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The metabolic implications of long term cannabis use in patients with psychosis

Published online by Cambridge University Press:  11 April 2011

Farrah Mushtaq ,
Valeria Mondelli  and
Carmine M. Pariante
Farrah Mushtaq
Affiliation:
Institute of Psychiatry, King's College London, Division of Psychological Medicine, London (United Kingdom)
Valeria Mondelli*
Affiliation:
Institute of Psychiatry, King's College London, Division of Psychological Medicine, London (United Kingdom)
Carmine M. Pariante
Affiliation:
Institute of Psychiatry, King's College London, Division of Psychological Medicine, London (United Kingdom)
*
Dr. V. Mondelli, Section and Laboratory of Stress, Psychiatry and Immunology (SPI-Lab), Centre for the Cellular Basis of Behaviour, The James Black Centre, Institute of Psychiatry, Kings College London, 125 Coldharbour Lane, London SE5 9NU (United Kingdom). E-mail: [email protected]
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Summary

Aims The aim of this paper is to summarise the effects of cannabis use on appetite and energy balance, and to subsequently investigate the possible implications this may have in patients with psychosis, in whom a high prevalence of cannabis use has been reported. Methods – A narrative review based on the recent literature regarding cannabis use in the gen-eral population and patients with psychosis. Results – The short-term abilities of cannabis to increase appetite and body weight, through actions on the endogenous endocannabinoid system, have been well characterised throughout the literature. The long term effects of cannabis use are however unclear and only a minority of studies have been conducted in the general population with overall conflicting results. In terms of the effects of cannabis in patients with psychosis, there has only been one study to date that has investigated this and interestingly found cannabis use to be associated with increased body weight and blood glucose levels, thus providing evidence that cannabis use may be an important contributing factor to the reduced life expectancy, as is currently observed in this vulnerable patient group. Conclusions – It is clear from the literature that patients with psychosis are at a high risk of metabolic and cardiovascular disease in comparison to the general population. However the contribution of cannabis use to this risk is as of yet undetermined and further long term studies are need to confirm current findings and evaluate hypothesised mechanisms.

Declaration of Interest: None.

Keywords

cannabispsychosisweightmetabolic syndrome
Type
Special Articles
Information
Epidemiology and Psychiatric Sciences , Volume 17 , Issue 3 , September 2008 , pp. 221 - 226
Copyright
Copyright © Cambridge University Press 2008

