Abstract
Cannabis use has increased greatly over the last three decades. The various types of cannabis differ in their concentration of the main psychoactive component, Δ9-tetrahydrocannabinol (THC), and the other major ingredient, cannabidiol (CBD). Plant engineering has maximized levels of THC, thus increasing the potency of street cannabis. It is well known that cannabis intoxication can cause brief psychotic symptoms like paranoia, whilst recent evidence demonstrates that heavy use of cannabis increases the risk of chronic psychoses like schizophrenia; genetic vulnerability seems to predispose some people to a higher risk. This paper starts to consider the neurochemical mechanisms whereby cannabis use increases the risk of psychosis.
This is a preview of subscription content, access via your institution.
References
Aguado T, J Palazuelos, K Monory, N Stella, B Cravatt, B Lutz, G Marsicano, Z Kokaia, M Guzman and I Galve-Roperh (2006) The endocannabinoid system promotes astroglial differentiation by acting on neural progenitor cells.J. Neurosci. 26, 1551–1561.
Andréasson S, P Allebeck, A Engström and U Rydberg (1987) Cannabis and schizophrenia. A longitudinal study of Swedish conscripts.Lancet 2(8574), 1483–1486.
Antonelli T, MC Tomasini, M Tattoli, T Cassano, S Tanganelli, S Finetti, E Mazzoni, L Trabace, L Steardo, V Cuomo and L Ferraro (2005) Prenatal exposure to the CB1receptor agonist WIN 55,212-2 causes learning disruption associated with impaired cortical NMDA receptor function and emotional reactivity changes in rat offspring.Cereb. Cortex 15, 2013–2020.
Arseneault L, M Cannon, R Poulton, R Murray, A Caspi and TE Moffit (2002) Cannabis use in adolescence and risk for adult psychosis: longitudinal prospective study.Br. Med. J. 7374, 1212–1213.
Arseneault L, M Cannon, J Witton and RM Murray (2004) Causal association between cannabis and psychosis: examination of the evidence.Br. J. Psychiatry 184, 110–117.
Ashton H (2002) Cannabis or health?Curr. Opin. Psychiatry 15, 247–253.
Bailey CH, M Giustetto, YY Huang, RD Hawkins and ER Kandel (2000) Is heterosynaptic modulation essential for stabilizing Hebbian plasticity and memory?Nat. Rev. Neurosci. 1, 11–20.
Berghuis P, MB Dobszay, X Wang, S Spano, F Ledda, KM Sousa, G Schulte, P Ernfors, K Mackie, G Paratcha, YL Hurd and T Harkany (2005) Endocannabinoids regulate interneuron migration and morphogenesis by transactivating the TrkB receptor.Proc. Natl. Acad. Sci. USA 102, 19115–19120.
Berghuis P, AM Rajnicek, YM Morozov, RA Ross, J Mulder, GM Urban, K Monory, G Marsicano, M Matteoli, A Canty, AJ Irving, I Katona, Y Yanagawa, P Rakic, B Lutz, K Mackie and T Harkany (2007) Hardwiring the brain: endocannabinoids shape neuronal connectivity.Science 316, 1212–1216.
Bernard C, M Milh, YM Morozov, Y Ben-Ari, TF Freund and H Gozlan (2005) Altering cannabinoid signaling during development disrupts neuronal activity.Proc. Natl. Acad. Sci. USA 102, 9388–9393.
Caspi A, ET Mofitt, M Cannon, J McClay, R Murray, HL Harrington, A Taylor, L Arseneault, B Williams, A Braithwaite, R Poulton and IW Craig (2005) Moderation of the effect of adolescent-onset cannabis use on adult psychosis by a functional polymorphism in the catechol-O-methyltransferase gene: longitudinal evidence of a gene X environment interaction.Biol. Psychiatry 57, 1117–1127.
