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Psychosis associated with cannabis withdrawal: systematic review and case series

Abstract BackgroundAbrupt cessation of heavy cannabis use can cause a withdrawal syndrome characterised by irritability, anxiety, insomnia, reduced appetite and restlessness. Recent reports have also described people in whom cannabis withdrawal immediately preceded the acute onset of psychosis. AimsTo identify cases of psychosis associated with cannabis withdrawal. MethodWe completed a systematic review of the literature, which comprised case reports, case series and other studies. We also searched a large electronic database of psychiatric healthcare records. ResultsThe systematic review identified 44 individuals from 21 studies in whom cannabis withdrawal preceded the development of acute psychosis. In the health record study, we identified another 68 people,...
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Cannabis use patterns and association with hyperemesis: A comprehensive review

Please use this link to access this publication. Abstract Background Cannabis use in the general population is prevalent and is rising because of increased acceptance of its use, legalization in most US states, and perceived health benefits. Cannabis product potency has dramatically increased with higher delta-9-tetrahydrocannabinol content. Cannabis has documented antiemetic properties and cannabinoid pharmaceuticals are used in disorders like chemotherapy-induced nausea and vomiting. Purpose Forty to eighty percent of cyclic vomiting syndrome (CVS) patients use cannabis products, which reportedly reduce stress as well as nausea and vomiting. Cannabinoid hyperemesis syndrome (CHS) has a presentation similar to CVS, but is associated with longstanding, high...
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Cannabis use disorder: an overview of treatment approaches in Europe

Abstract Between 8 and 22% of lifetime cannabis users develop Cannabis Use Disorder (CUD). It is the most frequent reason for first-time drug-related treatment admissions in Europe. Many countries have general substance use treatment programs for individuals with cannabis use disorders. This study presents an updated overview of cannabis-specific treatment availability across Europe. Data on treatment programs in 27 EU member states, United Kingdom, Norway and Turkey was gathered. The study used a mixed-methods approach, combining (1) a quantitative survey among the National Focal Points of the European Drugs Agency (EUDA), (2) a qualitative analysis of “Drug Workbooks 2021” and ‘Treatment Workbooks 2020 and 2021’...
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Are Cannabis-Based Medicines a Useful Treatment for Neuropathic Pain? A Systematic Review

Abstract Neuropathic pain is a chronic disorder that arises from damaged or malfunctioning nerves. Hypersensitivity to stimuli, also known as hyperalgesia, can cause a person to experience pain from non-painful stimuli, termed allodynia. Cannabis-based medicines (CBMs) may provide new treatment options to manage neuropathic pain. A review of the relevant studies was conducted to evaluate the effectiveness of CBMs in treating neuropathic pain. Scientific literature was systematically searched from January 2003 to December 2024 using the Web of Science Core Collection, PubMed, and MEDLINE. A total of 22 randomized controlled trials (RCTs) were identified that considered the use of 1′,1′-dimethylheptyl-Δ8-tetrahydrocannabinol-11-oic acid (CT-3), Δ9-tetrahydrocannabinol (Δ9-THC),...
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Cannabis Hyperemesis Syndrome in Children: A Review of Epidemiology, Pathology, Diagnosis, and Treatment

Please use this link to access this publication. Abstract Cannabis remains one of the most frequently misused substances among adolescents. As recreational cannabis has proliferated across the United States, cannabis-related emergency department visits have increased. Cannabis hyperemesis syndrome, a variant of cyclic vomiting syndrome, has emerged as a recognized but poorly understood complication of chronic cannabis use among a subset of individuals. Cannabis hyperemesis syndrome is characterized by repeated cycles of abdominal pain, nausea, and vomiting refractory to standard antiemetics, with users reporting the compulsive use of hot showers to mitigate symptoms. Treatment modalities include intravenous fluid and electrolyte repletion, topical application of capsaicin,...
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Medicinal cannabis: is current use clinically justified?

Abstract Cannabis products are increasingly perceived and advertised as natural and safe treatments for a variety of conditions, including chronic non-cancer pain (CNCP). The number of prescriptions for medicinal cannabis (MC) currently averages >80 000 per month for >1 million Australians. Although over 800 different cannabis products are available to prescribe in Australia, only two are registered on the Australian Register of Therapeutic Goods and approved by the Therapeutic Goods Administration for specific clinical indications. Using treatment for CNCP as an example, evidence of efficacy across nine systematic reviews was inconsistent and/or of low quality and, with the exception of neuropathic pain, was unable to...
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Oral Cannabis Extract for Secondary Prevention of Chemotherapy-Induced Nausea and Vomiting: Final Results of a Randomized, Placebo-Controlled, Phase II/III Trial

Abstract Purpose The aim of this randomized, placebo-controlled, two-stage, phase II/III trial was to determine the efficacy of an oral cannabis extract in adults with refractory nausea and/or vomiting during moderately or highly emetogenic, intravenous chemotherapy despite guideline-consistent antiemetic prophylaxis. Here, we report results of the prespecified combined analysis including the initial phase II and subsequent phase III components. Patients and Methods Study treatment consisted of oral capsules containing either tetrahydrocannabinol 2.5 mg plus cannabidiol 2.5 mg capsules (THC:CBD) or matching placebo, taken three times a day from days –1 to 5, in addition to guideline-consistent antiemetics. The primary measure of effect was the...
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Prenatal cannabis exposure in the clinic and laboratory: What do we know and where do we need to go?

Abstract Coincident with the legalisation of cannabis in many nations, rates of cannabis use during pregnancy have increased. Like prior investigations on smoking and alcohol, understanding how prenatal cannabis exposure (PCE) impacts offspring outcomes across the lifespan will be critical for informing choices for pregnant people, clinicians, and policy makers alike. A thorough characterization of the life-long impacts is especially urgent for supporting all of these stakeholders in the decision-making process. While studies in humans bring forth the most direct information, it can be difficult to parse the impact of PCE from confounding variables. Laboratory studies in animal models can provide experimental designs that allow for causal inferences...
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Does Cannabis Use Contribute to Schizophrenia? A Causation Analysis Based on Epidemiological Evidence

Abstract Cannabis abuse has been linked to acute psychotic symptoms as well as to the development of schizophrenia. Although the association has been well described, causation has not yet been investigated. Therefore, we investigated whether cannabis or cannabinoid use is causal for the development of schizophrenia, conducting a systematic literature review according to the PRISM guidelines. Epidemiological studies and randomized clinical trials investigating the links between cannabis and psychosis-like events (PLE) and schizophrenia were identified (according to PRISM guidelines), and relevant studies were included in a Forest plot analysis. Confounder analysis was performed using a funnel plot, and the Hill causality criteria were used...
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Medicinal cannabis in the management of anxiety disorders: A systematic review

Abstract Background With rising anxiety disorder diagnoses, many individuals are seeking alternatives to standard pharmacotherapies, like medicinal cannabis. This systematic review focuses exclusively on anxiety-related disorders and examines a wide range of cannabis-based preparations and interventions. Method We searched MEDLINE, EMBASE, CINAHL, and PsycInfo (October–December 2023) for peer-reviewed empirical studies, excluding case series, case studies, and review papers. Inclusion criteria were studies on adults (18+ years) diagnosed with anxiety-related disorders, examining the efficacy or effectiveness of medicinal cannabis. Studies on recreational cannabis or cannabis-use-disorder were excluded. The MASTER and QualSyst tools were used to assess bias. Results Fifty-seven studies met the inclusion criteria: 40...
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