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References

Abel, E.L. (1971). Effects of marihuana on the solution of anagrams, memory and appetite. Nature 231, 260–261.Google Scholar
Ashton, C.H. (2001). Pharmacology and effects of cannabis: a brief review. British Journal of Psychiatry 178, 101–106.Google Scholar
Bellocchio, L., Mancini, G., Vicennati, V., Pasquali, R. & Pagotto, U. (2006). Cannabinoid receptors as therapeutic targets for obesity and metabolic diseases. Current Opinion in Pharmacology 6, 586–591.Google Scholar
Brown, S. (1997). Excess Mortality of schizophrenia: A metaanalysis. British Journal of Psychiatry 171,502–508.Google Scholar
Casey, D.E. (2005). Metabolic issues and cardiovascular disease in patients with psychiatric disorders. American Journal of Medicine 118, 15–22.Google Scholar
Cota, D., Marsicano, G., Lutz, B., Vicennati, V., Stalla, G.K., Pasquali, R. & Pagotto, U. (2003a). Endogenous cannabinoid system as a modulator of food intake. International Journal of Obesity 27, 289–301.Google Scholar
Cota, D.M, Marsicano, G., Tschop, M., Grubler, Y., Flachskamm, C., Schubert, M., Auer, D., Yassouridis, A., Thone-Reineke, C., Ortmann, S., Tomassoni, F., Cervino., , Nisoli, E., Linthorst, A.C., Pasquali, R., Lutz, B., Stalla, G.K. & Pagotto, U. (2003b). The endogenous cannabinoid system affects energy balance via central orexigenic drive and peripheral lipogenesis. Journal of Clinical Investigation 112, 423–431.CrossRefGoogle ScholarPubMed
De Pasquale, A., Costa, G. & Trovato, A. (1978). The influence of cannabis on glucoregulation. Bulletin on Narcotics 30, 33–41.Google Scholar
Di, Forti M., Morrison, P.D., Butt, A. & Murray, R.M. (2007). Cannabis use and psychiatric and cognitive disorders: the chicken or the egg. Current Opinion in Psychiatry 20, 228–234.Google Scholar
Di, Marzo V. & Matias, I. (2005). Endocannabinoid control of food intake and energy balance. Nature Neuroscience 8, 585–589.Google Scholar
Di, Marzo V., Goparaju, S.K., Wang, L., Liu, J., Batkai, S., Jarai, Z., Fezza, F., Miura, G.I., Palmiter, R.D., Sugiura, T. & Kunos, G. (2001). Leptin-regulated endocannabinoids are involved in maintain food intake. Nature 410, 822–825.Google Scholar
Despres, J.P., Golay, A. & Sjostrom, L. (2005). Effects of Rimonabant on metabolic risk-factors in overweight patients with dyslipidemia. New England Journal of Medicine 353, 2121–2134.Google Scholar
Gamber, K.M., Macarthur, H. & Westfall, T.C. (2005). Cannabinoid augment the release of neuropeptide Y in the rat hypothalamus. Neuropharmacology 49, 646–652.Google Scholar
Gaoni, Y., Mechoulam, R. (1964). Isolation, structure, and partial synthesis of an active constituent of hashish. Journal of the American Chemical Society 86, 1646–1647.Google Scholar
Gorter, R.W. (1999). Cancer cachexia and cannabinoids. Forschende Komplementarmedizin 6, 21–22.Google Scholar
Green, B., Young, R. & Kavanagh, D. (2005). Cannabis use and misuse prevalence amongst people with psychosis. British Journal of Psychiatry 187, 306–313.Google Scholar
Greenberg, I., Kuehnle, J., Mendelson, J.H. & Bernstein, J.G. (1976). Effects of marihuana use on body weight and colric intake in humans. Psychopharmacology 49, 79–84.Google Scholar
Guy, G.W., Whittle, B.A. & Robson, P.J. (ed.) (2004). The Medicinal Uses of Cannabis and Cannabinoids. Pharmaceutical press: London.Google Scholar
Haney, M., Gunderson, E.W., Rabkin, J., Hart, C.L., Vosburg, S.K., Comer, S.D. & Foltin, R.W. (2007). Dronabinol and marijuana in HIV-positive marijuana smokers. Journal of Acquired Immune Deficiency Syndromes 45, 545–554.Google Scholar
Hollister, L.E. (1971). Hunger and appetite after single doses of marijuana, alcohol and dextroamphetamine. Clinical Pharmacy 12, 44–49.Google Scholar
Holt, R.I.G., Pevelert, R.C. & Byrne, C.D. (2003). Schizophrenia, the metabolic syndrome and diabetes. Diabetic Medicine 21, 515–523.Google Scholar