Chavarría-Siles I, J Contreras-Rojas, E Hare, C Walss-Bass, P Quezada, A Dassori, S Contreras, R Medina, M Ramírez, R Salazar, H Raventos and MA Escamilla (2008) Cannabinoid receptor 1 gene(CNR1) and susceptibility to a quantitative phenotype for hebephrenic schizophrenia.Am. J. Med. Genet. B Neuropsychiatr. Genet. 147B(3), 279–284.
Cheer JF, KM Wassum, ML Heien, PE Phillips and RM Wightman (2004) Cannabinoids enhance subsecond dopamine release in the nucleus accumbens of awake rats.J. Neurosci. 24(18), 4393–4400.
D’Souza DC, E Perry, L MacDougall, Y Ammerman, T Cooper, Y-T Wu, G Braley, R Gueorguieva, JH Krystalet al. (2004) The psychotomimetic effects of intravenous Δ-9-tetrahydrocannabinol in healthy individuals: implications for psychosis.Neuropsychopharmacology 29(8), 1558–1572.
Day NL, L Goldschmidt and CA Thomas (2006) Prenatal marijuana exposure contributes to the prediction of marijuana use at age 14.Addiction 101, 1313–1322.
Eggan SM and DA Lewis (2007) Immunocytochemical distribution of the cannabinoid CB1receptor in the primate neocortex: a regional and laminar analysis.Cereb. Cortex 17, 175–191.
Fergusson DM, LJ Horwood and NR Swain-Campbell (2003) Cannabis dependence and psychotic symptoms in young people.Psychol. Med. 33, 15–21.
Freund TF, I Katona and D Piomelli (2003) Role of endogenous cannabinoids in synaptic signaling.Physiol. Rev. 83, 1017–1066.
Fried PA (2002) Conceptual issues in behavioral teratology and their application in determining long-term sequelae of prenatal marihuana exposure.J. Child Psychol. Psychiatry 43, 81–102.
Fried PA and AM Smith (2001) A literature review of the consequences of prenatal marihuana exposure. An emerging theme of a deficiency in aspects of executive function.Neurotoxicol. Teratol. 23, 1–11.
Fried PA, B Watkinson and R Gray (1992) A follow-up study of attentional behavior in 6-year-old children exposed prenatally to marihuana, cigarettes, and alcohol.Neurotoxicol. Teratol. 14, 299–311.
Giuffrida A., LH Parsons, TM Kerr, F Rodriguez de Fonseca, M Navarro and D Piomelli (1999) Dopamine activation of endogenous cannabinoid signaling in dorsal striatum.Nat. Neurosci. 2, 358–363.
Goldschmidt L, NL Day and GA Richardson (2000) Effects of prenatal marijuana exposure on child behavior problems at age 10.Neurotoxicol. Teratol. 22, 325–336.
Goldschmidt L, GA Richardson, MD Cornelius and NL Day (2004) Prenatal marijuana and alcohol exposure and academic achievement at age 10.Neurotoxicol. Teratol. 26, 521–532.
Gray KA, NL Day, S Leech and GA Richardson (2005) Prenatal marijuana exposure: effect on child depressive symptoms at ten years of age.Neurotoxicol. Teratol. 27, 439–448.
Grech A, J Van Os, PB Jones, SW Lewis RM Murray (2005) Cannabis use and outcome of recent onset psychosis.Eur. Psychiatry 20(4), 349–353.
Harkany T, M Guzman, I Galve-Roperh, P Berghuis, LA Devi and K Mackie (2007) The emerging functions of endocannabinoid signaling during CNS development.Trends Pharmacol. Sci. 28, 83–92.
Harkany T, E Keimpema, K Barabas and J Mulder (2008) Endocannabinoid functions controlling neuronal specification during brain development.Mol. Cell. Endocrinol. 286, S84-S90.
Henquet C, L Krabbendam, J Spauwen, C Kaplan, R Lieb, H-U Wittchenet al. (2005) Prospective cohort study of cannabis use, predisposition for psychosis, and psychotic symptoms in young people.BMJ 330(7481), 11. Epub 2004 Dec 1.
