The prevalence and clinical correlates of cannabis use and cannabis use disorder among patients with bipolar disorder: A systematic review with meta-analysis and meta-regression

Pinto, Jairo Vinícius; Medeiros, Leonardo Simão; Rosa, Gabriel Santana da; Oliveira, Carlos Eduardo Santana de; Crippa, José Alexandre de Souza; Passos, Ives Cavalcante; Kauer-Sant’Anna, Márcia

doi:10.1016/j.neubiorev.2019.04.004

Cited by 54 publications

(48 citation statements)

References 36 publications

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“…Analyzing SUD and bipolar comorbidity in clinical settings, the same group reports the highest prevalence for AUD (42%) followed by cannabis use (20%) and any other illicit drug use (17%) (21). Cannabis ranking second after AUD has also been confirmed in other studies (7,27,29). Similar rates of SUD were also reported in the Systematic Treatment Enhancement Program Bipolar Disorders (STEP BD) study including 3,750 Bipolar I or II patients (30).…”

Section: Comorbidity Of Bipolar Affective Disorders In Alcohol Use DIsupporting

confidence: 59%

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Comorbid Bipolar and Alcohol Use Disorder—A Therapeutic Challenge

et al. 2021

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Comorbidity rates in Bipolar disorder rank highest among major mental disorders, especially comorbid substance use. Besides cannabis, alcohol is the most frequent substance of abuse as it is societally accepted and can be purchased and consumed legally. Estimates for lifetime comorbidity of bipolar disorder and alcohol use disorder are substantial and in the range of 40–70%, both for Bipolar I and II disorder, and with male preponderance. Alcohol use disorder and bipolarity significantly influence each other's severity and prognosis with a more complicated course of both disorders. Modern treatment concepts acknowledge the interplay between these disorders using an integrated therapy approach where both disorders are tackled in the same setting by a multi-professional team. Motivational interviewing, cognitive behavioral and socio- therapies incorporating the family and social environment are cornerstones in psychotherapy whereas the accompanying pharmacological treatment aims to reduce craving and to optimize mood stability. Adding valproate to lithium may reduce alcohol consumption whereas studies with antipsychotics or naltrexone and acamprosate did not affect mood fluctuations or drinking patterns. In summary, there is a continuous need for more research in order to develop evidence-based approaches for integrated treatment of this frequent comorbidity.

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Section: Comorbidity Of Bipolar Affective Disorders In Alcohol Use DIsupporting

confidence: 59%

“…Whereas numbers for legal substances, e.g., alcohol, are considered as relatively robust and reproducible, many cases of illicit drug use remain undetected in patients with BD. Cannabis is likely to be second after alcohol as substance of abuse in BD patients, affecting approximately one quarter of bipolar patients (7).…”

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confidence: 99%

Comorbid Bipolar and Alcohol Use Disorder—A Therapeutic Challenge

et al. 2021

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“…Further, he started writing suicidal notes to himself and was pulled over by a police officer for driving under the influence of marijuana and alcohol. Up until the shooting, evidence indicates that Abdulazeez had a hard time keeping a job because of his manic depressive/bipolar disorder and drug use [23,24].…”

Section: Marijuana Violencementioning

confidence: 99%

A Review of Cases of Marijuana and Violence

Miller

Ipeku

Oberbarnscheidt

2020

IJERPH

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Marijuana is the most consumed illicit drug in the world, with over 192 million users. Due to the current legalization push of marijuana in the United States, there has been a lack of oversight regarding its public health policies, as marijuana advocates downplay the drug's negative effects. This paper's approach is from a public health perspective, focusing specifically on the cases of violence amongst some marijuana users. Here, we present 14 cases of violence with chronic marijuana users that highlight reoccurring consequences of: marijuana induced paranoia (exaggerated, unfounded distrust) and marijuana induced psychosis (radical personality change, loss of contact with reality). When individuals suffering from pre-existing medical conditions use marijuana in an attempt to alleviate their symptoms, ultimately this worsens their conditions over time. Although marijuana effects depend on the individual's endocannabinoid receptors (which control behavioral functions, like aggression) and the potency level of tetrahydrocannabinol (THC) in the drug, scientifically documented links between certain marijuana users and violence do exist. Wider public awareness of the risks and side effects of marijuana, as well as a more prudent health policy, and government agency monitoring of the drug's composition, creation, and distribution, are needed and recommended. of cardiovascular diseases, and deterioration in health for individuals who have pre-existing mental health issues such as Post Traumatic Stress Disorder, social anxiety, and depression [4][5][6].According to research studies, marijuana use causes aggressive behavior, causes or exacerbates psychosis, and produces paranoia. These effects have been illustrated through case studies of highly publicized incidents and heightened political profiles.These cases contain examples of repeated illustrations of aggression, psychosis and paranoia by marijuana users and intoxication. Ultimately, without the use and intoxication of marijuana, the poor judgment and misperceptions displayed by these individuals would not have been present, reducing the risk for actions that result in senseless deaths. Import to these assertions, is that the current marijuana is far more potent in THC concentrations, the psychoactive component. Accordingly, and demonstrated in direct studies, more potent marijuana results in a greater risk for paranoid thinking and psychosis. In turn, paranoid behavior increases the risk for paranoid behaviors and predictably associated with aggressive and violent behaviors.

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“…It is well documented that bipolar disorder is commonly associated with substance use disorders, with cannabis being the most commonly abused drug. 26 Some bipolar patients report cannabis use to relieve both manic and depressive symptoms and stated that it was more effective than conventional drugs or helped to relieve the side effects of those medications. 27 Also, medical cannabis was associated with better neurocognitive function in these patients.…”

Section: Bipolar Disordermentioning

confidence: 99%

Cannabinoids and their therapeutic applications in mental disorders

Scherma

Muntoni

Riedel

et al. 2020

Dialogues in Clinical Neuroscience

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Mental disorders represent a significant public health burden worldwide due to their high prevalence, chronically disabling nature, and substantial impact on quality of life. Despite growing knowledge of the pathological mechanisms that underlie the development of these disorders, a high percentage of patients do not respond to first-line clinical treatments; thus, there is a strong need for alternative therapeutic approaches. During the past half-century, after the identification of the endocannabinoid system and its role in multiple physiological processes, both natural and synthetic cannabinoids have attracted considerable interest as putative medications in pathological conditions such as, but not exclusive to, mental disorders. Here, we provide a summary of cannabinoid effects in support of possible therapeutic applications for major depression, bipolar disorder, anxiety, posttraumatic stress disorder, and schizophrenia. Considering this evidence, highlighted benefits and risks of cannabinoid use in the management of these illnesses require further experimental study.

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The prevalence and clinical correlates of cannabis use and cannabis use disorder among patients with bipolar disorder: A systematic review with meta-analysis and meta-regression

Cited by 54 publications

References 36 publications

Comorbid Bipolar and Alcohol Use Disorder—A Therapeutic Challenge

Comorbid Bipolar and Alcohol Use Disorder—A Therapeutic Challenge

A Review of Cases of Marijuana and Violence

Cannabinoids and their therapeutic applications in mental disorders

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