additional influence of both schizotypy and licit drug use (alcohol, nicotine). Cognitive attenuations commonly seen in psychosis were associated with cannabis and alcohol use, but not schizotypy. Future studies should therefore consider (i) non-excessive licit substance use (e.g., alcohol) in studies investigating the effect of cannabis use on cognition and (ii) both enhanced illicit and licit substance use in studies investigating cognition in schizotypal populations.
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Affiliation(s)
- Daniela A. Herzig
- Department of Experimental Psychology, University of Bristol, Bristol, UK
- Institute for Response-Genetics, University of Zurich, Kilchberg, Switzerland
- Clienia AG Littenheid, Littenheid, Switzerland
| | - David J. Nutt
- Neuropsychopharmacology Unit, Imperial College London, London, UK
| | - Christine Mohr
- Department of Experimental Psychology, University of Bristol, Bristol, UK
- Faculté des Sciences Sociales et Politiques, Institut de Psychologie, Université de Lausanne, Lausanne, Switzerland
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Hartmann A. Clinical pharmacology of nondopaminergic drugs in Tourette syndrome. INTERNATIONAL REVIEW OF NEUROBIOLOGY 2014; 112:351-72. [PMID: 24295626 DOI: 10.1016/b978-0-12-411546-0.00011-1] [Citation(s) in RCA: 23] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 02/12/2023]
Abstract
Treatment of tics and Gilles de la Tourette syndrome (GTS) by nondopaminergic drugs was initiated more than three decades ago. These approaches were driven by the wish to circumvent antipsychotic-related side effects (metabolic disturbances, parkinsonian syndromes, tardive dyskinesia) or to use these treatments as a valuable add-on therapy in patients at least partially refractory to antipsychotics. In this review, we will therefore discuss the potential value of treating tics with alpha2 receptor agonists, nicotine, tetrabenazine, GABA agonists, botulinum toxin, cannabinoids, and immune modulators (plasmapheresis, intravenous immunoglobulins, antibiotic prophylaxis). Future directions for clinical trials based on our expanding understanding of the pathophysiology of GTS with regard to cholinergic, glutamatergic, and histaminergic neurotransmission will also be briefly outlined.
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Affiliation(s)
- Andreas Hartmann
- Centre de Référence National Maladie Rare: 'Syndrome Gilles de la Tourette', Département de Neurologie, Pôle des Maladies du Système Nerveux, Paris, France; Centre de Recherche de l'Institut du Cerveau et de la Moelle Epinière, UPMC/INSERM UMR_S975; CNRS UMR 7225, Paris, France.
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Jouanjus E, Lapeyre‐Mestre M, Micallef J. Cannabis use: signal of increasing risk of serious cardiovascular disorders. J Am Heart Assoc 2014; 3:e000638. [PMID: 24760961 PMCID: PMC4187498 DOI: 10.1161/jaha.113.000638] [Citation(s) in RCA: 168] [Impact Index Per Article: 16.8] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/18/2013] [Accepted: 02/02/2014] [Indexed: 11/16/2022]
Abstract
BACKGROUND Cannabis is known to be associated with neuropsychiatric problems, but less is known about complications affecting other specified body systems. We report and analyze 35 recent remarkable cardiovascular complications following cannabis use. METHODS AND RESULTS In France, serious cases of abuse and dependence in response to the use of psychoactive substances must be reported to the national system of the French Addictovigilance Network. We identified all spontaneous reports of cardiovascular complications related to cannabis use collected by the French Addictovigilance Network from 2006 to 2010. We described the clinical characteristics of these cases and their evolution: 1.8% of all cannabis-related reports (35/1979) were cardiovascular complications, with patients being mostly men (85.7%) and of an average age of 34.3 years. There were 22 cardiac complications (20 acute coronary syndromes), 10 peripheral complications (lower limb or juvenile arteriopathies and Buerger-like diseases), and 3 cerebral complications (acute cerebral angiopathy, transient cortical blindness, and spasm of cerebral artery). In 9 cases, the event led to patient death. CONCLUSIONS Increased reporting of cardiovascular complications related to cannabis and their extreme seriousness (with a death rate of 25.6%) indicate cannabis as a possible risk factor for cardiovascular disease in young adults, in line with previous findings. Given that cannabis is perceived to be harmless by the general public and that legalization of its use is debated, data concerning its danger must be widely disseminated. Practitioners should be aware that cannabis may be a potential triggering factor for cardiovascular complications in young people.