Henquet C, R Murray, D Linszen and J van Os (2005) The environment and schizophrenia: the role of cannabis use.Schizophr. Bull. 31, 608–612.
Henquet C, A Rosa, L Krabbendam, S Papiol, L Fananás, M Drukker, JG Ramaekers and J van Os (2006) An experimental study of catechol-O-methyltransferase Val158Met moderation of Δ-9-tetrahydrocannabinol-induced effects on psychosis and cognition.Neuropsychopharmacology 31(12), 2748–2755.
Huizink AC and EJ Mulder (2006) Maternal smoking, drinking or cannabis use during pregnancy and neurobehavioral and cognitive functioning in human offspring.Neurosci. Biobehav. Rev. 30, 24–41.
Kawamura Y, M Fukaya, T Maejima, T Yoshida, E Miura, M Watanabe, T Ohno-Shosaku and M Kano (2006) The CB1 cannabinoid receptor is the major cannabinoid receptor at excitatory presynaptic sites in the hippocampus and cerebellum.J. Neurosci. 26, 2991–3001.
Kapur S, R Mizrahi and M Li (2005) From dopamine to salience to psychosis-linking biology, pharmacology and phenomenology of psychosis.Schizophr. Res. 79, 59–68.
Laruelle M, A Abi-Dargham, CH van Dyck, R Gil, CD D’Souza, J Erdos, E McCance, W Rosenblatt, C Fingado, SS Zoghbi, RM Baldwin, JP Seibyl, JH Krystal, DS Charney and RB Innis (1996) Single photon emission computerized tomography imaging of amphetamine-induced dopamine release in drug-free schizophrenic subjects.Proc. Natl. Acad. Sci. USA 93, 9235–9240.
Leech SL, GA Richardson, L Goldschmidt and NL Day (1999) Prenatal substance exposure: effects on attention and impulsivity of 6-year-olds.Neurotoxicol. Teratol. 21, 109–118.
Leweke F, U Schneider, M Radwan, E Schmidt and HM Emrik (2000) Different effects of nabilone and cannabidiol on binocular bepth inversion in man.Pharmacol. Biochem. Behav. 66, 175–181.
Mackie K, Y Lai, R Westenbroek and R Mitchell (1995) Cannabinoids activate an inwardly rectifying potassium conductance and inhibit Q-type calcium currents in AtT20 cells transfected with rat brain cannabinoid receptor.J. Neurosci. 15, 6552–6561.
Mátyás F, Y Yanovsky, K Mackie, W Kelsch, U Misgeld and TF Freund (2006) Subcellular localization of type 1 cannabinoid receptors in the rat basal ganglia.Neuroscience 137, 337–361.
Mereu G, M Fa, L Ferraro, R Cagiano, T Antonelli, M Tattoli, V Ghiglieri, S Tanganelli, GL Gessa and V Cuomo (2003) Prenatal exposure to a cannabinoid agonist produces memory deficits linked to dysfunction in hippocampal long-term potentiation and glutamate release.Proc. Natl. Acad. Sci. USA 100, 4915–4920.
Moore TH, S Zammit, A Lingford-Hughes, TR Barnes, PB Jones, M Burke and G Lewis (2007) Cannabis use and risk of psychotic or affective mental health outcomes: a systematic review.Lancet 370(9584), 319–328.
Morita Y, H Ujike, Y Tanaka, N Uchida, A Nomura, K Ohtani, M Kishimoto, A Morio, T Imamura, A Sakai, T Inada, M Harano, T Komiyama, M Yamada, Y Sekine, N Iwata, M Iyo, I Sora, N Ozaki and S Kuroda (2005) A nonsynonymous polymorphism in the human fatty acid amide hydrolase gene did not associate with either methamphetamine dependence or schizophrenia.Neurosci. Lett. 376(3), 182–187. Epub 2004 Dec 9.
