title: Psychopharmacological comparison of schizophrenia spectrum disorder with and without cannabis dependency.
abstract: BACKGROUND
  Although incidence of schizophrenia is higher among cannabis users and marijuana is the most common abused drug by adolescents, etiological linkage between schizophrenia and cannabis use is still not clarified. Clinical experiences suggest that regular cannabis user can show similar psychotic episode to schizophrenic disorders but it is still unclear if chronic cannabis use with schizophreniform disorder is a distinct entity requiring special therapy or it can be treated as classical schizophrenia. There are no data available on the comparison of pharmacotherapy between schizophreniform patients with and without cannabis use.
  
  
  METHODS
  Clinical data of 85 patients with schizophrenia spectrum disorder were analyzed retrospectively. Cannabis use was not reported by 43 persons (Cnbs0 subgroup) and 42 patients used regularly cannabis during at least 1 year (Cnbs1 subgroup). Comparison of anamnesis, family history, social-demographic condition, positive and negative symptoms, acute and long-term therapies recorded by clinical interviews was performed with chi square tests, logistic binary regression and t-tests using SPSS 13.0 for Windows software.
  
  
  RESULTS
  Men were over-represented in cannabis dependent group while mean age was lower among them compared to Cnbs0 subgroup. Prevalence of suicidal attempt was increased in men without cannabis use (OR = 5.25, p = 0.016). Patients without cannabis use spent more time in hospital (p = 0.026) and smoking was more frequent among them (OR = 1.36, p = 0.047). The chance to get olanzapine for acute therapy and aripiprazol for long term therapy was more than two fold in Cnbs1 subgroup (OR = 2.66, OR = 3.67, respectively). However, aripiprazol was used for acute therapy with significantly lower risk in Cnbs1 subgroup (OR = 0.47, p = 0.023). Olanzapine was administered for long term therapy in a higher dose to Cnbs0 patients (p = 0.040). Also higher dose of risperidon LAI was used in women without cannabis dependency compared to women of Cnbs1 subgroup (p=0.020). Positive and negative symptoms and family history did not differ significantly between the two subgroups.
  
  
  CONCLUSIONS
  Although symptom profile was similar, hospitalization time, suicidal anamnesis, smoking habit and also dosage, intensity and lasting of therapy were different between the two subgroups. Further prospective studies are required for the investigation of the clinical and molecular background of this discrepancy in order to determine a relevant protocol of prevention and treatment of the chronic cannabis use related psychotic disorder.
authors.affiliation: 1st Department of Psychiatry, Nyírő Gyula Hospital, Budapest, Hungary.
authors.forename: Zoltan
authors.initials: Z
authors.lastname: Makkos
authors.forename: Lilla
authors.initials: L
authors.lastname: Fejes
authors.forename: Gabriella
authors.initials: G
authors.lastname: Inczédy-Farkas
authors.forename: Akos
authors.initials: A
authors.lastname: Kassai-Farkas
authors.forename: Gabor
authors.initials: G
authors.lastname: Faludi
authors.forename: Judit
authors.initials: J
authors.lastname: Lazary
mesh_terms: D000328:Adult; D000367:Age Factors; D014150:Antipsychotic Agents / Q000627:therapeutic use; D005260:Female; D006801:Humans; D008297:Male; D002189:Marijuana Abuse / Q000175:diagnosis / Q000188:drug therapy / Q000453:epidemiology* / Q000523:psychology*; D011939:Mental Recall / Q000502:physiology; D016017:Odds Ratio; D015995:Prevalence; D011600:Psychopharmacology; D011618:Psychotic Disorders / Q000175:diagnosis / Q000188:drug therapy / Q000453:epidemiology* / Q000523:psychology*; D012189:Retrospective Studies; D012737:Sex Factors; D013406:Suicide, Attempted / Q000523:psychology; D013997:Time Factors; D055815:Young Adult
chemical_list: D014150:Antipsychotic Agents