Cannabis and schizophrenia: risk factor or therapeutic alternative?

Cannabinoids

Schizophrenia is a chronic mental illness that affects approximately 1% of the population. Its onset generally occurs during adolescence, and its disabling potential persists and worsens throughout life. Thus, the life expectancy of schizophrenic patients is reduced by about 10 years compared to the normal population. Due to its associated deficits and its chronic nature, schizophrenia is the fifth most costly disease in society, mainly due to its early onset, the frequency of hospitalizations, the need for psychosocial support, and the loss of productivity.

 

In schizophrenia, three groups of symptoms are distinguished: positive psychotic (hallucinations, delusions, disorganized thinking), negative (anhedonia, alogia, social retraction or associability), and cognitive (attention difficulties, memory, and executive functions). The course of schizophrenia is characterized by alternating relapses or psychotic exacerbations with periods of partial remission where negative and cognitive symptoms predominate. Buy CBD cigarettes – regular

 

The etiology of schizophrenia is multifactorial with evidence suggesting the existence of genetic and environmental factors that could contribute to its appearance. Among these environmental factors, there are various epidemiological studies that seem to suggest that cannabis use is a risk factor for the development of schizophrenia.

 

Risk factor?

The observed relationship between cannabis use and psychosis has been known for more than a hundred years. Extensive evidence indicates that cannabis use can produce a series of transitory psychotic symptoms, such as delusions, paranoids, auditory and visual hallucinations, ideas of persecution …, which are symptoms similar to those observed in schizophrenia. Some authors suggest that this acute and transient cannabis-induced psychosis could be the antecedent of schizophrenia itself, or of the so-called prodromal symptoms that precede the onset of this disease. Buy CBD cigarettes – menthol online

 

However, what seems clear is that there is no direct causal relationship between cannabis use and the appearance of schizophrenia because the prevalence of schizophrenia is similar in very different regions and cultures, with different rates and patterns of use. cannabis. Furthermore, the prevalence and incidence of schizophrenia have also not varied substantially in recent decades despite a significant increase in cannabis use. Finally, only a small proportion of cannabis users end up developing schizophrenia, and in addition, this relationship is also observed in the opposite sense, that is, the majority of schizophrenic patients have never used cannabis.

 

On the contrary, there is ample evidence that suggests an association between the consumption of high amounts of cannabis and an increased risk of schizophrenia in certain individuals. In this sense, various epidemiological studies have shown that cannabis users have a 1.4 times higher risk of developing schizophrenia than non-users. Furthermore, this risk would rise to 2.1 infrequent users of high amounts of cannabis. The general conclusion drawn from the meta-analyzes that these studies have analyzed is that the association between cannabis use and schizophrenia is mild-moderate. Buy CBD flower online

 

This relationship could also be mediated by the coexistence of other vulnerability factors to the development of the disease such as the consumption of other types of substances of abuse, a low socioeconomic level or a family history of schizophrenia. In this sense, it has been suggested that the consumption of cannabis in people with a certain genetic vulnerability to the development of schizophrenia could substantially increase its risk, advance its onset and cause a worse course of the disease with more severe symptoms and a worse response to pharmacological treatment. Additionally, many studies support that the first psychotic episode may be brought forward a few years by cannabis use. According to the population studied, this advance has turned out to be 3-7 years. Also, A study carried out in the Spanish population has confirmed this advance in the age of the first psychotic treatment, and also observes a correlation of this advance with the frequency of cannabis use. On the other hand, an earlier age of onset of schizophrenia is observed in male cannabis users than in female users. Some authors have suggested that this difference may be due to an earlier onset of cannabis use in males.

