Cannabis use among youth in the United States, 2004–2016: Faster rate of increase among youth with depression

Weinberger, Andrea H.; Zhu, Jiaqi; Lee, Joun; Anastasiou, Elle; Copeland, Jan; Goodwin, Renée D.

doi:10.1016/j.drugalcdep.2020.107894

Cited by 31 publications

(21 citation statements)

References 29 publications

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“…This is accompanied with a worldwide trend toward liberalizing cannabis policy and commercializing its sale [ 129 ]. The upsetting reality is that cannabis use was more than twice as common and increased more rapidly from 2004 to 2016 among youth with depression compared to youth without depression [ 45 ].…”

Section: Summary: What Is Known and What Needs To Be Studied About Antidepressants And Cannabinoids?mentioning

confidence: 99%

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Examining the Use of Antidepressants for Adolescents with Depression/Anxiety Who Regularly Use Cannabis: A Narrative Review

Hen-Shoval

Weller

Weizman

et al. 2022

IJERPH

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Depression and anxiety disorders are two of the most common and growing mental health concerns in adolescents. Consequently, antidepressant medication (AD) use has increased widely during the last decades. Several classes of antidepressants are used mainly to treat depression, anxiety, and obsessive-compulsive disorders by targeting relevant brain neurochemical pathways. Almost all randomized clinical trials of antidepressants examined patients with no concomitant medications or drugs. This does not address the expected course of therapy and outcome in cannabis users. Cannabis is the most commonly used illicit substance globally. Substantial changes in its regulation are recently taking place. Many countries and US states are becoming more permissive towards its medical and recreational use. The psychological and physiological effects of cannabis (mainly of its major components, tetrahydrocannabinol (THC) and cannabidiol (CBD)) have been extensively characterized. Cannabis use can be a risk factor for depressive and anxiety symptoms, but some constituents or mixtures may have antidepressant and/or anxiolytic potential. The aim of this literature review is to explore whether simultaneous use of AD and cannabis in adolescence can affect AD treatment outcomes. Based on the current literature, it is reasonable to assume that antidepressants are less effective for adolescents with depression/anxiety who frequently use cannabis. The mechanisms of action of antidepressants and cannabis point to several similarities and conjunctions that merit future investigation regarding the potential effectiveness of antidepressants among adolescents who consume cannabis regularly.

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Section: Summary: What Is Known and What Needs To Be Studied About Antidepressants And Cannabinoids?mentioning

confidence: 99%

“…A core problem is that use amongst depressed teens has increased more rapidly over the past 15 years compared to their peers [ 45 ], yet, almost all clinical studies of ADs examined ‘clean’ patients; with no concomitant use of psychoactive substances. This does not represent the course of therapy in cannabis users.…”

Section: Introductionmentioning

confidence: 99%

Examining the Use of Antidepressants for Adolescents with Depression/Anxiety Who Regularly Use Cannabis: A Narrative Review

Hen-Shoval

Weller

Weizman

et al. 2022

IJERPH

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“…As the prevalence of major depressive episodes among adolescents is on the rise, adolescents with major depressive disorder (MDD), including treatment‐resistant depression, are more likely to use psychoactive substances, such as alcohol, cannabis, and other illegal drugs, compared to those without MDD 2,3 . The association between major depressive episodes and substance use among adolescents is well established, particularly with respect to cannabis use, 4 alcohol use disorder, 5 heroin use, 6 and nonmedical opioid use 7 . As such, it appears that adolescents experiencing untreated or treatment‐resistant depression may be at risk for other psychoactive substance use as well.…”