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Affiliation(s)
- Emilie Jouanjus
- Centres d'évaluation et d'information sur la Pharmacodépendance – Addictovigilance, Service de Pharmacologie Médicale et Clinique, Centre Hospitalier Universitaire, Faculté de Médecine, Toulouse, France (E.J., M.L.M.)
- Inserm, UMR1027, Toulouse, France (E.J., M.L.M., J.M.)
- Université de Toulouse III, UMR1027, Toulouse, France (E.J., M.L.M., J.M.)
| | - Maryse Lapeyre‐Mestre
- Centres d'évaluation et d'information sur la Pharmacodépendance – Addictovigilance, Service de Pharmacologie Médicale et Clinique, Centre Hospitalier Universitaire, Faculté de Médecine, Toulouse, France (E.J., M.L.M.)
- Inserm, UMR1027, Toulouse, France (E.J., M.L.M., J.M.)
- Université de Toulouse III, UMR1027, Toulouse, France (E.J., M.L.M., J.M.)
| | - Joelle Micallef
- Inserm, UMR1027, Toulouse, France (E.J., M.L.M., J.M.)
- Université de Toulouse III, UMR1027, Toulouse, France (E.J., M.L.M., J.M.)
- Centres d'Évaluation et d'Information sur la Pharmacodépendance – Addictovigilance, Centre Hospitalier Universitaire, Service de Pharmacologie Clinique, Institut de Neurosciences Timone, Aix Marseille Université, Marseille Cedex 5, France (J.M.)
| | - The French Association of the Regional Abuse and Dependence Monitoring Centres (CEIP‐A) Working Group on Cannabis Complications*
- Centres d'évaluation et d'information sur la Pharmacodépendance – Addictovigilance, Service de Pharmacologie Médicale et Clinique, Centre Hospitalier Universitaire, Faculté de Médecine, Toulouse, France (E.J., M.L.M.)
- Inserm, UMR1027, Toulouse, France (E.J., M.L.M., J.M.)
- Université de Toulouse III, UMR1027, Toulouse, France (E.J., M.L.M., J.M.)
- Centres d'Évaluation et d'Information sur la Pharmacodépendance – Addictovigilance, Centre Hospitalier Universitaire, Service de Pharmacologie Clinique, Institut de Neurosciences Timone, Aix Marseille Université, Marseille Cedex 5, France (J.M.)
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Greenwood LM, Broyd SJ, Croft R, Todd J, Michie PT, Johnstone S, Murray R, Solowij N. Chronic effects of cannabis use on the auditory mismatch negativity. Biol Psychiatry 2014; 75:449-58. [PMID: 23830666 DOI: 10.1016/j.biopsych.2013.05.035] [Citation(s) in RCA: 14] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/11/2012] [Revised: 05/26/2013] [Accepted: 05/30/2013] [Indexed: 01/01/2023]
Abstract
BACKGROUND Cannabis use is associated with the development of psychotic symptoms and increased risk for schizophrenia. The mismatch negativity (MMN) is a brain event-related potential marker of change detection thought to index glutamatergic N-methyl-D-aspartate receptor-mediated neurotransmission, which is known to be deficient in schizophrenia. This study examined auditory MMN in otherwise healthy chronic cannabis users compared with nonuser control subjects. METHODS Forty-two chronic cannabis users and 44 nonuser healthy control subjects completed a multi-feature MMN paradigm, which included duration, frequency, and intensity deviants (deviants 6%; standards 82%). The MMN was compared between users and control subjects as well as between long- and short-term users and age- and gender-matched control subjects. Associations between MMN, cannabis use measures, and symptoms were examined. RESULTS The MMN amplitude was significantly reduced to frequency but not duration or intensity deviants in overall cannabis users relative to control subjects. Frequency MMN was similarly attenuated in short- and long-term users relative to control subjects. Long-term users also exhibited reduced duration MMN relative to control subjects and short-term users and this was correlated with increased duration of exposure to cannabis and increased psychotic-like experiences during intoxication. In short-term users, a younger age of onset of regular cannabis use and greater frequency of use were associated with greater psychotic-like experiences and symptomatic distress. CONCLUSIONS These results suggest impaired sensory memory that might reflect N-methyl-D-aspartate receptor dysfunction in chronic cannabis users. The pattern of MMN alterations in cannabis users differed from that typically observed in patients with schizophrenia, indicating overlapping but distinct underlying pathology.
