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Effects of cannabidiol on schizophrenia-like symptoms in people who use cannabis

  • Celia J. A. Morgan (a1) and H. Valerie Curran (a1)
Summary

Cannabis contains various cannabinoids, two of which have almost opposing actions: δ9-tetrahydrocannabinol (Δ9-THC) is psychotomimetic, whereas cannabidiol (CBD) has antipsychotic effects. Hair samples were analysed to examine levels of Δ9-THC and CBD in 140 individuals. Three clear groups emerged: ‘THC only’, ‘THC+CBD’ and those with no cannabinoid in hair. The THC only group showed higher levels of positive schizophrenia-like symptoms compared with the no cannabinoid and THC+CBD groups, and higher levels of delusions compared with the no cannabinoid group. This provides evidence of the divergent properties of cannabinoids and has important implications for research into the link between cannabis use and psychosis.

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Copyright
Corresponding author
Celia Morgan, Clinical Psychopharmacology Unit, Sub-Department of Clinical Health Psychology, University College London, Gower Street, London WC1E 6BT, UK. Email: c.morgan@ucl.ac.uk
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Declaration of interest

None.

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References
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1 Moore, TH, Zammit, S, Lingford-Hughes, A, Barnes, TR, Jones, PB, Burke, M, Lewis, G. Cannabis use and risk of psychotic or affective mental health outcomes: a systematic review. Lancet 2007; 370: 319–32.
2 D'Souza, DC, Perry, E, MacDougall, L, Ammerman, Y, Cooper, T, Wu, YT, Braley, G, Gueorguieva, R, Krystal, JH. The psychotomimetic effects of intravenous delta-9-tetrahydrocannabinol in healthy individuals: implications for psychosis. Neuropsychopharmacology 2004; 29: 1558–72.
3 Zuardi, AW, Crippa, JA, Hallak, JE, Moreira, FA, Guimaraes, FS. Cannabidiol, a Cannabis sativa constituent, as an antipsychotic drug. Braz J Med Biol Res 2006; 39: 421–9.
4 Leweke, FM, Schneider, U, Radwan, M, Schmidt, E, Enrich, HM. Different effects of nabilone and cannabidiol on binocular depth inversion in man. Pharmacol Biochem Behav 2000; 66: 175–81.
5 Hermann, D, Sartorius, A, Welzel, H, Walter, S, Skopp, G, Ende, G. Dorsolateral prefrontal cortex N-acetylaspartate/total creatine (NAA/tCr) loss in male recreational cannabis users. Biol Psychiatry 2007; 61: 1281–9.
6 Ross, SA, Mehmedic, Z, Murphy, TP, Elsohly, MA. GC-MS analysis of the total delta9-THC content of both drug- and fiber-type cannabis seeds. J Anal Toxicol 2000; 24: 715–7.
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8 Morgan, CJA, Muetzelfeldt, L, Curran, HV. Attentional bias to incentive stimuli in heavy ketamine users. Psychol Med 2008; 4: 110.
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11 Peters, ER, Joseph, SA, Garety, PA. Measurement of delusional ideation in the normal population: introducing the PDI (Peters et al. Delusions Inventory). Schizophr Bull 1999; 25: 553–76.
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The British Journal of Psychiatry
  • ISSN: 0007-1250
  • EISSN: 1472-1465
  • URL: /core/journals/the-british-journal-of-psychiatry
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Effects of cannabidiol on schizophrenia-like symptoms in people who use cannabis

  • Celia J. A. Morgan (a1) and H. Valerie Curran (a1)
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eLetters

Cannabis induced psychosis

Dr. Dev Vrat Singh, Psychiatry trainee
01 July 2009

Dear Sir,

I read this article recently after researching about the antipsychotic properties of cannabidiol.[1] [2] [3]

In addition to the previously mentioned comments, I would also like to point out a few more things.

The study claims to that no prior research has looked at the THC/CBD ratio and yet later discounts the ratio itself.

Not only do the numbers not add up, they are also not consistent. In the method section, in line no.7, the no. of subjects who had both THC andCBD in the hair has been stated 26 yet further down the paragraph (column 2, line 3) this number becomes 27 a change of 3.8%.

Secondly, The OLIFE inventory has been described as Oxford Liverpool Inventory of Life Experiences whereas it actually is Oxford and Liverpool Inventory of Feelings and Experiences.

In the results section, the mean age at which CBD + THC group starts smoking is stated as 5.48 years.

Despite the shortcomings, I found the paper very interesting especially in the light of the vast amount of past, recent and current research done on the “wonder drug” cannabidiol. [4] [5] [6]

Sincerely,

Dr. Dev Vrat Singh,StR in Substance misuse,St. Anne’s Hospital,Haringey,London.

[1] "Effects of CBD in animal models predictive of anti-psychotic activity," Zuardi, A.W., Rodrigues, J.A., Cunha, J.M., Psychopharmacology 1991

[2] "Pharmacological Interaction between Cannabidiol and Tetrahydrocannabinol," Karniol, I.G., Carlini, E.A., Psychopharmacologia 1973

[3] "Cannabidiol Interferes with the effects of Tetrahydrocannabinol in Man," Karniol, I.G., Shirakawa, I., Kasinski, N., Pfeferman, A., Carlini, E.A., European Journal of Pharmacology 1974

[4] "Analgesic and Anti-inflammatory Activity of Constituents of Cannabis Sativa L.," E.A. Formukong, A.T. Evans, and F.J. Evans, Inflammation, Vol. 4, 1988

[5] "Open Label Evaluation of Cannabidiol in Dystonic Movement Disorders," Consroe, et al, International Journal of Neuroscience, 1986[6] “Effects of Cannabidiol in Huntington's Disease," Sandyk, Consroe, Stern, and Snider, Neurology, 36 (Suppl. 1) April, 1986
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Conflict of interest: None Declared

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"Cannabidiol and psychotic symptoms"

Satish K Karunakaran, Consultant Psychiatrist
15 April 2008

An interesting paper. The notion that cannabis smokers may differ in their metabolism of cannabis and this may affect the pharmacological properties experienced and in turn the propensity for developing psychoticsymptoms need further exploration.

However, some issues need discussion. The sample is from a populationof substance abusers. It is highly likely that some of them also abuse other psychotomimetic substances including cocaine, amphetamines and LSD. Although the authors state that the groups were similar in their "recreational drug use", it is unclear whether they specifically controlled for these substances. Differential use of these drugs could easily account for the observed differences between the groups with regardto 'psychosis proneness' and 'delusional thinking'. Moreover, stimulants can also significantly affect 'introvertive anhedonia'factor scores.

It should also be pointed out that the numbers mentioned do not add up. 'Methods' section report that the sample consisted of 140 individuals,of whom 54 tested positive for a cannabis related compound (20 with THC only; 26 with THC+CBD and 8 CBD only) with presumably 86 with no cannabinoids. Yet, when they divided the sample, it became 20 (THC only); 27 (THC+CBD) and 85 (no cannabinoids).
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Conflict of interest: None Declared

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