Cannabis-associated psychosis: Neural substrate and clinical impact

Murray, Robin M.; Englund, Amir; Abi‐Dargham, Anissa; Lewis, David A.; Forti, Marta Di; Davies, Cathy; Sherif, Mohamed; McGuire, Philip; D’Souza, Deepak Cyril

doi:10.1016/j.neuropharm.2017.06.018

Cited by 152 publications

(176 citation statements)

References 245 publications

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“…Finally, the present review highlights a possible link between the two conditions, but further research is needed. Second, cannabis use has been associated with a significantly increased risk of the subsequent development of psychotic symptoms in the literature [83-85]. Therefore, cannabis-induced psychotic disorder with onset during intoxication (292.9 [F12.959]) or substance withdrawal with perceptual disturbances (292.89 [F12.222]) could be considered as another differential diagnosis according to the DSM-5.…”

Section: Discussionmentioning

confidence: 99%

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

et al. 2018

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

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Section: Discussionmentioning

confidence: 99%

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

et al. 2018

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“…Side effects generally depend on the amount of THC in the product. Varieties available for recreational use with very high THC (commonly called “skunk” in the UK) can cause serious mental health problems 13. In medicinal cannabis, however, lower THC levels, often combined with CBD which counteracts the effects of THC, are usually recommended.…”

Section: Side Effectsmentioning

confidence: 99%

The case for medical cannabis—an essay by M P Barnes

Barnes

2018

BMJ

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“…Les études d'imagerie cérébrale chez l'homme montrent que l'exposition chronique au cannabis induit une réduction de volume de matière grise dans les régions cérébrales présentant une concentration élevée de CB1R, c'est-à-dire, dans l'hippocampe, le cortex préfrontal, l'amygdale et le cervelet [35][36][37]. Plusieurs études font état d'une altération de la substance blanche dans de nombreuses zones du cerveau (tractus préfrontal, limbique, pariétal et cérébelleux) chez les consommateurs de cannabis adolescents.…”

Section: Cannabis Et Adolescenceunclassified

“…. La consommation précoce de cannabis (15-18 ans) multiplie encore plus le risque de développer des symptômes psychotiques (risque supplémentaire entre 2 à 4 fois) [35,42]. Une étude de cohorte de naissance sur 50 000 sujets suivis pendant 35 ans retrouve que le risque accru de schizophrénie chez les consommateurs fréquents de cannabis à l'adolescence était de 3,7 par rapport aux non-utilisateurs [43].…”

Section: Complications Psychiatriquesunclassified

Cannabis et neurodéveloppement

Krebs¹,

Demars²,

Frajerman³

et al. 2020

Bulletin de l'Académie Nationale de Médecine

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Le développement cérébral est un phénomène complexe, qui s'étend de la vie foetale à l'adolescence, pendant laquelle la maturation cérébrale suit une série d'événements ordonnés incluant des périodes critiques de plasticité. Le cerveau est particulièrement sensible à l'environnement pendant ces remaniements. Le système endocannabinoïde participe directement et indirectement à ces processus de plasticité et de maturation. Le delta-9tetrahydrocanabinol, principal composant psychoactif du cannabis, diffuse dans le placenta, le lait maternel et le cerveau. Il interagit avec le système endocannabinoïde, notamment par l'activation des récepteurs aux cannabinoïdes 1 CB1R, ce qui peut entraîner des altérations du neurodéveloppement et du fonctionnement des circuits neuronaux. Par conséquent, l'exposition au cannabis in utero, en période périnatale ainsi qu'à l'adolescence est susceptible d'entraîner des perturbations de la maturation cérébrale dont les conséquences, sur le plan cognitif, psychotique et addictif, persistent bien au-delà de la période d'exposition. Plusieurs facteurs modulent le risque de telles complications mais les études réalisées sur des modèles animaux ainsi que chez l'homme ont montré qu'une exposition durant les phases critiques, en particulier durant la phase de développement périnatal et à l'adolescence, constitue en soi un facteur de risque. Les données actuelles incitent à diffuser une information objective aux jeunes, pour prévenir et limiter les consommations précoces. © 2020 Publié par Elsevier Masson SAS au nom de l'Académie nationale de médecine. ଝ Étant donné le contexte sanitaire épidémique lié au Covid-19 du mois de mars 2020, la présentation orale de cette communication en séance à l'Académie a été reportée.Summary. -Brain development is a complex phenomenon, stretching from fetal life to adolescence, during which brain maturation proceeds through a series of ordered events including critical periods of plasticity. The brain is particularly sensitive to the environment during these changes. The endocannabinoid system participates directly and indirectly in these plasticity and maturation processes. The main psychoactive component of cannabis, the delta-9-tetrahydrocanabinol, can cross the placental barrier, is present in breastmilk and diffuses in the brain. It interacts with the endocannabinoid signaling, especially through the activation of cannabinoid receptors 1 CB1R, which can lead to abnormal neurodevelopmental processes and neuronal circuits functions. Therefore, exposure to cannabis in utero, in perinatal phase, as well as during the adolescence disrupts the brain maturation and can cause disturbances on the cognitive, psychotic and addictive levels that persist far beyond the period of exposure. Several factors modulate the risk of such complications, but studies performed in animal models as well as in human cohorts have shown that exposure during both the critical perinatal and adolescence phases is a risk factor per se. Current knowledge encourages the dissemination of obje...

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Cannabis-associated psychosis: Neural substrate and clinical impact

Cited by 152 publications

References 245 publications

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

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

The case for medical cannabis—an essay by M P Barnes

Cannabis et neurodéveloppement

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