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Affiliation(s)
- Lisa-Marie Greenwood
- School of Psychology and ψ-P3: Centre for Psychophysics, Psychophysiology and Psychopharmacology, University of Wollongong, Wollongong
| | - Samantha J Broyd
- School of Psychology and ψ-P3: Centre for Psychophysics, Psychophysiology and Psychopharmacology, University of Wollongong, Wollongong
| | - Rodney Croft
- School of Psychology and ψ-P3: Centre for Psychophysics, Psychophysiology and Psychopharmacology, University of Wollongong, Wollongong
| | - Juanita Todd
- School of Psychology and Priority Research Centre for Translational Neuroscience and Mental Health, University of Newcastle, Newcastle; Schizophrenia Research Institute, Sydney, New South Wales, Australia
| | - Patricia T Michie
- School of Psychology and Priority Research Centre for Translational Neuroscience and Mental Health, University of Newcastle, Newcastle; Schizophrenia Research Institute, Sydney, New South Wales, Australia
| | - Stuart Johnstone
- School of Psychology and ψ-P3: Centre for Psychophysics, Psychophysiology and Psychopharmacology, University of Wollongong, Wollongong
| | - Robin Murray
- Institute of Psychiatry, Kings College, London, United Kingdom
| | - Nadia Solowij
- School of Psychology and ψ-P3: Centre for Psychophysics, Psychophysiology and Psychopharmacology, University of Wollongong, Wollongong; Schizophrenia Research Institute, Sydney, New South Wales, Australia.
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van Winkel R, Kuepper R. Epidemiological, neurobiological, and genetic clues to the mechanisms linking cannabis use to risk for nonaffective psychosis. Annu Rev Clin Psychol 2014; 10:767-91. [PMID: 24471373 DOI: 10.1146/annurev-clinpsy-032813-153631] [Citation(s) in RCA: 41] [Impact Index Per Article: 4.1] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/09/2022]
Abstract
Epidemiological studies have shown that the association between cannabis and psychosis is robust and consistent across different samples, with compelling evidence for a dose-response relationship. Because longitudinal work indicates that cannabis use precedes psychotic symptoms, it seems reasonable to assume a causal relationship. However, more work is needed to address the possibility of gene-environment correlation (for example, genetic risk for psychosis causing onset of cannabis use). Moreover, knowledge about underlying biological mechanisms linking cannabis use and psychosis is still relatively limited. In order to understand how cannabis use may lead to an increased risk for psychosis, in the present article we (a) review the epidemiological, neurobiological, and genetic evidence linking cannabinoids and psychosis, (b) assess the quality of the evidence, and finally (c) try to integrate the most robust findings into a neurodevelopmental model of cannabis-induced psychosis and identify the gaps in knowledge that are in need of further investigation.
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Affiliation(s)
- Ruud van Winkel
- Department of Psychiatry and Psychology, School of Mental Health and Neuroscience, European Graduate School of Neuroscience (EURON), South Limburg Mental Health Research and Teaching Network (SEARCH), Maastricht University Medical Center, Maastricht, The Netherlands;
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Lejoyeux M, Basquin A, Koch M, Embouazza H, Chalvin F, Ilongo M. Cannabis Use and Dependence among French Schizophrenic Inpatients. Front Psychiatry 2014; 5:82. [PMID: 25076916 PMCID: PMC4097102 DOI: 10.3389/fpsyt.2014.00082] [Citation(s) in RCA: 9] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/27/2014] [Accepted: 06/29/2014] [Indexed: 12/28/2022] Open
Abstract
BACKGROUND To assess the prevalence of cannabis use and dependence in a population of schizophrenic inpatients and to compare schizophrenics with and without cannabis consumption. METHODS One hundred one schizophrenic patients were examined during their first week of hospitalization. They answered the PANNS scale of schizophrenia, the CAGE and the Fagerström questionnaire, and the DSM-IV-TR criteria for cannabis, alcohol, opiates, and nicotine use dependence were checked. We also assessed socio-demographic characteristics, the motive of cannabis consumption, and the number of cannabis joints and alcoholic drinks taken. RESULTS The prevalence of cannabis consumption was 33.6% among schizophrenic inpatients. Schizophrenics consuming cannabis were younger than non-schizophrenics (33.3 vs. 44.7 years p < 0.0001), more often male (77 vs. 54%, p = 0.02) and had been hospitalized for the first time in psychiatry earlier (24.3 vs. 31.3 p = 0.003). Eighty-eight percent of cannabis consumers were dependent on cannabis. They were more often dependent on opiates (17 vs. 0%) and alcohol (32 vs. 7.4%, p = 0.001) and presented compulsive buying more often (48 vs. 27%, p = 0.04). Logistic regression revealed that factors associated to cannabis consumption among schizophrenics were cannabis dependence, male gender, pathological gambling, opiate dependence, number of joints smoked each day, and compulsive buying. CONCLUSION 33.6% of the schizophrenic patients hospitalized in psychiatry consume cannabis and most of them are dependent on cannabis and alcohol. Hospitalization in psychiatry may provide an opportunity to systematically identify a dependence disorder and to offer appropriate information and treatment.
