Skip to main content Accessibility help

We use cookies to distinguish you from other users and to provide you with a better experience on our websites. Close this message to accept cookies or find out how to manage your cookie settings.

Close cookie message
×
Hostname: page-component-78c5997874-fbnjt Total loading time: 0 Render date: 2024-11-11T04:21:55.328Z Has data issue: false hasContentIssue false

Chapter 13 - Cannabis and Bipolar Disorder

from Part IV - Cannabis, Anxiety, and Mood

Published online by Cambridge University Press:  12 May 2023

By
Jairo Vinícius Pinto  and
Mauren Letícia Ziak
Edited by
Deepak Cyril D'Souza ,
David Castle  and
Sir Robin Murray
Deepak Cyril D'Souza
Affiliation:
Staff Psychiatrist, VA Connecticut Healthcare System; Professor of Psychiatry, Yale University School of Medicine
David Castle
Affiliation:
University of Tasmania, Australia
Sir Robin Murray
Affiliation:
Honorary Consultant Psychiatrist, Psychosis Service at the South London and Maudsley NHS Trust; Professor of Psychiatric Research at the Institute of Psychiatry
Get access

Summary

Persons with bipolar disorder (BD) commonly use cannabis and have a high prevalence of co-occurring cannabis use disorder (CUD). In addition, persons with BD and co-occurring CUD tend to have earlier onset of symptoms and are more likely to have psychosis, suicide attempts, and other SUDs in comparison to those without CUD. Moreover, convergent evidence indicates that CUD is associated with longitudinal impacts on the course of BD, demonstrating an association with longer and more frequent mood episodes, lower recovery and remission rates, as well as poorer psychosocial functioning; however, abstinence from cannabis may improve clinical outcomes, partly by increasing treatment adherence. Although the impact of CUD on the course of BD is known, there are no published randomized controlled trials so far that have explicitly focused on this comorbidity; therefore, there is no specific evidence to guide the treatment of co-occurring BD and CUD.

Keywords

bipolar disordercannabiscannabis use disordersubstance use disorderendocannabinoid system
Type
Chapter
Information
Marijuana and Madness , pp. 128 - 138
Publisher: Cambridge University Press
Print publication year: 2023

Access options

Get access to the full version of this content by using one of the access options below. (Log in options will check for institutional or personal access. Content may require purchase if you do not have access.)

