Psychopharmacological comparison of schizophrenia spectrum disorder with and without cannabis dependency

• Published in: Progress in neuro-psychopharmacology & biological psychiatry 2011-01, Vol.35 (1), p.212-217
• Main Authors: Makkos, Zoltan, Fejes, Lilla, Inczédy-Farkas, Gabriella, Kassai-Farkas, Akos, Faludi, Gabor, Lazary, Judit
• Format: Article
• Language: English
• Subjects: Addiction; Adolescence; Adult; Adult and adolescent clinical studies; Age; Age Factors; Antipsychotic Agents - therapeutic use; Biological and medical sciences; Cannabis; Computer programs; Data processing; Drug abuse; Emotional behavior; Female; Hospitals; Humans; Male; Marijuana Abuse - diagnosis; Marijuana Abuse - drug therapy; Marijuana Abuse - epidemiology; Marijuana Abuse - psychology; Medical sciences; Mental disorders; Mental Recall - physiology; Neuropharmacology; Odds Ratio; olanzapine; Pharmacology. Drug treatments; Prevalence; Psychology. Psychoanalysis. Psychiatry; Psychopathology. Psychiatry; Psychopharmacology; Psychopharmacotherapy; Psychoses; Psychosis; Psychotic Disorders - diagnosis; Psychotic Disorders - drug therapy; Psychotic Disorders - epidemiology; Psychotic Disorders - psychology; Retrospective Studies; Risk factors; Schizophrenia; Sex Factors; Smoking; software; Suicide, Attempted - psychology; THC; Time Factors; Young Adult
• ISSN: 0278-5846; 1878-4216
• DOI: 10.1016/j.pnpbp.2010.11.007

Although incidence of schizophrenia is higher among cannabis users and marijuana is the most common abused drug by adolescents, etiological linkage between schizophrenia and cannabis use is still not clarified. Clinical experiences suggest that regular cannabis user can show similar psychotic episode to schizophrenic disorders but it is still unclear if chronic cannabis use with schizophreniform disorder is a distinct entity requiring special therapy or it can be treated as classical schizophrenia. There are no data available on the comparison of pharmacotherapy between schizophreniform patients with and without cannabis use. Clinical data of 85 patients with schizophrenia spectrum disorder were analyzed retrospectively. Cannabis use was not reported by 43 persons (Cnbs0 subgroup) and 42 patients used regularly cannabis during at least 1year (Cnbs1 subgroup). Comparison of anamnesis, family history, social-demographic condition, positive and negative symptoms, acute and long-term therapies recorded by clinical interviews was performed with chi square tests, logistic binary regression and t-tests using SPSS 13.0 for Windows software. Men were over-represented in cannabis dependent group while mean age was lower among them compared to Cnbs0 subgroup. Prevalence of suicidal attempt was increased in men without cannabis use (OR=5.25, p=0.016). Patients without cannabis use spent more time in hospital (p=0.026) and smoking was more frequent among them (OR=1.36, p=0.047). The chance to get olanzapine for acute therapy and aripiprazol for long term therapy was more than two fold in Cnbs1 subgroup (OR=2.66, OR=3.67, respectively). However, aripiprazol was used for acute therapy with significantly lower risk in Cnbs1 subgroup (OR=0.47, p=0.023). Olanzapine was administered for long term therapy in a higher dose to Cnbs0 patients (p=0.040). Also higher dose of risperidon LAI was used in women without cannabis dependency compared to women of Cnbs1 subgroup (p=0.020). Positive and negative symptoms and family history did not differ significantly between the two subgroups. Although symptom profile was similar, hospitalization time, suicidal anamnesis, smoking habit and also dosage, intensity and lasting of therapy were different between the two subgroups. Further prospective studies are required for the investigation of the clinical and molecular background of this discrepancy in order to determine a relevant protocol of prevention and treatment of the chronic cannabis