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Affiliation(s)
- Michel Lejoyeux
- Department of Psychiatry and Addictive Medicine, Maison Blanche Hospital, Bichat-Claude Bernard Hospital, AP-HP, Paris Diderot University , Paris , France
| | - Anne Basquin
- Department of Psychiatry and Addictive Medicine, Maison Blanche Hospital, Bichat-Claude Bernard Hospital, AP-HP, Paris Diderot University , Paris , France
| | - Marie Koch
- Department of Psychiatry and Addictive Medicine, Maison Blanche Hospital, Bichat-Claude Bernard Hospital, AP-HP, Paris Diderot University , Paris , France
| | - Houcine Embouazza
- Department of Psychiatry and Addictive Medicine, Maison Blanche Hospital, Bichat-Claude Bernard Hospital, AP-HP, Paris Diderot University , Paris , France
| | - Florence Chalvin
- Department of Psychiatry and Addictive Medicine, Maison Blanche Hospital, Bichat-Claude Bernard Hospital, AP-HP, Paris Diderot University , Paris , France
| | - Michaelle Ilongo
- Department of Psychiatry and Addictive Medicine, Maison Blanche Hospital, Bichat-Claude Bernard Hospital, AP-HP, Paris Diderot University , Paris , France
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Schubart CD, Sommer IEC, Fusar-Poli P, de Witte L, Kahn RS, Boks MPM. Cannabidiol as a potential treatment for psychosis. Eur Neuropsychopharmacol 2014; 24:51-64. [PMID: 24309088 DOI: 10.1016/j.euroneuro.2013.11.002] [Citation(s) in RCA: 64] [Impact Index Per Article: 6.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/22/2013] [Revised: 11/05/2013] [Accepted: 11/09/2013] [Indexed: 12/18/2022]
Abstract
Although cannabis use is associated with an increased risk of developing psychosis, the cannabis constituent cannabidiol (CBD) may have antipsychotic properties. This review concisely describes the role of the endocannabinoid system in the development of psychosis and provides an overview of currently available animal, human experimental, imaging, epidemiological and clinical studies that investigated the antipsychotic properties of CBD. In this targeted literature review we performed a search for English articles using Medline and EMBASE. Studies were selected if they described experiments with psychosis models, psychotic symptoms or psychotic disorders as outcome measure and involved the use of CBD as intervention. Evidence from several research domains suggests that CBD shows potential for antipsychotic treatment.
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Affiliation(s)
- C D Schubart
- Tergooi Hospital, Department of Psychiatry, Blaricum, The Netherlands
| | - I E C Sommer
- Brain Center Rudolf Magnus, University Medical Centre Utrecht, Department of Psychiatry, The Netherlands
| | - P Fusar-Poli
- Department of Psychosis Studies, Institute of Psychiatry, King's College London, UK
| | - L de Witte
- Brain Center Rudolf Magnus, University Medical Centre Utrecht, Department of Psychiatry, The Netherlands
| | - R S Kahn
- Tergooi Hospital, Department of Psychiatry, Blaricum, The Netherlands
| | - M P M Boks
- Brain Center Rudolf Magnus, University Medical Centre Utrecht, Department of Psychiatry, The Netherlands.
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Abstract
Cannabis is a known risk factor for schizophrenia, although the exact neurobiological process through which the effects on psychosis occur is not well-understood. In this review, we attempt to develop and discuss a possible pathway for the development of psychosis. We examine the neurobiological changes due to cannabis to see if these changes are similar to those seen in schizophrenic patients the findings show similarities; however, these mere similarities cannot establish a 'cause-effect' relationship as a number of people with similar changes do not develop schizophrenia. Therefore, the 'transition-to-psychosis' due to cannabis, despite being a strong risk factor, remains uncertain based upon neurobiological changes. It appears that other multiple factors might be involved in these processes which are beyond neurobiological factors. Major advances have been made in understanding the underpinning of marijuana dependence, and the role of the cannabinoid system, which is a major area for targeting medications to treat marijuana withdrawal and dependence, as well as other addictions is of now, it is clear that some of the similarities in the neurobiology of cannabis and schizophrenia may indicate a mechanism for the development of psychosis, but its trajectories are undetermined.
