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
Klarer NutzenGRADEHoch41 Zitate
Stichprobek = 10 Studien n = 400 Pat.
Dauerunklar
KontrollePlacebo
EndpunktPANSS
Verblindungdoppelblind
DesignMeta-Analyse
Cannabinoidthc
Applikationinhalativ
”Kernaussage
Intravenöses THC induziert konsistent psychotomimetische Effekte, einschließlich positiver und negativer Symptome; die Effekte sind dosisabhängig und bei häufigen Cannabiskonsumenten reduziert.
Zusammenfassung
IPD-Mega-Analyse über k=10 doppelblinde, randomisierte, placebokontrollierte Cross-over-Studien mit n=400 i.v. THC-Infusionen bei gesunden Probanden. Klinisch bedeutsame Zunahme von Positivsymptomen in 44,75% der Infusionen; Positivsymptome positiv assoziiert mit THC-Dosis (β=11,13, p<0,001) und negativ assoziiert mit häufigem Cannabis-Konsum (β=-0,575, p<0,001). Starke Korrelation zwischen Positivsymptomen und perzeptuellen Alterationen (rs=0,514, p<0,001).
P
PopulationGesunde Probanden aus 10 randomisierten, placebokontrollierten Crossover-Studien, n=400 i.v. THC-Infusionen
OutcomeKlinisch bedeutsame Zunahme der Positivsymptome bei 44,75% der Infusionen; positiver Zusammenhang mit THC-Dosis (β=11,13, p<0,001), negativer Zusammenhang mit häufigem Cannabiskonsum (β=-0,575, p<0,001); starke Korrelation mit CADSS-Wahrnehmungsveränderungen (rs=0,514, p<0,001)
Vertrauen in die Evidenz
Sehr niedrigNiedrigModeratHoch
Hoch
Höchste von vier GRADE-Stufen, die Effektschätzung ist sehr verlässlich.
Qualitätsprofil
Größe★★★★★
VerblindungDoppelblind
EffektstärkeKlarer Nutzen
Zitate / Jahr★★★★★
Autoren
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.