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HOW MARIJUANA (CANNABIS) USE CAN MAKE SYMPTOMS OF BIPOLAR DISORDER WORSE! (2722 hits)


For Immediate Release!



Research With Negative Findings Regarding Marijuana Use In Bipolar Disorder Treatment:

Some researchers have actually found that marijuana use can make symptoms of bipolar disorder worse in some people. Examples of their studies include:

Triggering manic episodes and worsening symptoms

A review published in early 2015 found that using marijuana could make manic symptoms worse in a person with bipolar disorder. They also found that marijuana use could trigger a manic episode.

In addition, the 2015 study Trusted Source above touting benefits to marijuana use, also found that it worsened manic or depressive symptoms in some people.

Higher rates of attempted suicide and early onset:

According to another study from 2015, suicide attempt rates in people with bipolar disorder were higher in those who used marijuana than in those who didn’t use marijuana.

The study also found that people who used marijuana were younger at bipolar disorder onset (when their symptoms first started) than those who didn’t use it. This is a concern, as doctors think that a younger age at onset causes worse symptoms throughout a person’s life.

The effect of marijuana on early onset and suicide rates wasn’t clear however, researchers said.

While marijuana may help some people with bipolar disorder, these studies show that it could also cause problems for others with the condition.
Read the full article HERE!: https://www.healthline.com/health/bipolar-...


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Cannabis Use in Bipolar Disorder Presents a Treatment Challenge
Abigail Nover


Among patients with bipolar disorder, cannabis is the most commonly abused drug. Lifetime use of cannabis among bipolar patients is estimated to be around 70%, and 30% present a comorbidity of cannabis abuse or dependence. The risk for psychotic disorders increases with the frequency and intensity of cannabis use. Researchers have found that cannabis use is also associated with a younger age at onset of first manic episode, increased manic and depressive episodes, increased risk of rapid cycling, poorer outcome, and poorer treatment compliance.1

These findings illuminate the challenges in treating patients with bipolar disorder who use cannabis, especially as an increasing number of US states legalize marijuana. Self-medication with cannabis was recently found to be 3.73 percentage points higher among those living in states with medical marijuana laws.2 Although further investigations are needed to clarify the relationship between mania onset and cannabis use, researchers say they are “undeniably correlated.”1

Psychiatry Advisor spoke with Girish Subramanyan, MD, a psychiatrist in full-time private practice in San Francisco, California, specializing in the treatment of adults with mood and anxiety disorders, including treatment-resistant mood and anxiety disorders.

Psychiatry Advisor: Does cannabis use present any challenges in treating patients with bipolar disorder? If so, what are the challenges and how do they affect treatment?

Dr Girish Subramanyan: Yes. It can complicate the management of bipolar disorder by virtue of causing mood instability and psychosis in certain patients with bipolar disorder. Cannabis is a known psychotogenic drug for some people, although the majority of people who use it do not develop psychosis. But, among those that do, there seems to be a higher risk for conversion to schizophrenia and bipolar disorders, unfortunately. Moreover, it’s not uncommon for me to see patients with bipolar disorder relapse into mania with recent cannabis use. Observational studies have demonstrated a correlation between cannabis use and hypomanic and manic relapse in bipolar disorder.

Psychiatry Advisor: Are there distinct challenges or effects of cannabis use in patients with bipolar I vs bipolar II?

Dr Subramanyan: Yes. The possibility of cannabis contributing to manic relapse in bipolar I disorder makes it potentially more dangerous in bipolar I disorders. Manias have the potential to cause devastating consequences in the lives of patients and their families. Plus, there is a real possibility that cannabis can contribute to psychotic manic episodes. This risk is probably lower in individuals with bipolar II disorder, but it is possible, I suppose, that someone with a true diagnosis of bipolar II disorder could have a cannabis-induced manic episode with psychotic features, something that may never have occurred spontaneously for this individual.
In bipolar II disorder, you may end up seeing more mood instability, mixed states, and hypomanic episodes, and although these states are uncomfortable, and even dangerous, if they are accompanied by suicidal ideations, they generally don’t do as much damage as full-blown manic episodes.

Psychiatry Advisor: Has the legalization of recreational marijuana use in California had any noticeable effect on your treatment of bipolar disorder?

Dr Subramanyan: Surprisingly, I don’t think I’ve seen much in the way of increased incidence of mania or psychosis in my practice since the legalization of recreational marijuana in California. What I have noticed, however, is that more and more patients in my practice are using some kind of cannabinoid for a variety of reasons: treatment of anxiety, treatment of pain, treatment of insomnia, etc. Patients seem to be using cannabidiol (CBD) products, in particular, more frequently. CBD is interesting in that it seems to have opposite effects in the brain as does THC. There is a thought that it could actually have antipsychotic function.

