Risks and Benefits of Cannabis and Cannabinoids in Psychiatry.
Kevin P Hill, Mark S. Gold, Charles B. Nemeroff, William McDonald, Adrienne Grzenda, Alik S. Widge, Carolyn I. Rodríguez, Nina V. Kraguljac, John H. Krystal, Linda L. Carpenter
American Journal of Psychiatry February 2022 DOI: 10.1176/appi.ajp.2021.21030320 (opens in new tab)
Study at a glance
AI-extracted from the abstract| Characteristics | Systematic review Randomized Placebo-controlled Double-blind Peer reviewed |
|---|---|
| Topics | Cannabis |
| Keywords | Cannabinoids |
| Key findings | The authors conclude that no psychiatric indications for cannabinoids are FDA-approved and that evidence supporting cannabinoid prescription for psychiatric disorders is limited and insufficient. Evidence beyond FDA-approved indications is strongest for pain and spasticity, while considerable evidence indicates potential harm in adolescents and people with psychotic disorders. |
Abstract
The United States is in the midst of rapidly changing laws regarding cannabis. The increasing availability of cannabis for recreational and medical use requires that mental health clinicians be knowledgeable about evidence to be considered when counseling both patients and colleagues. In this review, the authors outline the evidence from randomized double-blind placebo-controlled trials for therapeutic use of cannabinoids for specific medical conditions and the potential side effects associated with acute and chronic cannabis use. Searches of PubMed and PsycInfo were conducted for articles published through July 2021 reporting on "cannabis" or "cannabinoids" or "medicinal cannabis." Additional articles were identified from the reference lists of published reviews. Articles that did not contain the terms "clinical trial" or "therapy" in the title or abstract were not reviewed. A total of 4,431 articles were screened, and 841 articles that met criteria for inclusion were reviewed by two or more authors. There are currently no psychiatric indications approved by the U.S. Food and Drug Administration (FDA) for cannabinoids, and there is limited evidence supporting the therapeutic use of cannabinoids for treatment of psychiatric disorders. To date, evidence supporting cannabinoid prescription beyond the FDA indications is strongest for the management of pain and spasticity. As cannabinoids become more available, the need for an evidence base adequately evaluating their safety and efficacy is increasingly important. There is considerable evidence that cannabinoids have a potential for harm in vulnerable populations such as adolescents and those with psychotic disorders. The current evidence base is insufficient to support the prescription of cannabinoids for the treatment of psychiatric disorders.
Comparable studies
Other systematic reviews and meta-analyses on cannabis, most cited first.
| Study | Year | Design | Participants |
|---|---|---|---|
| Effects of cannabis use on outcomes of psychotic disorders: systematic review People with psychotic disorders, as examined in 13 longitudinal studies | 2008 | Systematic review | |
| The Impact of Cannabis Use on Cognitive Functioning in Patients With Schizophrenia: A Meta-analysis of Existing Findings and New Data in a First-Episode Sample Patients with established schizophrenia (meta-analysis: 572) and patients with... | 2010 | Meta-analysis and cross-sectional observational study | n = 700 |
| Medicinal cannabis for psychiatric disorders: a clinically-focused systematic review | 2020 | Systematic review | |
| Neuroimaging in cannabis use: a systematic review of the literature Cannabis users and controls in neuroimaging studies | 2009 | Systematic review | |
| Human Laboratory Studies on Cannabinoids and Psychosis. Healthy human subjects and individuals with schizophrenia | 2016 | Systematic review |
Citations in the library
Cited by 5
- Opioid use disorder: current trends and potential treatments Frontiers in Public Health January 25, 2024
- Psychedelics for the Treatment of Psychiatric Disorders: Interpreting and Translating Available Evidence and Guidance for Future Research. American Journal of Psychiatry 2025
- Novel Pharmacologic and Other Somatic Treatment Approaches for Posttraumatic Stress Disorder in Adults: State of the Evidence. American Journal of Psychiatry December 1, 2024
- Clinical Diagnosis and Management of Gradual Onset Cannabis-Induced Psychosis Following the Consumption of Delta-8-Tetrahydrocannabinol Cureus March 1, 2024
- Moon Rock Cannabis-Induced Psychosis and New-Onset Seizures in a 20-Year-Old Male Cureus July 1, 2023
Cites 12
- Global Street Food: la cocina de la calle Diseño interior 2009
- The short-term impact of 3 smoked cannabis preparations versus placebo on PTSD symptoms: A randomized cross-over clinical trial PLoS One March 17, 2021
- Cannabinoids for the treatment of mental disorders and symptoms of mental disorders: A systematic review and meta-analysis The Lancet Psychiatry October 28, 2019
- The contribution of cannabis use to variation in the incidence of psychotic disorder across Europe (EU-GEI): a multicentre case-control study The Lancet Psychiatry May 1, 2019
- Association of Cannabis With Cognitive Functioning in Adolescents and Young Adults: A Systematic Review and Meta-analysis JAMA Psychiatry June 1, 2018
and 7 more in the library