title: A Study of the Impact of Cannabis on Doses of Discharge Antipsychotic Medication in Individuals with Schizophrenia or Schizoaffective Disorder.
abstract: Patients with schizophrenia or schizoaffective disorder have a high prevalence of comorbid cannabis use disorder (CUD). CUD has been associated with poorer outcomes in patients. We compared doses of antipsychotic medications at the time of discharge from hospital among inpatients with schizophrenia or schizoaffective disorder with or without concurrent cannabis use. We reviewed the medical records of patients (N = 8157) with schizophrenia or schizoaffective disorder discharged from the hospital between 2008 and 2012. The patients were divided into two groups; those with urine drug tests positive for cannabis and those negative for cannabis. Doses of antipsychotic medications were converted to chlorpromazine equivalents. Bivariate analyses were done with Student's t test for continuous variables and χ2test for categorical variables. Linear regression was carried out to adjust for potential confounders. Unadjusted analysis revealed that the cannabis positive group was discharged on lower doses of antipsychotic medication compared with the cannabis negative group (geometric mean chlorpromazine equivalent doses 431.22 ± 2.20 vs 485.18 ± 2.21; P < 0.001). However, the difference in geometric mean chlorpromazine equivalent doses between the two groups was no longer significant after adjusting for sex, age, race, and length of stay (geometric mean difference 0.99; 95 % CI 0.92-1.10). Though limited by lack of information on duration, amount and severity of cannabis use, as well as inability to control for other non-antipsychotic medications, our study suggests that cannabis use did not significantly impact on doses of antipsychotics required during the periods of acute exacerbation in patients with schizophrenia or schizoaffective disorder.
authors.affiliation: University of Texas Harris County Psychiatric Center, 2800 South MacGregor Way, Houston, TX, 77021, USA.
authors.forename: Taiwo
authors.initials: T
authors.lastname: Babatope
authors.affiliation: University of Texas Harris County Psychiatric Center, 2800 South MacGregor Way, Houston, TX, 77021, USA.
authors.forename: Jigar
authors.initials: J
authors.lastname: Chotalia
authors.affiliation: University of Texas Harris County Psychiatric Center, 2800 South MacGregor Way, Houston, TX, 77021, USA.
authors.forename: Rania
authors.initials: R
authors.lastname: Elkhatib
authors.affiliation: University of Texas Harris County Psychiatric Center, 2800 South MacGregor Way, Houston, TX, 77021, USA.
authors.forename: Satyajit
authors.initials: S
authors.lastname: Mohite
authors.affiliation: University of Texas Harris County Psychiatric Center, 2800 South MacGregor Way, Houston, TX, 77021, USA.
authors.forename: Joel
authors.initials: J
authors.lastname: Shah
authors.affiliation: University of Texas Harris County Psychiatric Center, 2800 South MacGregor Way, Houston, TX, 77021, USA.
authors.forename: Sumana
authors.initials: S
authors.lastname: Goddu
authors.affiliation: University of Texas Harris County Psychiatric Center, 2800 South MacGregor Way, Houston, TX, 77021, USA.
authors.forename: Ruchir Arvind
authors.initials: RA
authors.lastname: Patel
authors.affiliation: University of Texas Harris County Psychiatric Center, 2800 South MacGregor Way, Houston, TX, 77021, USA.
authors.forename: Osarhiemen Ruth
authors.initials: OR
authors.lastname: Aimienwanu
authors.affiliation: University of Texas Harris County Psychiatric Center, 2800 South MacGregor Way, Houston, TX, 77021, USA.
authors.forename: Devanshu
authors.initials: D
authors.lastname: Patel
authors.affiliation: University of Texas Harris County Psychiatric Center, 2800 South MacGregor Way, Houston, TX, 77021, USA.
authors.forename: Titilayo
authors.initials: T
authors.lastname: Makanjuola
authors.affiliation: University of Texas Harris County Psychiatric Center, 2800 South MacGregor Way, Houston, TX, 77021, USA. olaoluwa.o.okusaga@uth.tmc.edu.
authors.forename: Olaoluwa O
authors.initials: OO
authors.lastname: Okusaga
mesh_terms: D000328:Adult; D014150:Antipsychotic Agents / Q000008:administration & dosage*; D015897:Comorbidity; D005260:Female; D006778:Hospitals, Psychiatric; D006801:Humans; D016014:Linear Models; D008297:Male; D002189:Marijuana Abuse / Q000453:epidemiology* / Q000523:psychology / Q000652:urine; D008385:Marijuana Smoking / Q000453:epidemiology* / Q000523:psychology / Q000652:urine; D008875:Middle Aged; D010351:Patient Discharge; D011618:Psychotic Disorders / Q000188:drug therapy* / Q000453:epidemiology / Q000523:psychology; D012559:Schizophrenia / Q000188:drug therapy* / Q000453:epidemiology; D012565:Schizophrenic Psychology; D014481:United States; D055815:Young Adult
chemical_list: D014150:Antipsychotic Agents
keywords: Antipsychotics; Cannabis; Chlorpromazine equivalent; Discharge dose; Schizoaffective disorder; Schizophrenia