Read the full article HERE!: https://www.psychiatryadvisor.com/home/bip...



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Cannabis: Patients With Bipolar Should Avoid Use


Regardless of whatever short-term benefit patients perceive from cannabis, the evidence points clearly to an association between usage and worsening course of bipolar disorder over time.




We frequently encounter patients who use cannabis. More than 50 indications for medical marijuana are approved by various state governments, although no indications are FDA-approved. Marijuana is legal in 36 states-and 10 states allow recreational use-but regulation of the quality or purity of these products is minimal. Some patients are convinced that marijuana calms them, uplifts them, blunts their anxiety, enables them to sleep, and has other benefits like helping with pain. Many report that it is the only thing that is reliably helpful for neuropsychiatric symptoms, compared with prescribed medications. Notably, scores of nicotine users say the same thing: it is their coping strategy of choice for just about every stress or even their “only pleasure in life.” Others say the same things about benzodiazepines. Rhetorical question: What do these substances have in common?

Regardless of whatever short-term benefit patients perceive from cannabis, the evidence points clearly to an association between usage and worsening course of bipolar disorder over time. In a study of 4915 participants, Henquet et al.1 found a strong increased risk of manic symptoms associated with cannabis over a three year follow-up (after controlling for possible covariates). They also saw an earlier age of onset of bipolar disorder, greater overall illness severity, more rapid cycling, poorer life functioning, and poorer adherence with prescribed treatments.
Zorrilla and colleagues2 evaluated the subsequent course of patients with bipolar disorder who stopped cannabis use after an illness episode and compared their outcome with patients with bipolar disorder who had never used cannabis and a group that continued to use. The total sample included 1922 patients. In a two year period, the continued users had significantly lower rates of recovery, greater work impairment, and fewer were living with a partner. The data were based on patient reports; given that fact, there was likely under-reporting and probably an underestimate of the association between cannabis use and lives worsened. A systematic review of the effects of cannabis on mood and anxiety disorders confirmed a negative association between cannabis use and long-term outcomes.3

Some patients exhibit psychotic symptoms after cannabis use. A recent study found that schizophrenia or bipolar disorder developed in many of these patients.4 This happened in 47% of patients who became psychotic on cannabis over the next four years. This was the highest incidence of conversion after initial psychosis following use of various substances: the second highest was with amphetamine, at 32%. More patients converted to schizophrenia than to bipolar. As for any possible benefits, a recent review concluded that the evidence supporting use of cannabis for psychotic (or other psychiatric) disorders is “very low” and “inadequate.”5

The non-psychiatric medical benefits of cannabis are also very thinly evidenced despite outsized claims to the contrary.6 It is said to be “irresponsible” to encourage patients addicted to opiates to switch to cannabis for their problems with pain.7

Thus, it seems that patients with bipolar disorder should stay away from cannabis in all its forms. Quitting cannabis should be on the short list of interventions if patients are not doing well. This is a tough sell in today’s political environment regarding cannabis legalization. Many newspaper editorials and politicians support its beneficial effects and use. Clinicians should not back down and accept patients’ insistence on using this product; rather, they should continue efforts to educate and to consider the problem to be a serious one that potentially interferes with otherwise appropriate and effective bipolar treatments that may be offered.

Read the full article HERE!: https://www.psychiatrictimes.com/view/cann...



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What Are Co-occurring Disorders?

People who have substance use disorders as well as mental health disorders are diagnosed as having co-occurring disorders, or dual disorders. This is also sometimes called a dual diagnosis. Substance use disorder. A substance use disorder includes
alcohol or drug abuse, alcohol, or drug dependence.


Alcohol or drug abuse is diagnosed when substance use interferes with functioning at work, at school, and in social relationships. It is also diagnosed when substance use creates or worsens a medical condition or when substance use occurs in dangerous situations.

Alcohol or drug dependence is a more severe condition than alcohol or drug abuse. In addition to facing more negative consequences, people with dependence have failed in their attempts to abstain from or control their use of substances. In some cases, physiological dependence may also exist, which is indicated by heightened tolerance (needing more of a substance to get the same effect) and withdrawal (experiencing symptoms such as tremors or nausea when substance use has stopped).
Mental health disorders.

Some of the most common mental health disorders found in chemically dependent people include mood- and anxiety disorders. An even higher percentage of people with severe mental illness also have co-occurring substance use disorders. Called severe because of the severity and length of episodes of illness, these mental health disorders include schizophrenia and schizoaffective disorder. (These latter two disorders with their symptoms of hallucinations or delusions are also sometimes called thought disorders.).

Read the full article HERE!: http://www.bhevolution.org/public/cooccurr...
Posted By: agnes levine
Monday, December 7th 2020 at 10:28AM
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