Home Office. (2007). Drug Misuse Declared: Findings from the 2006/07 British Crime Survey. HMSO: London.Google Scholar
Isaac, M., Isaac, M. & Holloway, F. (2005). Is cannabis an anti-antipsychotic? The experience in psychiatric intensive care. Human Psychopharmacology 20, 207–210.Google Scholar
Jacob, R. & Chowdhury, A.N. (2008). Metabolic comorbidity in schizo-phrenia. Indian Journal of Medical Sciences 62, 23–31.Google Scholar
Kirkham, T.C. (2005). Endocannabinoids in the regulation of appetite and body weight. Behavioural Pharmacology 16, 297–313.Google Scholar
Kirkham, T.C. & William, C.M. (2001). Endogenous cannabinoids and appetite. Nutrition Research Reviews 14, 65–86.CrossRefGoogle ScholarPubMed
Matias, I. & Di, Marzo V. (2007). Endocannabinoids and the control of energy balance. Trends in Endocrinology and Metabolism 18, 27–37.Google Scholar
Matsuda, L.A., Lolait, S.J., Brownstein, M.J., Young, A.C. & Bonner, T.I. (1990). Structure of a cannabinoid receptor and functional expression of the cloned cDNA. Nature 346, 561–564.Google Scholar
Mittleman, M.A., Lewis, R.A., Maclure, M., Sherwood, J.B. & Muller, J.E. (2001). Triggering myocardial infarction by marijuana. Circulation 103, 2805–2809.Google Scholar
Murray, R.M., Morrison, P.D., Henquet, C.Di, Forti M. (2007). Cannabis, the mind and society: the hash realities. Nature Reviews Neuroscience 8, 885–895.Google Scholar
Newman, S.C. & Bland, R.C. (1991). Mortality in a cohort of patients with schizophrenia: A record linkage study. Canadian Journal of Psychiatry 171, 502–508.Google Scholar
Pagotto, U., Vicennati, V. & Pasquali, R. (2005). The endocannabinoid system and the treatment of obesity. Annals of Medicine 2005, 270–275.Google Scholar
Percudani, M., Barbui, C., Fortino, I., Tansella, M. & Petrovich, L. (2006). Antidepressant and antipsychotic drug prescribing in Lombardy. Epidemiologia e Psichiatria Sociale 15, 59–70.Google Scholar
Pi-Sunyer, F.X., Aronne, L.J., Heshmati, H.M.Decin, J. & Rosenstock, J. (2006). Effect of Rimonabant, a cannabinoid-1 receptor blocker, on weight and cardiometabolic risk factors in overweight or obese patients. Journal of the American Medical Association 295, 761–775.Google Scholar
Rodondi, N., Pletcher, M.J., Liu, K., Hulley, S.B. & Sidney, S. (2006). Marijuana use, diet, body mass index and cardiovascular risk factors (from the CARDIA study). American Journal of Cardiology 98, 478–484.Google Scholar
Russo, E.B. (2007). History of cannabis and its preparations in saga, science and sobriquet. Chemistry & Biodiversity 4, 1614–1648.Google Scholar
Samele, C. (2004). Factors leading to poor physical health in people with psychosis. Epidemiologia e Psichiatria Sociale 13, 141–145.Google Scholar
Scheen, A.J., Finer, N., Priscilla, H., Jensen, M.D. & Van Gaal, L.F. (2006). Efficacy and tolerability of rimonabant in overweight or obese patients with type 2 diabetes: a randomised controlled study. The Lancet 368, 1660–1672.Google Scholar
Siler, J.F., Sheep, W.L., Bates, L.B., Clark, G.F., Cook, G.W. & Smith, W.H. (1933). Marihuana smoking in Panama. Military Surgeon 73, 269–280.Google Scholar
Smit, E. & Crespo, C.J. (2001). Dietary intake and nutritional status of US adult marijuana users: results from the third national health and nutrition examination survey. Public Health Nutrition 4, 781–786.Google Scholar
Tart, C.T. (1970). Marijuana intoxication experiences. Nature 226, 701–704.CrossRefGoogle Scholar
Tylee, A. & Haddad, M. (2007). Managing complex problems: treatment for common mental disorders in the UK. Epidemiologia e Psichiatria Sociale 16, 302–308.Google Scholar
Verdoux, H. & Tournier, M. (2004). Cannabis use and risk of psychosis: an etiological link. Epidemiologia e Psichiatria Sociale 13, 113–119.Google Scholar
Zwillich, C.W., Doekel, , Hammil, S., Weil, J.V. (1978). The effects of smoked marijuana on metabolism and respiratory control. The American Review of Respiratory Disease 118, 885–891.Google Scholar