Psychotomimetic symptoms after a moderate dose of a synthetic cannabinoid (JWH-018): implications for psychosis
Eef L. Theunissen, Johannes T. Reckweg, Nadia R. P. W. Hutten, Kim P. C. Kuypers, Stefan W. Toennes, Merja A. Neukamm, Sebastian Halter, Johannes G. Ramaekers
Psychopharmacology January 26, 2021 DOI: 10.1007/s00213-021-05768-0 (opens in new tab)
Study at a glance
AI-extracted from the abstract| Characteristics | Placebo-controlled, double blind, within-subjects trial Double-blind Peer reviewed |
|---|---|
| Sample size | 24 |
| Population | Healthy participants with no history of mental illness |
| Intervention | JWH-018 |
| Dose | 75 μg/kg bodyweight (average 5.52 mg), with as-needed booster |
| Duration | 4.5-h time window after drug administration |
| Measures | CADSS, Bowdle, POMS, SCRQ |
| Topics | Cannabis |
| Keywords | Psychotomimetic Psychosis Synthetic cannabinoids Hallucinogen Poison control Anesthesia Medical emergency Receptor |
| Citations | 20 |
| Key findings | A moderate dose of JWH-018 induces pronounced psychotomimetic symptoms in healthy participants. |
Abstract
Background: Synthetic cannabinoids (SCs) are the largest class of novel psychoactive substances (NPS) and are associated with an increased risk of overdosing and adverse events such as psychosis. JWH-018 is one of the earliest SCs and still widely available in large parts of the world. Controlled studies to assess the safety and behavioural profiles of SCs are extremely scarce.
Aim: The current study was designed to assess the psychotomimetic effects of a moderate dose of JWH-018.
Methods: Twenty-four healthy participants (10 males, 14 females) entered a placebo-controlled, double blind, within-subjects trial and inhaled vapour of placebo or 75μg/kg bodyweight JWH-018. To ascertain a minimum level of intoxication, a booster dose of JWH-018 was administered on an as-needed basis. The average dose of JWH-018 administered was 5.52 mg. Subjective high, dissociative states (CADSS), psychedelic symptoms (Bowdle), mood (POMS) and cannabis reinforcement (SCRQ) were assessed within a 4.5-h time window after drug administration.
Results: JWH-018 caused psychedelic effects, such as altered internal and external perception, and dissociative effects, such as amnesia, derealisation and depersonalisation and induced feelings of confusion.
Conclusion: Overall, these findings suggest that a moderate dose of JWH-018 induces pronounced psychotomimetic symptoms in healthy participants with no history of mental illness, which confirms that SCs pose a serious risk for public health.
Comparable studies
Other randomized controlled trials on cannabis, most cited first.
| Study | Year | Design | Participants |
|---|---|---|---|
| Cannabidiol inhibits THC-elicited paranoid symptoms and hippocampal-dependent memory impairment Healthy participants | 2012 | Randomized controlled trial | n = 48 |
| Distinct Effects of Δ9-Tetrahydrocannabinol and Cannabidiol on Neural Activation During Emotional Processing Healthy, English-native, right-handed men who had used cannabis 15 times or less in... | 2009 | Double-blind, randomized, placebo-controlled crossover trial | n = 15 |
| Acute Effects of a Single, Oral dose of d9-tetrahydrocannabinol (THC) and Cannabidiol (CBD) Administration in Healthy Volunteers Healthy male subjects | 2012 | Randomized controlled trial | n = 16 |
| Modulation of Mediotemporal and Ventrostriatal Function in Humans by Δ9-Tetrahydrocannabinol Healthy, native English-speaking, right-handed men of white race/ethnicity who had used... | 2009 | Randomized controlled trial | n = 15 |
| Cannabidiol (CBD) content in vaporized cannabis does not prevent tetrahydrocannabinol (THC)-induced impairment of driving and cognition Healthy volunteers with a history of light cannabis use | 2019 | Randomized, double-blind, within-subjects crossover | n = 14 |
Citations in the library
Cited by 11
- A Comparison of Acute Neurocognitive and Psychotomimetic Effects of a Synthetic Cannabinoid and Natural Cannabis at Psychotropic Dose Equivalence Frontiers in Psychiatry May 19, 2022
- Novel psychoactive substances (NPS) as a risk factor for psychosis: A systematic review of the literature Neuroscience & Biobehavioral Reviews October 19, 2025
- Clinical Management of Synthetic-Cannabinoid-Induced Psychosis: A Systematic Review of Treatment Strategies and Outcomes. Brain Sciences September 17, 2025
- Cannabis and Mental Health: A Systematic Review and Meta-analysis of the Neuropsychiatric Effects, Therapeutic Potentials, and Policy Implications of THC and CBD Archives of Psychiatry and Mental Health July 29, 2026
- How can we facilitate research on the risks and potential benefits of novel psychoactive substances? EClinicalMedicine June 19, 2026
and 6 more in the library
Cites 20
- Measurement of dissociative states with the Clinician‐Administered Dissociative States Scale (CADSS) Journal of Traumatic Stress 1998
- High-potency cannabis and the risk of psychosis The British Journal of Psychiatry November 30, 2009
- Psychiatric effects of cannabis The British Journal of Psychiatry February 1, 2001
- Psychedelic Effects of Ketamine in Healthy Volunteers Anesthesiology 1998
- Gone to Pot – A Review of the Association between Cannabis and Psychosis Frontiers in Psychiatry May 22, 2014
and 15 more in the library