Section: Introductionmentioning

confidence: 99%

Ketamine use in relation to depressive symptoms among high school seniors

et al. 2022

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Background and Objectives Ketamine is efficacious in treating treatment‐resistant depression in medical settings and the drug was approved for such use by the US Federal Drug Administration in 2019. However, little is known about how use outside of medical settings relates to depression. We determined whether recreational ketamine use, relative to the use of other drugs, is related to the current experience of depression among adolescents. Methods We examined data from the 2016 to 2019 Monitoring the Future nationally representative survey of high school seniors in the United States (N = 15,673). We determined how past‐year drug use and frequency of past‐year drug use were associated with students reporting a high level of current depressive symptoms relative to other students. Results Ketamine use was associated with highest risk for a high level of depression (aPR = 1.55, 95% confidence interval [CI]: 1.24–1.94), followed by use of cannabis (aPR = 1.29, 95% CI: 1.19–1.39), and nonmedical use of tranquilizers (aPR = 1.22, 95% CI: 1.04–1.44) and amphetamine (aPR = 1.17, 95% CI: 1.01–1.34). Alcohol use was associated with decreased risk (aPR = 0.92, 95% CI: 0.85–0.99). With respect to frequency of past‐year use, more frequent use of ketamine and cannabis was associated with increased risk for a high level of depression in a dose‐response‐like manner, with past‐year use of ketamine and cannabis ≥10 times associated with increased risk for depression by 70% and 40%, respectively. Discussion and Conclusions Past‐year recreational ketamine use is a risk factor for reporting current depression than most other drugs. Scientific Significance This was the first study to compare the risk of use of various drugs in relation to depression.

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“…Youth with depression are twice as likely to report cannabis use and use amongst depressed teens has increased more rapidly over the past 15 years compared to their peers [ 13 ]. Further, an estimated one in three twelfth graders (17–18 years old) used marijuana in the past year and 6% of these adolescents used marijuana on a daily basis.…”

Section: Introductionmentioning

confidence: 99%

The Impact of Marijuana on Antidepressant Treatment in Adolescents: Clinical and Pharmacologic Considerations

Vaughn

Poweleit

Sarangdhar

et al. 2021

JPM

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The neuropharmacology of marijuana, including its effects on selective serotonin reuptake inhibitor (SSRI)/antidepressant metabolism and the subsequent response and tolerability in youth, has received limited attention. We sought to (1) review clinically relevant pharmacokinetic (PK) and pharmacodynamic (PD) interactions between cannabinoids and selected SSRIs, (2) use PK models to examine the impact of cannabinoids on SSRI exposure (area under curve (AUC)) and maximum concentration (CMAX) in adolescents, and (3) examine the frequency of adverse events reported when SSRIs and cannabinoids are used concomitantly. Cannabinoid metabolism, interactions with SSRIs, impact on relevant PK/PD pathways and known drug–drug interactions were reviewed. Then, the impact of tetrahydrocannabinol (THC) and cannabidiol (CBD) on exposure (AUC24) and CMAX for escitalopram and sertraline was modeled using pediatric PK data. Using data from the Food and Drug Administration Adverse Events Reporting System (FAERS), the relationship between CBD and CYP2C19-metabolized SSRIs and side effects was examined. Cannabis and CBD inhibit cytochrome activity, alter serotonergic transmission, and modulate SSRI response. In PK models, CBD and/or THC increases sertraline and es/citalopram concentrations in adolescents, and coadministration of CBD and CYP2C19-metabolized SSRIs increases the risk of cough, diarrhea, dizziness, and fatigue. Given the significant SSRI–cannabinoid interactions, clinicians should discuss THC and CBD use in youth prescribed SSRIs and be aware of the impact of initiating, stopping, or decreasing cannabinoid use as this may significantly affect es/citalopram and sertraline exposure.

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Cannabis use among youth in the United States, 2004–2016: Faster rate of increase among youth with depression

Cited by 31 publications

References 29 publications

Examining the Use of Antidepressants for Adolescents with Depression/Anxiety Who Regularly Use Cannabis: A Narrative Review

Examining the Use of Antidepressants for Adolescents with Depression/Anxiety Who Regularly Use Cannabis: A Narrative Review

Ketamine use in relation to depressive symptoms among high school seniors

The Impact of Marijuana on Antidepressant Treatment in Adolescents: Clinical and Pharmacologic Considerations

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