Study register · detailMeta-Analyse · Psychosis Risk · 2020
Psychosis-Relevant Effects of Intravenous Delta-9-Tetrahydrocannabinol: A Mega Analysis of Individual Participant-Data from Human Laboratory Studies.
Ganesh et al.·The international journal of neuropsychopharmacologyImpact 0.7
Clear benefitGRADEHigh41 citations
Samplek = 10 Studien n = 400 Pat.
Durationunclear
ControlPlacebo
EndpointPANSS
Blindingdoppelblind
DesignMeta-Analyse
Cannabinoidthc
Routeinhalativ
”Key finding
Intravenous THC consistently induces psychotomimetic effects, including positive and negative symptoms; the effects are dose-dependent and reduced in frequent cannabis users.
Summary
IPD mega-analysis across k=10 double-blind, randomized, placebo-controlled crossover studies with n=400 i.v. THC infusions in healthy volunteers. Clinically meaningful increase in positive symptoms in 44,75% of infusions; positive symptoms positively associated with THC dose (β=11,13, p<0,001) and negatively associated with frequent cannabis use (β=-0,575, p<0,001). Strong correlation between positive symptoms and perceptual alterations (rs=0,514, p<0,001).
OutcomeClinically meaningful increase in positive symptoms in 44,75% of infusions; positive association with THC dose (β=11,13, p<0,001), negative association with frequent cannabis use (β=-0,575, p<0,001); strong correlation with CADSS perceptual alterations (rs=0,514, p<0,001)
Confidence in the evidence
Very lowLowModerateHigh
High
The highest of four GRADE levels, the effect estimate is very reliable.
Quality profile
Sample size★★★★★
BlindingDouble-blind
Effect sizeClear benefit
Citations / year★★★★★
Authors
Ganesh S, Cortes-Briones J, Ranganathan M, Radhakrishnan R, Skosnik PD, D'Souza DC
Introduction: There is increasing interest in the relationship between cannabinoids and psychosis. While individual human laboratory studies have been critical in demonstrating that cannabinoids (e.g., delta-9-tetrahydrocannabinol [THC]) can induce acute transient psychosis-like effects in healthy human volunteers, combining data from multiple studies offers a fine-grained view of these effects.
Methods: THC-induced psychosis-relevant effects were examined using a data repository of 10 double-blind, randomized, placebo-controlled, crossover studies with 400 i.v. THC infusions in healthy human volunteers. The Positive and Negative Syndrome scale was used to measure psychotomimetic effects. The profile of symptoms, frequency of a response, its relationship to THC dose and substance use, latent structure in Positive and Negative Syndrome scale response, and the relationships between psychotomimetic and perceptual alteration symptoms were evaluated.
Results: Clinically meaningful increases in positive symptoms were noted in 44.75% infusions; conceptual disorganization, hallucinations, blunted affect, somatic concern, motor retardation, and poor attention were the items most frequently altered by THC. The increase in Positive and Negative Syndrome scale positive symptoms was positively associated with THC dose (beta = 11.13, SE = 4.94, Wald chi 2 = 19.88, P < .001) and negatively associated with frequent cannabis use (beta = -0.575, SE = 0.14, Wald chi 2 = 18.13, P < .001). Furthermore, positive symptoms were strongly correlated with Clinician Administered Dissociative States Scale perceptual alterations score (rs = 0.514, P < .001).
Conclusion: Intravenous administration of THC consistently induces psychotomimetic effects that include symptoms across Positive and Negative Syndrome scale domains. Moreover, healthy individuals who frequently use cannabis have a blunted psychotomimetic response.