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4 results

  • Chapter 22 - The Acute Effects of Cannabinoids in Patients with Psychotic Illness

  • from Part VII - Cannabinoids and Schizophrenia: Aetiopathology and Treatment Implications
  • Edited by Deepak Cyril D'Souza, Staff Psychiatrist, VA Connecticut Healthcare System; Professor of Psychiatry, Yale University School of Medicine, David Castle, University of Tasmania, Australia, Sir Robin Murray, Honorary Consultant Psychiatrist, Psychosis Service at the South London and Maudsley NHS Trust; Professor of Psychiatric Research at the Institute of Psychiatry
  • Book:
    Marijuana and Madness
    Published online:
    12 May 2023
    Print publication:
    01 June 2023, pp 225-239

  • Summary

    People with psychosis and those at clinical high risk (CHR) for this syndrome have significantly higher prevalence of cannabis use compared to the general population. Furthermore, cannabis use can negatively impact the course and treatment outcomes in psychosis. Understanding the acute subjective and cognitive effects of cannabis and cannabinoids in this population is necessary if we are to disentangle the reasons for the increased prevalence of use; and also to help design interventions. There is little evidence to support the ’self-medication’ hypothesis, in its original form. Among principal phyto-cannabinoids, while THC exacerbates positive and cognitive symptoms of psychosis, cannabidiol lacks these effects and may even improve these symptoms. With the liberalization of cannabis laws in many countries, cannabis and cannabis-based products will be more accessible to both individuals with psychotic disorders and those at risk for psychosis. This chapter summarizes the literature regarding acute effects of cannabis and cannabinoids in people at CHR and with established psychosis.

  • Recent consumption of a caffeine-containing beverage and serum biomarkers of cardiometabolic function in the UK Biobank

  • Marilyn C. Cornelis
  • Journal:
    British Journal of Nutrition / Volume 126 / Issue 4 / 28 August 2021
    Published online by Cambridge University Press:
    04 November 2020, pp. 582-590
    Print publication:
    28 August 2021
    • Article
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  • We investigated the impact of recent caffeine drinking on glucose and other biomarkers of cardiometabolic function under free-living conditions while also accounting for lifestyle and genetic factors that alter caffeine metabolism and drinking behaviour. Up to 447 794 UK Biobank participants aged 37–73 years in 2006–2010 provided a non-fasting blood sample, for genetic and biomarker measures, and completed questionnaires regarding sociodemographics, medical history and lifestyle. Caffeine drinking (yes/no) about 1 h before blood collection was also recorded. Multivariable regressions were used to examine the association between recent caffeine drinking and serum levels of glycated Hb, glucose, lipids, apo, lipoprotein(a) and C-reactive protein. Men and women reporting recent caffeine drinking had clinically and significantly higher glucose levels than those not recently drinking caffeine (P < 0·0001). Larger effect sizes were observed among those 55+ years of age and with higher adiposity and longer fasting times (P ≤ 0·02 for interactions). Significant CYP1A2 rs2472297×caffeine and MLXIPL rs7800944 × caffeine interactions on glucose levels were observed among women (P = 0·004), with similar but non-significant interactions in men. Larger effect sizes were observed among women with rs2472297 CC or rs7800944 CC genotypes than among rs2472297 T or rs7800944 T carriers, respectively. In summary, men and women drinking caffeine within about 1 h of blood draw had higher glucose levels than those not drinking caffeine. Findings were modified by age, adiposity, fasting time and genetic factors related to caffeine metabolism and drinking behaviour. Implications for clinical and population studies of caffeine-containing beverages and cardiometabolic health are discussed.