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Affiliation(s)
- Amresh Shrivastava
- Department of Psychiatry, Elgin Early Intervention Program for Psychosis, University of Western Ontario, London, Ontario, Canada ; Mental Health Resource Foundation, Mumbai, Maharashtra, India
| | - Megan Johnston
- Department of Psychology, University of Toronto, St. George, Toronto, Canada
| | - Kristen Terpstra
- Department of Psychology, University of Western Ontario, London, Ontario, Canada
| | - Yves Bureau
- Lawson Health Research Institute, University of Western Ontario, London, Ontario, Canada
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40
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Have the genetics of cannabis involvement gone to pot? NEBRASKA SYMPOSIUM ON MOTIVATION. NEBRASKA SYMPOSIUM ON MOTIVATION 2014; 61:71-108. [PMID: 25306780 DOI: 10.1007/978-1-4939-0653-6_5] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 01/06/2023]
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Cannabis use and brain structural alterations of the cingulate cortex in early psychosis. Psychiatry Res 2013; 214:102-8. [PMID: 24054726 DOI: 10.1016/j.pscychresns.2013.06.006] [Citation(s) in RCA: 21] [Impact Index Per Article: 1.9] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/26/2012] [Revised: 06/13/2013] [Accepted: 06/14/2013] [Indexed: 02/07/2023]
Abstract
As cannabis use is more frequent in patients with psychosis than in the general population and is known to be a risk factor for psychosis, the question arises whether cannabis contributes to recently detected brain volume reductions in schizophrenic psychoses. This study is the first to investigate how cannabis use is related to the cingulum volume, a brain region involved in the pathogenesis of schizophrenia, in a sample of both at-risk mental state (ARMS) and first episode psychosis (FEP) subjects. A cross-sectional magnetic resonance imaging (MRI) study of manually traced cingulum in 23 FEP and 37 ARMS subjects was performed. Cannabis use was assessed with the Basel Interview for Psychosis. By using repeated measures analyses of covariance, we investigated whether current cannabis use is associated with the cingulum volume, correcting for age, gender, alcohol consumption, whole brain volume and antipsychotic medication. There was a significant three-way interaction between region (anterior/posterior cingulum), hemisphere (left/right cingulum) and cannabis use (yes/no). Post-hoc analyses revealed that this was due to a significant negative effect of cannabis use on the volume of the posterior cingulum which was independent of the hemisphere and diagnostic group and all other covariates we controlled for. In the anterior cingulum, we found a significant negative effect only for the left hemisphere, which was again independent of the diagnostic group. Overall, we found negative associations of current cannabis use with grey matter volume of the cingulate cortex, a region rich in cannabinoid CB1 receptors. As this finding has not been consistently found in healthy controls, it might suggest that both ARMS and FEP subjects are particularly sensitive to exogenous activation of these receptors.
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42
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Thieme U, Schelling G, Hauer D, Greif R, Dame T, Laubender RP, Bernhard W, Thieme D, Campolongo P, Theiler L. Quantification of anandamide and 2-arachidonoylglycerol plasma levels to examine potential influences of tetrahydrocannabinol application on the endocannabinoid system in humans. Drug Test Anal 2013; 6:17-23. [PMID: 24424856 DOI: 10.1002/dta.1561] [Citation(s) in RCA: 22] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/24/2013] [Revised: 08/28/2013] [Accepted: 09/03/2013] [Indexed: 01/05/2023]
Abstract
The effects of tetrahydrocannabinol (THC) and endogenous cannabinoids (endocannabinoids, ECs) are both mediated by activation of the cannabinoid receptors CB1 and CB2. Exogenous activation of these receptors by THC could therefore alter EC levels. We tested this hypothesis in healthy volunteers (n = 25) who received a large intravenous dose of THC (0.10 mg/kg). Effects on the EC system were quantified by serial measurements of plasma ECs after THC administration. Eleven blood samples were drawn during the first 5 h after THC administration and two more samples after 24 and 48 h. THC, its metabolites THC-OH (biologically active) and THC-COOH (non-active), and the ECs anandamide and 2-arachidonoylglycerol (2-AG) were quantified by liquid chromatography-mass spectrometry. EC-plasma levels showed a biphasic response after THC injection reaching maximal values at 30 min. Anandamide increased slightly from 0.58 ± 0.21 ng/ml at baseline to 0.64 ± 0.24 ng/ml (p < 0.05) and 2-AG from 7.60 ± 4.30 ng/ml to 9.50 ± 5.90 ng/ml (p < 0.05). After reaching maximal concentrations, EC plasma levels decreased markedly to a nadir of 300 min after THC administration (to 0.32 ± 0.15 ng/ml for anandamide and to 5.50 ± 3.01 ng/ml for 2-AG, p < 0.05). EC plasma concentrations returned to near baseline levels until 48 h after the experiment. THC (0.76 ± 0.16 ng/ml) and THC-OH (0.36 ± 0.17 ng/ml) were still measurable at 24 h and remained detectible until 48 h after THC administration. Although the underlying mechanism is not clear, high doses of intravenous THC appear to influence endogenous cannabinoid concentrations and presumably EC-signalling.