 

One of the conclusions that can be drawn from epidemiological studies is that the early use of cannabis, during adolescence, increases the risk of developing schizophrenia and / or psychotic symptoms in adulthood. Furthermore, adolescent cannabis users who develop schizophrenia would have a poorer prognosis with earlier onset of the disease, greater psychopathology, increased relapses, and a greater probability of failure of antipsychotic treatment. Both cannabinoid receptors and endocannabinoids themselves appear in the early stages of brain development and appear to be involved in synaptogenesis processes in neural circuits during brain development. The endocannabinoid system has been described to have a significant role in neuronal development, a role that it would exert mainly through its modulating role on the release of the neurotransmitter glutamate. Cannabis, through the activation of CB1 cannabinoid receptors, could interfere with these normal physiological processes, causing alterations in glutamate release that would induce mild neurotoxic effects and, consequently, structural defects. The maturation of the prefrontal cortex is one of the most important processes during adolescence and it is possible that the consumption of cannabis in this critical period of development predominantly affects the consolidation processes of certain neurocircuits of the said brain region. This abnormal maturation process induced by cannabis use during adolescence could justify the increased risk of schizophrenia in adulthood, Buy CBD prerolls online

 

In any case, and regardless of the role that cannabis use plays in the onset of schizophrenia, what does seem clear is that continuing to use cannabis after the diagnosis of schizophrenia is associated with a higher incidence and severity of positive symptoms and a worse general functioning of the sick. On the contrary, the abandonment of consumption improves depressive symptoms and the level of anxiety, reduces psychotic symptoms, and generally induces a better psychosocial functioning of the patient. For this reason, it is important to highlight the idea that abandoning cannabis use can be useful to favor the treatment and evolution of patients with schizophrenia.

 

Could any of the components of cannabis be a therapeutic alternative for the treatment of schizophrenia?

The current pharmacological treatment of schizophrenia is based on the use of antipsychotic medications. These drugs are very effective in reducing the positive symptoms of schizophrenia but have very limited efficacy in controlling negative and cognitive symptoms. Furthermore, these drugs usually cause significant adverse effects in the patients who take them (extrapyramidal or parkinsonian symptoms, weight gain, metabolic syndrome …), and even 20% of patients show no improvement after administration. For all these reasons, in recent years a growing interest has been developed in the study of the endogenous cannabinoid system as a possible new therapeutic target for the treatment of schizophrenia. This is mainly due to the homeostatic role that this system plays both in brain neurotransmission and in inflammatory processes. Furthermore, the existence of different alterations of the endogenous cannabinoid system has been demonstrated in schizophrenic patients. Within this context, the possible therapeutic utility of modulating endocannabinoid levels through the use of the phytocannabinoid cannabidiol has been postulated. Thus, several clinical studies are currently being carried out to evaluate the antipsychotic properties of cannabidiol in patients with schizophrenia. Unfortunately, there is still little data in the scientific literature regarding these studies on the antipsychotic effects of cannabidiol. Buy marijuana online

 

As early as 1995, the first case of a patient with schizophrenia resistant to antipsychotic treatment was published in which treatment with cannabidiol (up to 1500 mg/day) improved his symptoms. Since then, several clinical trials have been started on the efficacy of cannabidiol in patients with schizophrenia. In one of the first published trials, the efficacy of cannabidiol was compared to that of the antipsychotic amisulpride for 4 weeks. Both compounds produced significant clinical improvement with comparable antipsychotic efficacy. Furthermore, cannabidiol produced fewer adverse effects than amisulpride (without increasing prolactin levels, nor producing weight gain or extrapyramidal symptoms). At least two more clinical trials are currently underway. One of them compares the effect of cannabidiol versus placebo, and the other cannabidiol versus placebo as an adjuvant in patients treated with the antipsychotic risperidone. In summary, the data we currently have on the antipsychotic effects of cannabidiol is still limited, although they show promising results.

 

As a final conclusion, a social alarm that attributes cannabis the sole responsibility of triggering schizophrenia should be avoided, without ignoring the influence that this risk factor can have on a vulnerable population. Therefore, cannabis use is a factor to be taken into account and monitored especially in vulnerable subjects and adolescents. Preventive pedagogical work should be carried out trying to delay the age of onset of consumption as much as possible to minimize their risk of contributing to the appearance of serious diseases in adulthood. Buy real marijuana online

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