Regular Cannabis Use Linked to Better Decision-Making in People With Bipolar Disorder
People with bipolar disorder who used cannabis regularly showed decision-making and daily functioning comparable to healthy non-users, while cannabis impaired decision-making in healthy people.
Quick Facts
What This Study Found
Among 87 participants, people with bipolar disorder who used cannabis regularly (4+ times/week) performed comparably to healthy non-users on decision-making and functional capacity measures. In contrast, healthy participants who used cannabis showed impaired decision-making. Non-using bipolar participants performed worst.
Key Numbers
N=87. Four groups compared. Bipolar cannabis users matched healthy non-users on Iowa Gambling Task and UPSA-2 scores. Cannabis use defined as 4+ times per week.
How They Did This
Observational study comparing 87 participants across four groups (healthy cannabis users, healthy non-users, bipolar cannabis users, bipolar non-users) on the Iowa Gambling Task and UCSD Performance-based Skills Assessment.
Why This Research Matters
This counterintuitive finding suggests cannabis may have different cognitive effects depending on underlying brain conditions, potentially normalizing disrupted decision-making circuits in bipolar disorder.
The Bigger Picture
This challenges the assumption that cannabis uniformly impairs cognition. If cannabis normalizes decision-making in bipolar disorder while impairing it in healthy brains, this could reflect fundamentally different underlying neurochemistry.
What This Study Doesn't Tell Us
Small observational sample cannot establish causation. Selection bias: bipolar patients who use cannabis regularly may differ in important ways from those who do not. Cross-sectional snapshot does not capture long-term trajectories.
Questions This Raises
- ?Does cannabis genuinely improve bipolar cognition, or are higher-functioning bipolar patients more likely to use cannabis?
- ?Could cannabinoid-based treatments be developed specifically for bipolar cognitive deficits?
Trust & Context
- Key Stat:
- Bipolar cannabis users matched healthy non-users on decision-making tasks
- Evidence Grade:
- Small observational study with important selection bias concerns. Intriguing but needs replication in larger, controlled studies.
- Study Age:
- 2025 study with novel findings on cannabis-bipolar cognitive interactions.
- Original Title:
- Chronic cannabis use in people with bipolar disorder is associated with comparable decision-making and functional outcome to healthy participants.
- Published In:
- Translational psychiatry, 15(1), 506 (2025)
- Authors:
- Miranda, Alannah(2), Roberts, Benjamin Z(2), Holloway, Breanna M(3), Peek, Elizabeth, Rosberg, Holden, Ayoub, Samantha M, Piomelli, Daniele, Jung, Kwang-Mook, Barnes, Samuel A, Rossi, Steven, Geyer, Mark A, Perry, William, Minassian, Arpi, Young, Jared W
- Database ID:
- RTHC-07147
Evidence Hierarchy
Watches what happens naturally without intervening.
What do these levels mean? →Frequently Asked Questions
Can cannabis help with bipolar disorder symptoms?
This study found regular cannabis users with bipolar disorder performed as well as healthy non-users on decision-making tests, while bipolar non-users performed worse. However, the small sample and observational design mean this could reflect selection effects rather than a true treatment benefit.
Does cannabis affect everyone's cognition the same way?
No. This study found cannabis was associated with impaired decision-making in healthy participants but comparable or improved performance in those with bipolar disorder, suggesting the effects depend on underlying brain chemistry.
Read More on RethinkTHC
Cite This Study
https://rethinkthc.com/research/RTHC-07147APA
Miranda, Alannah; Roberts, Benjamin Z; Holloway, Breanna M; Peek, Elizabeth; Rosberg, Holden; Ayoub, Samantha M; Piomelli, Daniele; Jung, Kwang-Mook; Barnes, Samuel A; Rossi, Steven; Geyer, Mark A; Perry, William; Minassian, Arpi; Young, Jared W. (2025). Chronic cannabis use in people with bipolar disorder is associated with comparable decision-making and functional outcome to healthy participants.. Translational psychiatry, 15(1), 506. https://doi.org/10.1038/s41398-025-03718-4
MLA
Miranda, Alannah, et al. "Chronic cannabis use in people with bipolar disorder is associated with comparable decision-making and functional outcome to healthy participants.." Translational psychiatry, 2025. https://doi.org/10.1038/s41398-025-03718-4
RethinkTHC
RethinkTHC Research Database. "Chronic cannabis use in people with bipolar disorder is asso..." RTHC-07147. Retrieved from https://rethinkthc.com/research/miranda-2025-chronic-cannabis-use-in
Access the Original Study
Study data sourced from PubMed, a service of the U.S. National Library of Medicine, National Institutes of Health.
This study breakdown was produced by the RethinkTHC research team. We analyze and report published research findings without making health recommendations. All interpretations are based solely on the published abstract and study data.