Mulder J, T Aguado, E Keimpema, K Barabas, CJ Ballester-Rosado, L Nguyen, K Monory, G Marsicano, V Di Marzo, YL Hurd, F Guillemot, K Mackie, B Lutz, M Guzman, HC Lu, I Galve-Roperh and T Harkany (2008) Endocannabinoid signaling controls pyramidal cell specification and long-range axon patterning.Proc. Natl. Acad. Sci. USA 105, 8760–8765.
Seeman P, D Weinshenker, R Quirion, LK Srivastava, SK Bhardwaj, DK Grandy, RT Premont, TD Sotnikova, P Boksa, M El-Ghundi, B O’Dowd, F George, SR Perreault, ML Mannisto, PT Robinson, S Palmiter and RD Tallerico (2005) Dopamine supersensitivity correlates with D2High states, implying many paths to psychosis.Proc. Natl. Acad. Sci. USA 102, 3513–3518.
Seifert J, S Ossege, HM Emrich, U Schneider and M Stuhrmann (2007) No association of CNR1 gene variations with susceptibility to schizophrenia.Neurosci. Lett. 426(1), 29–33. Epub 2007Aug10.
Spano MS, M Ellgren, X Wang and YL Hurd (2007) Prenatal cannabis exposure increases heroin seeking with allostatic changes in limbic enkephalin systems in adulthood.Biol. Psychiatry 61, 554–563.
Stefanis NC, M Hanssen, NK Smirniset al. (2002) Evidence that three dimensions of psychosis have a distribution in the general population.Psychol. Med. 32, 347–358.
Stefanis NC, P Delespaul, C Henquet, C Bakoula, CN Stefanis and J Van Os (2004) Early adolescent cannabis exposure and positive and negative dimensions of psychosis.Addiction 99, 1333–1341.
Ujike H, M Takaki, K Nakata, Y Tanaka, T Takeda, M Kodama, Y Fujiwara, A Sakai and S Kuroda (2002) CNR1, central cannabinoid receptor gene, associated with susceptibility to hebephrenic schizophrenia.Mol. Psychiatry 7, 515–518.
Uchigashima M, M Narushima, M Fukaya, I Katona, M Kano and M Watanabe (2007) Subcellular arrangement of molecules for 2-arachidonoyl-glycerol-mediated retrograde signaling and its physiological contribution to synaptic modulation in the striatum.J. Neurosci. 27, 3663–3676.
United Nations Office on Drugs and Crime UNODC World Drug Report (2006) [online] http://www.unodc.org/unodc/ en/world_drug_report_2006.html.
Zuardi AW, I Shirakawa, E Finkelfarbet al. (1982) Action of cannabidiol on the anxiety and other effects produced by Δ9-THC in normal subjects.Psychopharmacol. (Berl.) 76, 245–250.
Zuardi AW, JA Rodrigues and JM Cunha (1991) Effects of cannabidiol in animal models predictive of antipsychotic activity.Psychopharmacol. (Berl.) 104(2), 260–264.
Zuardi AW, SL Morais, FS Guimarães and R Mechoulam (1995) Antipsychoticeffectofcannabidiol.J. Clin. Psychiatry 56(10), 485–486.
Zuardi AW, JEC Hallak, SM Dursunet al. (2006) Cannabidiol monotherapy for treatment-resistant schizophrenia.J Psychopharmacol. 20(5), 683–686. Epub 2006 Jan 9.
Author information
Authors and Affiliations
Corresponding author
Rights and permissions
About this article
Cite this article
Luzi, S., Morrison, P.D., Powell, J. et al. What is the mechanism whereby cannabis use increases risk of psychosis?. neurotox res 14, 105–112 (2008). https://doi.org/10.1007/BF03033802
Received:
Revised:
Issue Date:
DOI: https://doi.org/10.1007/BF03033802
Keywords
- Cannabis
- Psychosis
- Endocannabinoid System
- Dopamine