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Affiliation(s)
- Ulrike Thieme
- Department of Anaesthesiology, Ludwig - Maximilians University of Munich, Germany
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43
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Vinkers CH, Van Gastel WA, Schubart CD, Van Eijk KR, Luykx JJ, Van Winkel R, Joëls M, Ophoff RA, Boks MPM, Bruggeman R, Cahn W, de Haan L, Kahn RS, Meijer CJ, Myin-Germeys I, van Os J, Wiersma D. The effect of childhood maltreatment and cannabis use on adult psychotic symptoms is modified by the COMT Val¹⁵⁸Met polymorphism. Schizophr Res 2013; 150:303-11. [PMID: 23954148 DOI: 10.1016/j.schres.2013.07.020] [Citation(s) in RCA: 50] [Impact Index Per Article: 4.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/20/2013] [Revised: 06/23/2013] [Accepted: 07/08/2013] [Indexed: 11/25/2022]
Abstract
BACKGROUND Cannabis use and childhood maltreatment are independent risk factors for the development of psychotic symptoms. These factors have been found to interact in some but not all studies. One of the reasons may be that childhood maltreatment and cannabis primarily induce psychotic symptoms in genetically susceptible individuals. In this context, an extensively studied psychosis vulnerability gene is catechol-methyl-transferase (COMT). Therefore, we aimed to examine whether the COMT Val(158)Met polymorphism (rs4680) moderates the interaction between childhood maltreatment and cannabis use on psychotic symptoms in the general population. METHOD The discovery sample consisted of 918 individuals from a cross-sectional study. For replication we used an independent sample of 339 individuals from the general population. RESULTS A significant three-way interaction was found between childhood maltreatment, cannabis use, and the COMT genotype (rs4680) in the discovery sample (P=0.006). Val-homozygous individuals displayed increased psychotic experiences after exposure to both cannabis use and childhood maltreatment compared to Met-heterozygous and Met-homozygous individuals. Supportive evidence was found in the replication sample with similar effect and direction even though the results did not reach statistical significance (P=0.25). CONCLUSIONS These findings suggest that a functional polymorphism in the COMT gene may moderate the interaction between childhood maltreatment and cannabis use on psychotic experiences in the general population. In conclusion, the COMT Val(158)Met polymorphism may constitute a genetic risk factor for psychotic symptoms in the context of combined exposure to childhood maltreatment and cannabis use.
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Affiliation(s)
- Christiaan H Vinkers
- Department of Psychiatry, Brain Center Rudolf Magnus, University Medical Center Utrecht (UMCU), Utrecht, The Netherlands; Division of Pharmacology, Utrecht Institute for Pharmaceutical Sciences and Rudolf Magnus Institute of Neuroscience, Utrecht University, Utrecht, The Netherlands.
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Freeman D, Morrison PD, Murray RM, Evans N, Lister R, Dunn G. Persecutory ideation and a history of cannabis use. Schizophr Res 2013; 148:122-5. [PMID: 23806582 DOI: 10.1016/j.schres.2013.06.008] [Citation(s) in RCA: 9] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/07/2013] [Revised: 05/03/2013] [Accepted: 06/04/2013] [Indexed: 12/27/2022]
Abstract
BACKGROUND Cannabis use is associated with the occurrence of psychotic experiences. However there are multiple distinct psychotic experiences, each likely to occur as quantitative traits in the general population. In this study we tested for an association of cannabis use with a dimensional assessment of persecutory ideation. METHOD A total of 1714 individuals from the general population completed a dimensional measure of current persecutory ideation and reported on whether they had ever taken cannabis. RESULTS Of all participants, 648 (38%) reported a history of cannabis use. These individuals reported significantly higher current levels of persecutory ideation. The amount of variance in paranoia scores explained was low. Individuals with a history of cannabis use had almost twice the odds of reporting any paranoid ideation in the past month compared with individuals who had never taken cannabis. CONCLUSIONS Using a state of the art assessment, the study adds to findings of an association of persecutory ideation with cannabis use.
