Psychose-Risiko
Studienlage · Detail RCT (doppelblind, placebo-kontrolliert) · Psychose-Risiko · 2009

The acute effects of synthetic intravenous Delta9-tetrahydrocannabinol on psychosis, mood and cognitive functioning.

Klarer Nutzen GRADE Moderat 304 Zitate
Stichproben = 22 Pat.
DauerMessungen bis 120 min…
KontrollePlacebo
EndpunktPANSS
Verblindungdoppelblind
DesignRCT (doppelblind, placebo-kontrolliert)
Cannabinoidthc
Max. Dosis2.5 mg
Applikationinhalativ
Kernaussage

Intravenöses THC induzierte transiente positive Psychosesymptome sowie Angst und kognitive Beeinträchtigungen gegenüber Placebo.

Zusammenfassung

n=22 gesunde erwachsene Männer (Alter 28±6 Jahre), IV THC 2,5 mg vs. Placebo (doppelblind); THC induzierte positive psychotische Symptome (PANSS, CAPE: signifikant erhöht vs. Placebo), erhöhte Angstbewertungen, verschlechterte neuropsychologische Leistung (RAVLT, Digit Span, Verbal Fluency); kein Zusammenhang zwischen psychotischen Symptomen und Angstintensität (r nicht signifikant) oder Arbeitsgedächtnisdefiziten — THC-induzierte transiente Psychose ist unabhängig von Angst und kognitiver Beeinträchtigung.

P
PopulationGesunde erwachsene Männer, n=22, Durchschnittsalter 28±6 Jahre
I
InterventionIntravenöses synthetisches THC (Δ9-Tetrahydrocannabinol), 2,5 mg i.v., Einzeldosis
C
KontrollePlacebo (i.v.)
O
OutcomeTHC induzierte signifikante positive Psychosesymptome (PANSS); keine Korrelation zwischen psychotischen Symptomen und Angstniveau oder neuropsychologischen Defiziten
Vertrauen in die Evidenz
Moderat

Dritte von vier GRADE-Stufen, die Effektschätzung ist wahrscheinlich verlässlich.

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Ungenauigkeit
Qualitätsprofil
Größe
Verblindung Doppelblind
Effektstärke Klarer Nutzen
Zitate / Jahr
Autoren
Morrison PD, Zois V, McKeown DA, Lee TD, Holt DW, Powell JF, Kapur S, Murray RM.
DOI 10.1017/s0033291709005522
Design: RCT (doppelblind, placebo-kontrolliert)
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Abstract
<h4>Background</h4>Recent work suggests that heavy use of cannabis is associated with an increased risk of schizophrenia-like psychosis. However, there is a dearth of experimental studies of the effects of the constituents of cannabis, such as Delta9-tetrahydrocannabinol (THC). In a study of intravenous (i.v.) synthetic THC in healthy humans, we aimed to study the relationship of the psychotic symptoms induced by THC to the consequent anxiety and neuropsychological impairment.<h4>Method</h4>Twenty-two healthy adult males aged 28+/-6 years (mean+/-s.d.) participated in experimental sessions in which i.v. THC (2.5 mg) was administered under double-blind, placebo-controlled conditions. Self-rated and investigator-rated measurements of mood and psychosis [the University of Wales Institute of Science and Technology Mood Adjective Checklist (UMACL), the Positive and Negative Syndrome Scale (PANSS) and the Community Assessment of Psychic Experiences (CAPE)] were made at baseline and at 30, 80 and 120 min post-injection. Participants also completed a series of neuropsychological tests [the Rey Auditory Verbal Learning Task (RAVLT), Digit Span, Verbal Fluency and the Baddeley Reasoning Task] within 45 min of injection.<h4>Results</h4>THC-induced positive psychotic symptoms, and participant- and investigator-rated measurements of these were highly correlated. Participants showed an increase in anxiety ratings but there was no relationship between either self- or investigator-rated positive psychotic symptoms and anxiety. THC also impaired neuropsychological performance but once again there was no relationship between THC-induced positive psychotic symptoms and deficits in working memory/executive function.<h4>Conclusions</h4>These findings confirm that THC can induce a transient, acute psychotic reaction in psychiatrically well individuals. The extent of the psychotic reaction was not related to the degree of anxiety or cognitive impairment.

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