References

Abush, H., Ghose, S., Van Enkevort, E. A., et al. (2018). Associations between adolescent cannabis use and brain structure in psychosis. Psychiatry Res Neuroimaging, 276, 53–64.CrossRefGoogle ScholarPubMed
Agrawal, A., Nurnberger, J. I. J., and Lynskey, M. T. (2011). Cannabis involvement in individuals with bipolar disorder. Psychiatry Res, 185, 459–461.CrossRefGoogle ScholarPubMed
Albanese, M. J., Clodfelter, R. C. J., and Khantzian, E. J. (2000). Divalproex sodium in substance abusers with mood disorder. J Clin Psychiatry, 61, 916–921.Google Scholar
Arjmand, S., Behzadi, M., Kohlmeier, K. A., et al. (2019). Bipolar disorder and the endocannabinoid system. Acta Nuropsychiatr, 31, 193–201.CrossRefGoogle ScholarPubMed
Bally, N., Zullino, D., and Aubry, J.-M. (2014). Cannabis use and first manic episode. J Affect Disord, 165, 103–108.Google Scholar
Beaulieu, S., Saury, S., Sareen, J., et al. (2012). The Canadian Network for Mood and Anxiety Treatments (CANMAT) task force recommendations for the management of patients with mood disorders and comorbid substance use disorders. Ann Clin Psychiatry, 24, 38–55.Google Scholar
Berk, M., Post, R., Ratheesh, A., et al. (2017). Staging in bipolar disorder: From theoretical framework to clinical utility. World Psychiatry, 16, 236–244.Google Scholar
Bitter, S. M., Adler, C. M., Eliassen, J. C., et al. (2014). Neurofunctional changes in adolescent cannabis users with and without bipolar disorder. Addiction, 109, 1901–1909.Google Scholar
Brady, K. T., Sonne, S. C., Anton, R., et al. (1995). Valproate in the treatment of acute bipolar affective episodes complicated by substance abuse: A pilot study. J Clin Psychiatry, 56, 118–121.Google ScholarPubMed
Braga, R. J., Burdick, K. E., Derosse, P., et al. (2012). Cognitive and clinical outcomes associated with cannabis use in patients with bipolar I disorder. Psychiatry Res, 200, 242–245.Google Scholar
Christensen, R., Kristensen, P. K., Bartels, E. M., et al. (2007). Efficacy and safety of the weight-loss drug rimonabant: A meta-analysis of randomised trials. Lancet, 370, 1706–1713.Google Scholar
Cuttler, C., Spradlin, A., and McLaughlin, R. J. (2018). A naturalistic examination of the perceived effects of cannabis on negative affect. J Affect Disord, 235, 198–205.CrossRefGoogle ScholarPubMed
D’Souza, D. C., Abi-Saab, W. M., Madonick, S., et al. (2005). Delta-9-tetrahydrocannabinol effects in schizophrenia: Implications for cognition, psychosis, and addiction. Biol Psychiatry, 15, 594–608.CrossRefGoogle Scholar
D’Souza, D. C., Perry, E., MacDougall, L., et al. (2004). The psychotomimetic effects of intravenous delta-9-tetrahydrocannabinol in healthy individuals: Implications for psychosis. Neuropsychopharmacology, 29, 1558–1572.Google Scholar
Duffy, A., Horrocks, J., Milin, R., et al. (2012). Adolescent substance use disorder during the early stages of bipolar disorder: A prospective high-risk study. J Affect Disord, 142, 57–64.Google Scholar
Feingold, D., Weiser, M., Rehm, J., et al. (2015). The association between cannabis use and mood disorders: A longitudinal study. J Affect Disord, 172, 211–218.CrossRefGoogle ScholarPubMed
Freeman, T. P., Hindocha, C., Baio, G., et al. (2020). Cannabidiol for the treatment of cannabis use disorder: A phase 2a, double-blind, placebo-controlled, randomised, adaptive Bayesian trial. Lancet Psychiatry, 7, 865–874.Google Scholar
Geller, B., Cooper, T. B., Sun, K., et al. (1998). Double-blind and placebo-controlled study of lithium for adolescent bipolar disorders with secondary substance dependency. J Am Acad Child Adolesc Psychiatry, 37, 171–178.CrossRefGoogle ScholarPubMed
Gibbs, M., Winsper, C., Marwaha, S., et al. (2015). Cannabis use and mania symptoms: A systematic review and meta-analysis. J Affect Disord, 171, 39–47.Google Scholar
González-Pinto, A., Reed, C., Novick, D., et al. (2010). Assessment of medication adherence in a cohort of patients with bipolar disorder. Pharmacopsychiatry, 43, 263–270.CrossRefGoogle Scholar
Gore, F. M., Bloem, P. J., Patton, G. C., et al. (2011). Global burden of disease in young people aged 10–24 years: A systematic analysis. Lancet, 377, 2093–2102.Google Scholar
Grinspoon, L., and Bakalar, J. B. (1998). The use of cannabis as a mood stabilizer in bipolar disorder: Anecdotal evidence and the need for clinical research. J Psychoactive Drugs, 30, 171–177.Google Scholar
Gruber, A. J., Pope, H. G. J., and Brown, M. E. (1996). Do patients use marijuana as an antidepressant? Depression, 4, 77–80.Google Scholar
Hartberg, C. B., Lange, E. H., Lagerberg, T. V., et al. (2018). Cortical thickness, cortical surface area and subcortical volumes in schizophrenia and bipolar disorder patients with cannabis use. Eur Neuropsychopharmacol, 28, 37–47.Google Scholar