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Affiliation(s)
- Daniel Freeman
- Oxford Cognitive Approaches to Psychosis, Department of Psychiatry, University of Oxford, Warneford Hospital, Oxford OX3 7JX, United Kingdom.
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45
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Parakh P, Basu D. Cannabis and psychosis: have we found the missing links? Asian J Psychiatr 2013; 6:281-7. [PMID: 23810133 DOI: 10.1016/j.ajp.2013.03.012] [Citation(s) in RCA: 18] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/28/2012] [Revised: 03/10/2013] [Accepted: 03/30/2013] [Indexed: 10/26/2022]
Abstract
BACKGROUND The association between cannabis and psychosis has long been a matter of debate, with cannabis widely perceived as a harmless recreational drug. METHODS Electronic bibliographic databases like PubMed and Google Scholar were searched using the format "(psychosis or schizophrenia or synonyms) and (cannabis or synonyms)". Cross-linked searches were made taking the lead from key articles. Recent articles and those exploring the genetic factors or gene-environment interaction between cannabis use and psychosis were focussed upon. RESULTS Heavy cannabis use at a n young age, in association with genetic liability to psychosis and exposure to environmental stressors like childhood trauma and urban upbringing increases the risk of psychotic outcome in later life. CONCLUSION Cannabis acts as a component cause of psychosis, that is, it increases the risk of psychosis in people with certain genetic or environmental vulnerabilities, though by itself, it is neither a sufficient nor a necessary cause of psychosis. Although significant progress has been made over the last few years, we are yet to find all the missing links. Further work is necessary to identify all the factors that underlie individual vulnerability to cannabis-related psychosis and to elucidate the biological mechanisms underlying this risk.
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Affiliation(s)
- Preeti Parakh
- Department of Psychiatry, Postgraduate Institute of Medical Education & Research, Chandigarh 160012, India.
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46
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Kuepper R, Ceccarini J, Lataster J, van Os J, van Kroonenburgh M, van Gerven JMA, Marcelis M, Van Laere K, Henquet C. Delta-9-tetrahydrocannabinol-induced dopamine release as a function of psychosis risk: 18F-fallypride positron emission tomography study. PLoS One 2013; 8:e70378. [PMID: 23936196 PMCID: PMC3723813 DOI: 10.1371/journal.pone.0070378] [Citation(s) in RCA: 62] [Impact Index Per Article: 5.6] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/16/2012] [Accepted: 06/18/2013] [Indexed: 11/18/2022] Open
Abstract
Cannabis use is associated with psychosis, particularly in those with expression of, or vulnerability for, psychotic illness. The biological underpinnings of these differential associations, however, remain largely unknown. We used Positron Emission Tomography and (18)F-fallypride to test the hypothesis that genetic risk for psychosis is expressed by differential induction of dopamine release by Δ(9)-THC (delta-9-tetrahydrocannabinol, the main psychoactive ingredient of cannabis). In a single dynamic PET scanning session, striatal dopamine release after pulmonary administration of Δ(9)-THC was measured in 9 healthy cannabis users (average risk psychotic disorder), 8 patients with psychotic disorder (high risk psychotic disorder) and 7 un-related first-degree relatives (intermediate risk psychotic disorder). PET data were analyzed applying the linear extension of the simplified reference region model (LSRRM), which accounts for time-dependent changes in (18)F-fallypride displacement. Voxel-based statistical maps, representing specific D2/3 binding changes, were computed to localize areas with increased ligand displacement after Δ(9)-THC administration, reflecting dopamine release. While Δ(9)-THC was not associated with dopamine release in the control group, significant ligand displacement induced by Δ(9)-THC in striatal subregions, indicative of dopamine release, was detected in both patients and relatives. This was most pronounced in caudate nucleus. This is the first study to demonstrate differential sensitivity to Δ(9)-THC in terms of increased endogenous dopamine release in individuals at risk for psychosis.
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Affiliation(s)
- Rebecca Kuepper
- Department of Psychiatry and Psychology, South Limburg Mental Health Research and Teaching Network, EURON, Maastricht University, Maastricht, The Netherlands.
