Treatment of cannabis use disorders in people with schizophrenia spectrum disorders — A systematic review

Hjorthøj, Carsten; Fohlmann, Allan; Nordentoft, Merete

doi:10.1016/j.addbeh.2009.02.001

Cited by 44 publications

(38 citation statements)

References 65 publications

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“…The preponderance of the evidence suggests that CM is effective against cannabis use and mood disorders but that patient drug use returns to baseline when it is stopped (Moore et al 2007) Hjorthǿj and colleagues (2009) report that MI and CBT appear to be effective when cannabis outcomes are grouped with other drug outcomes but, in fact, are ineffective against cannabis use as an outcome separate from other drugs. The authors suggest that studies of outcomes for several different types of drugs together may be overlooking differential effects of interventions.…”

Section: Resultsmentioning

confidence: 99%

Treatment of substance abusing patients with comorbid psychiatric disorders

Kelly

Daley

Douaihy

2012

Addictive Behaviors

223

163

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Objective To update clinicians on the latest in evidence-based treatments for substance use disorders (SUD) and non-substance use disorders among adults and suggest how these treatments can be combined into an evidence based process that enhances treatment effectiveness in comorbid patients. Method Articles were extracted from Pubmed using the search terms “dual diagnosis,” “comorbidity” and “co-occurring” and were reviewed for evidence of effectiveness for pharmacologic and psychotherapeutic treatments of comorbidity. Results Twenty-four research reviews and 43 research trials were reviewed. The preponderance of the evidence suggests that antidepressants prescribed to improve substance-related symptoms among patients with mood and anxiety disorders are either not highly effective or involve risk due to high side-effect profiles or toxicity. Second-generation antipsychotics are more effective for treatment of schizophrenia and comorbid substance abuse and current evidence suggests clozapine, olanzapine and risperidone are among the best. Clozapine appears to be the most effective of the antipsychotics for reducing alcohol, cocaine and cannabis abuse among patients with schizophrenia. Motivational interviewing has robust support as a highly effective psychotherapy for establishing a therapeutic alliance. This finding is critical since retention in treatment is essential for maintaining effectiveness. Highly structured therapy programs that integrate intensive outpatient treatments, case management services and behavioral therapies such as Contingency Management (CM) are most effective for treatment of severe comorbid conditions. Conclusions Creative combinations of psychotherapies, behavioral and pharmacological interventions offer the most effective treatment for comorbidity. Intensity of treatment must be increased for severe comorbid conditions such as the schizophrenia/cannabis dependence comorbidity due to the limitations of pharmacological treatments.

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Section: Resultsmentioning

confidence: 99%

Treatment of substance abusing patients with comorbid psychiatric disorders

Kelly

Daley

Douaihy

2012

Addictive Behaviors

223

163

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“…Hjorthøj et al 66 show a systematic review of experimental studies on the treatment of cannabis dependence using CM or MI and CBT integrated. The conclusions are CM is effective while it is active and the treatment with MI and CBT is not effective with cannabis as the main effect when the cannabis itself is associated with other substances.…”

Section: Psychotherapymentioning

confidence: 99%

“…62 The bidirectional relationship between schizophrenia and cannabis has recently been raised, 63 as there is evidence of common factors of vulnerability, 64 and schizotypal traits generally precede the use of cannabis. 65 Cannabis use in schizophrenia has been associated with a worse therapeutic course and adherence 63 and to an increase in psychosis and in negative symptoms, 66 especially in the cognitive functions (learning, memory, and maintaining attention) and symptoms such as akathisia, rigidity, and dyskinesias. 67 The prevalence of opioid dependence in schizophrenics ranges from 4% to 12%.…”

Section: Schizophrenia and Consumption Of Central Nervous System Deprmentioning

confidence: 99%

Protocols of Dual Diagnosis Intervention in Schizophrenia

Roncero

Barral

Grau-López

et al. 2011

Addictive Disorders &Amp; Their Treatment

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“…There is no evidence that one anti-depressant, anxiolytic, or anti-psychotic is more effective than another. Cannabis use disorders are common in those with schizophrenic spectrum disorders; however, there is no current literature that guides clinicians in the best treatment approaches for this dual diagnosis (228). Knowledge, however, is slowly emerging to guide pharmacologic therapies for cannabis-induced problems in the twenty-first century.…”

Section: Pharmacologic Therapiesmentioning

confidence: 99%

Marijuana: Current Concepts†

Greydanus¹,

Hawver²,

Greydanus³

et al. 2013

Front. Public Health

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Marijuana (cannabis) remains a controversial drug in the twenty-first century. This paper considers current research on use of Cannabis sativa and its constituents such as the cannabinoids. Topics reviewed include prevalence of cannabis (pot) use, other drugs consumed with pot, the endocannabinoid system, use of medicinal marijuana, medical adverse effects of cannabis, and psychiatric adverse effects of cannabis use. Treatment of cannabis withdrawal and dependence is difficult and remains mainly based on psychological therapy; current research on pharmacologic management of problems related to cannabis consumption is also considered. The potential role of specific cannabinoids for medical benefit will be revealed as the twenty-first century matures. However, potential dangerous adverse effects from smoking marijuana are well known and should be clearly taught to a public that is often confused by a media-driven, though false message and promise of benign pot consumption.

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Treatment of cannabis use disorders in people with schizophrenia spectrum disorders — A systematic review

Abstract: Insufficient evidence exists on treating this form of dual-diagnosis patients. Studies grouping several types of substances as a single outcome may overlook differential effects. Future RCTs should investigate combinations of psychosocial, pharmacological, and contingency management.

Cited by 44 publications

References 65 publications

Treatment of substance abusing patients with comorbid psychiatric disorders

Treatment of substance abusing patients with comorbid psychiatric disorders

Protocols of Dual Diagnosis Intervention in Schizophrenia

Marijuana: Current Concepts†

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