Healey, C., Peters, S., Kinderman, P., et al. (2009). Reasons for substance use in dual diagnosis bipolar disorder and substance use disorders: A qualitative study. J Affect Disord, 113, 118–126.CrossRefGoogle ScholarPubMed
Henquet, C., van Os, J., Kuepper, R., et al. (2010). Psychosis reactivity to cannabis use in daily life: An experience sampling study. Br J Psychiatry, 196, 447–453.Google Scholar
Hjorthøj, C., Østergaard, M. L. D., Benros, M. E., et al. (2015). Association between alcohol and substance use disorders and all-cause and cause-specific mortality in schizophrenia, bipolar disorder, and unipolar depression: A nationwide, prospective, register-based study. Lancet Psychiatry, 2, 801–808.Google Scholar
Hunt, G. E., Malhi, G. S., Cleary, M., et al. (2016a). Comorbidity of bipolar and substance use disorders in national surveys of general populations, 1990–2015: Systematic review and meta-analysis. J Affect Disord, 206, 321–330.Google Scholar
Hunt, G. E., Malhi, G. S., Cleary, M., et al. (2016b). Prevalence of comorbid bipolar and substance use disorders in clinical settings, 1990–2015: Systematic review and meta-analysis. J Affect Disord, 206, 331–349.CrossRefGoogle ScholarPubMed
Hurd, Y. L., Spriggs, S., Alishayev, J., et al. (2019). Cannabidiol for the reduction of cue-induced craving and anxiety in drug-abstinent individuals with heroin use disorder: A couble-blind randomized placebo-controlled trial. Am J Psychiatry, 176, 911–922.CrossRefGoogle Scholar
Jordan Walter, T., Pocuca, N., Young, J. W., et al. (2021). The relationship between cannabis use and cognition in people with bipolar disorder: A systematic scoping review. Psychiatry Res, 297, 113695.CrossRefGoogle ScholarPubMed
Kim, S.-W., Dodd, S., Berk, L., et al. (2015). Impact of cannabis use on long-term remission in bipolar I and schizoaffective disorder. Psychiatry Invest, 12, 349–355.Google Scholar
Lagerberg, T. V., Kvitland, L. R., Aminoff, S. R., et al. (2014). Indications of a dose–response relationship between cannabis use and age at onset in bipolar disorder. Psychiatry Res, 215, 101–104.Google Scholar
Lagerberg, T. V., Sundet, K., Aminoff, S. R., et al. (2011). Excessive cannabis use is associated with earlier age at onset in bipolar disorder. Eur Arch Psychiatry Clin Neurosci, 261, 397–405.Google Scholar
Lippard, E. T. C., Mazure, C. M., Johnston, J. A. Y., et al. (2017). Brain circuitry associated with the development of substance use in bipolar disorder and preliminary evidence for sexual dimorphism in adolescents. J Neurosci Res, 95, 777–791.CrossRefGoogle ScholarPubMed
Manrique-Garcia, E., Zammit, S., Dalman, C., et al. (2012). Cannabis use and depression: A longitudinal study of a national cohort of Swedish conscripts. BMC Psychiatry, 12, 112.Google Scholar
Marwaha, S., Winsper, C., Bebbington, P., et al. (2018). Cannabis use and hypomania in young people: A prospective analysis. Schizophr Bull, 44, 1267–1274.Google Scholar
McGuire, P., Robson, P., Cubala, W. J., et al. (2018). Cannabidiol (CBD) as an adjunctive therapy in schizophrenia: A multicenter randomized controlled trial. Am J Psychiatry, 175, 225–231.Google Scholar
Merikangas, K. R., Jin, R., He, J.-P., et al. (2012). Prevalence and correlates for bipolar spectrum disorder in the World Mental Health Survey Initiative. Arch Gen Psychiatry, 68, 241–251.Google Scholar
Mongeau-Pérusse, V., Brissette, S., Bruneau, J., et al. (2021). Cannabidiol as a treatment for craving and relapse in individuals with cocaine use disorder: A randomized placebo-controlled trial. Addiction, 116, 2431–2442.Google Scholar
Navarrete, F., García-Gutiérrez, M. S., Jurado-Barba, R., et al. (2020). Endocannabinoid system components as potential biomarkers in psychiatry. Front Psychiatry, 11, 315.Google Scholar
Ostacher, M. J., Perlis, R. H., Nierenberg, A. A., et al. (2010). Impact of substance use disorders on recovery from episodes of depression in bipolar disorder patients: Prospective data from the Systematic Treatment Enhancement Program for Bipolar Disorder (STEP-BD). Am J Psychiatry, 167, 289–297.Google Scholar
Østergaard, M. L. D., Nordentoft, M., and Hjorthøj, C. (2017). Associations between substance use disorders and suicide or suicide attempts in people with mental illness: A Danish nation-wide, prospective, register-based study of patients diagnosed with schizophrenia, bipolar disorder, unipolar depression or personality disorder. Addiction, 112, 1250–1259.Google Scholar
Pinto, J. V., Kauer-Sant’Anna, M., and Yatham, L. N. (2021). What impact does bipolar disorder staging have on the use of pharmacotherapy? Expert Opin Pharmacother, 22, 1513–1516.Google Scholar
Pinto, J. V., Medeiros, L. S., da Rosa, G. S., et al. (2019). The prevalence and clinical correlates of cannabis use and cannabis use disorder among patients with bipolar disorder: A systematic review with meta-analysis and meta-regression. Neurosci Biobehav Rev, 101, 78–84.Google Scholar