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Aripiprazole for treating cannabis-induced psychotic symptoms in ultrahigh-risk individuals. Clin Neuropharmacol 2013; 36:98-9. [PMID: 23673914 DOI: 10.1097/wnf.0b013e3182908330] [Citation(s) in RCA: 8] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/26/2022]
Abstract
Cannabis-induced psychotic symptoms (CIPSs) have both similarities and differences with positive symptoms of schizophrenia, and it remains unclear whether CIPSs result from dopaminergic mechanisms and can be treated with antipsychotics. We report the case of a 22-year-old male patient with ultrahigh risk criteria for psychosis, who reported cannabis addiction and recurrent CIPSs. Aripiprazole 10 mg/d could totally and durably suppress CIPSs in the patient, but had no effect on the smoking level. Treating CIPSs in ultrahigh risk individuals who cannot stop or refuse stopping cannabis might fit a harm-reduction strategy by preventing transition into psychosis.
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Kowal MA, Hazekamp A, Colzato LS, van Steenbergen H, Hommel B. Modulation of cognitive and emotional processing by cannabidiol: the role of the anterior cingulate cortex. Front Hum Neurosci 2013; 7:147. [PMID: 23616760 PMCID: PMC3629308 DOI: 10.3389/fnhum.2013.00147] [Citation(s) in RCA: 11] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/22/2013] [Accepted: 04/04/2013] [Indexed: 12/22/2022] Open
Affiliation(s)
- Mikael A Kowal
- Cognitive Psychology Unit, Leiden Institute for Brain and Cognition, Leiden University Leiden, Netherlands
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Sleep Disruption and Proprioceptive Delirium due to Acetaminophen in a Pediatric Patient. Case Rep Pediatr 2013; 2013:471294. [PMID: 23573447 PMCID: PMC3614074 DOI: 10.1155/2013/471294] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/25/2013] [Accepted: 02/17/2013] [Indexed: 12/01/2022] Open
Abstract
We present the case of a 7-year-old boy, who received acetaminophen for the treatment of hyperpyrexia, due to an infection of the superior airways. 13 mg/kg (260 mg) of acetaminophen was administered orally before bedtime, and together with the expected antipyretic effect, the boy experienced sleep disruption and proprioceptive delirium. The symptoms disappeared within one hour. In the following six months, acetaminophen was administered again twice, and the reaction reappeared with similar features. Potential alternative explanations were excluded, and analysis with the Naranjo algorithm indicated a “probable” relationship between acetaminophen and this adverse reaction. We discuss the potential mechanisms involved, comprising imbalances in prostaglandin levels, alterations of dopamine, and cannabinoid and serotonin signalings.
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The cannabinoid CB1 receptor biphasically modulates motor activity and regulates dopamine and glutamate release region dependently. Int J Neuropsychopharmacol 2013; 16:393-403. [PMID: 22391102 DOI: 10.1017/s1461145712000156] [Citation(s) in RCA: 48] [Impact Index Per Article: 4.4] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 01/28/2023] Open
Abstract
Cannabinoid administration modulates both dopaminergic and glutamatergic neurotransmission. The present study examines the effects of high and low dose WIN55,212-2, a CB1 receptor agonist, on extracellular dopamine and glutamate release in vivo via brain microdialysis in the nucleus accumbens (NAc), striatum and prefrontal cortex (PFC) in parallel to its effects on locomotor activity. WIN55,212-2 increased extracellular dopamine in the NAc (1 mg/kg i.p.), striatum (0.1 and 1 mg/kg i.p.) and PFC (1 mg/kg i.p.). Glutamate release was also elevated by WIN55,212-2 in the PFC (1 mg/kg i.p.) whereas in the NAc (0.1 and 1 mg/kg i.p.) and striatum, it was reduced (1 mg/kg i.p.). WIN55,212-2 administration produced hyperlocomotion at the lower dose (0.1 mg/kg i.p.) and hypolocomotion at the higher dose (1 mg/kg i.p.). Co-administration with the CB1 antagonist, SR-141716A (0.03 mg/kg i.p.), prevented the above effects. According to the present results, WIN55,212-2 affected locomotor activity biphasically while exerting converging effects on dopamine activity but diverging effects on glutamate release between cortical and subcortical regions, especially at the higher dose. These findings emphasize the involvement of the CB1 receptor in the simultaneous modulation of dopaminergic and glutamatergic neurotransmission in brain regions involved in reward and locomotion and suggest possible underlying mechanisms of acute cannabinoid exposure and its psychoactive and behavioural manifestations.
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