  • Acute effects of cannabis on speech illusions and psychotic-like symptoms: two studies testing the moderating effects of cannabidiol and adolescence

  • Claire Mokrysz, Natacha D. C. Shaban, Tom P. Freeman, Will Lawn, Rebecca A. Pope, Chandni Hindocha, Abigail Freeman, Matthew B. Wall, Michael A. P. Bloomfield, Celia J. A. Morgan, David J. Nutt, H. Valerie Curran
  • Journal:
    Psychological Medicine / Volume 51 / Issue 12 / September 2021
    Published online by Cambridge University Press:
    28 April 2020, pp. 2134-2142
  • Background

    Acute cannabis administration can produce transient psychotic-like effects in healthy individuals. However, the mechanisms through which this occurs and which factors predict vulnerability remain unclear. We investigate whether cannabis inhalation leads to psychotic-like symptoms and speech illusion; and whether cannabidiol (CBD) blunts such effects (study 1) and adolescence heightens such effects (study 2).

    Methods

    Two double-blind placebo-controlled studies, assessing speech illusion in a white noise task, and psychotic-like symptoms on the Psychotomimetic States Inventory (PSI). Study 1 compared effects of Cann-CBD (cannabis containing Δ-9-tetrahydrocannabinol (THC) and negligible levels of CBD) with Cann+CBD (cannabis containing THC and CBD) in 17 adults. Study 2 compared effects of Cann-CBD in 20 adolescents and 20 adults. All participants were healthy individuals who currently used cannabis.

    Results

    In study 1, relative to placebo, both Cann-CBD and Cann+CBD increased PSI scores but not speech illusion. No differences between Cann-CBD and Cann+CBD emerged. In study 2, relative to placebo, Cann-CBD increased PSI scores and incidence of speech illusion, with the odds of experiencing speech illusion 3.1 (95% CIs 1.3–7.2) times higher after Cann-CBD. No age group differences were found for speech illusion, but adults showed heightened effects on the PSI.

    Conclusions

    Inhalation of cannabis reliably increases psychotic-like symptoms in healthy cannabis users and may increase the incidence of speech illusion. CBD did not influence psychotic-like effects of cannabis. Adolescents may be less vulnerable to acute psychotic-like effects of cannabis than adults.

  • Acute effects on the thyroid gland after non-directed radiation therapy in children and adolescents

  • C. C. Bonato, H. B. Dias, M. da S. Alves, L. O. Duarte, T. M. Dias, M. O. Dalenogare, C. C. B. Viegas, R. H. Elnecave
  • Journal:
    Journal of Radiotherapy in Practice / Volume 13 / Issue 3 / September 2014
    Published online by Cambridge University Press:
    12 June 2013, pp. 310-316
  • Background

    During radiation therapy, unwanted scatter to healthy tissues outside the target field may occur. Children and adolescents are more sensitive to radiation injury, and the thyroid gland is particularly susceptible to these effects.

    Purpose

    To assess acute changes in thyroid function and volume in children and adolescents undergoing radiotherapy for a variety of non-thyroid cancers.

    Materials and Methods

    Thirty-one children and adolescents underwent radiation therapy of various body areas in which the thyroid was not included. Thyroid-stimulating hormone (TSH), thyroxine (T4), free thyroxine (fT4), triiodothyronine (T3), anti-thyroperoxidase antibodies and thyroglobulin were measured before, on the last day and at 1 and 3 months after the end of radiotherapy. Ultrasound scans were taken and 6- and 24-hour 131I uptake was measured before and after treatment. The scattered dose to the thyroid region was estimated with a treatment planning system or measured with thermoluminescent dosimeters.

    Results

    The median radiation dose scattered to the thyroid was 296·6 cGy (IQR 16·7–1,709·0). Levels of TSH (p = 0·575), T4 (p = 0·950), fT4 (p = 0·510), T3 (p = 0·842), thyroglobulin (p = 0·620) and anti-thyroid peroxidase antibodies (p = 0·546) were statistically similar at all four time points. There were no differences between pre- and post-radiotherapy thyroid volume and 131I uptake (p = 0·692 and 0·92, respectively).

    Conclusion

    More sensitive methods may be required to ascertain whether acute injury to the follicular epithelium occurs with lower radiation doses scattered to the thyroid.