Pinto, J. V., Saraf, G., Frysch, C., et al. (2020). Cannabidiol as a treatment for mood disorders: A systematic review. Can J Psychiatry, 65, 213–227.Google Scholar
Post, R. M., Leverich, G. S., Kupka, R. W., et al. (2010). Early-onset bipolar disorder and treatment delay are risk factors for poor outcome in adulthood. J Clin Psychiatry, 71, 864–872.Google Scholar
Ringen, P. A., Vaskinn, A., Sundet, K., et al. (2010). Opposite relationships between cannabis use and neurocognitive functioning in bipolar disorder and schizophrenia. Psychol Med, 40, 1337–1347.Google Scholar
Sagar, K. A., Dahlgren, M. K., Racine, M. T., et al. (2016). Joint effects: A pilot investigation of the impact of bipolar disorder and marijuana use on cognitive function and mood. PLoS ONE, 11(6), e0157060.Google Scholar
Scavone, A., Timmins, V., Collins, J., et al. (2018). Dimensional and categorical correlates of substance use disorders among Canadian adolescents with bipolar disorder. J Can Acad Child Adolesc Psychiatry, 27, 159–166.Google Scholar
Starzer, M. S. K., Nordentoft, M., and Hjorthøj, C. (2018). Rates and predictors of conversion to schizophrenia or bipolar disorder following substance-induced psychosis. Am J Psychiatry, 175, 343–350.CrossRefGoogle ScholarPubMed
Stone, J. M., Fisher, H. L., Major, B., et al. (2014). Cannabis use and first-episode psychosis: Relationship with manic and psychotic symptoms, and with age at presentation. Psychol Med, 44, 499–506.Google Scholar
Strakowski, S. M., DelBello, M. P., Fleck, D. E., et al. (2007). Effects of co-occurring cannabis use disorders on the course of bipolar disorder after a first hospitalization for mania. Arch Gen Psychiatry, 64, 57–64.Google Scholar
Sultan, A. A., Kennedy, K. G., Fiksenbaum, L., et al. (2021). Neurostructural correlates of cannabis use in adolescent bipolar disorder. Int J Neuropsychopharmacol, 24, 181–190.Google Scholar
Szkudlarek, H. J., Desai, S. J., Renard, J., et al. (2019). Delta-9-tetrahydrocannabinol and cannabidiol produce dissociable effects on prefrontal cortical executive function and regulation of affective behaviors. Neuropsychopharmacology, 44, 817–825.Google Scholar
UNDOC. (2018). World Drug Report 2018. Global Overview of Drug Demand and Supply. Available at: www.unodc.org/wdr2018 (Last accessed 12 November 2022).Google Scholar
Weiss, R. D., Griffin, M. L., Kolodziej, M. E., et al. (2007). A randomized trial of integrated group therapy versus group drug counseling for patients with bipolar disorder and substance dependence. Am J Psychiatry, 164, 100–107.CrossRefGoogle ScholarPubMed
Wright, M., Di Ciano, P., and Brands, B. (2020). Use of cannabidiol for the treatment of anxiety: A short synthesis of pre-clinical and clinical evidence. Cannabis Cannabinoid Res, 5, 191–196.Google Scholar
Yatham, L. N., Kennedy, S. H., Parikh, S. V., et al. (2018). Canadian Network for Mood and Anxiety Treatments (CANMAT) and International Society for Bipolar Disorders (ISBD) 2018 guidelines for the management of patients with bipolar disorder. Bipolar Disord, 20, 97–170.Google Scholar
Zorrilla, I., Aguado, J., Haro, J. M., et al. (2015). Cannabis and bipolar disorder: Does quitting cannabis use during manic/mixed episode improve clinical/functional outcomes? Acta Psychiat Scand, 131, 100–110.Google Scholar
Zuardi, A., Crippa, J., Dursun, S., et al. (2010). Cannabidiol was ineffective for manic episode of bipolar affective disorder. J Psychopharmacol, 24, 135–137.Google Scholar

Save book to Kindle

To save this book to your Kindle, first ensure coreplatform@cambridge.org is added to your Approved Personal Document E-mail List under your Personal Document Settings on the Manage Your Content and Devices page of your Amazon account. Then enter the ‘name’ part of your Kindle email address below. Find out more about saving to your Kindle.

Note you can select to save to either the @free.kindle.com or @kindle.com variations. ‘@free.kindle.com’ emails are free but can only be saved to your device when it is connected to wi-fi. ‘@kindle.com’ emails can be delivered even when you are not connected to wi-fi, but note that service fees apply.

Find out more about the Kindle Personal Document Service.

Available formats
×

Save book to Dropbox

To save content items to your account, please confirm that you agree to abide by our usage policies. If this is the first time you use this feature, you will be asked to authorise Cambridge Core to connect with your account. Find out more about saving content to Dropbox.

Available formats
×

Save book to Google Drive

To save content items to your account, please confirm that you agree to abide by our usage policies. If this is the first time you use this feature, you will be asked to authorise Cambridge Core to connect with your account. Find out more about saving content to Google Drive.

Available formats
×