Cannabis Use May Worsen Metabolic Problems in Psychosis Patients Already at Risk | Research

The takeaway

While cannabis acutely increases appetite and weight, its long-term metabolic effects in psychosis patients are unclear, with one study finding increased weight and blood glucose in cannabis-using patients.

Read this if you have psychosis and use cannabis, and want to understand potential metabolic health implications.

One study found cannabis increased weight and blood glucose in psychosis patients

What the researchers found

This narrative review examined how cannabis use might affect metabolic health in people with psychosis, a population already at elevated risk for cardiovascular and metabolic disease.

In the general population, cannabis's short-term appetite-stimulating effects through the endocannabinoid system are well documented. However, the long-term metabolic effects of chronic cannabis use remain unclear, with conflicting results from the few studies conducted.

In patients with psychosis specifically, only one study had examined this question at the time of the review. That study found cannabis use was associated with increased body weight and blood glucose levels, suggesting cannabis may compound the metabolic risks already elevated in this population (due to both the illness itself and antipsychotic medications).

The authors noted that psychosis patients already have reduced life expectancy partly due to metabolic and cardiovascular disease, and cannabis use could be an additional contributing factor.

Why it matters

People with psychosis have higher rates of metabolic syndrome, diabetes, and cardiovascular disease. Understanding whether cannabis use adds to these risks is important for clinical care, especially since cannabis use is common in this population.

The numbers in context

One study in psychosis patients found cannabis use associated with increased body weight and blood glucose. Psychosis patients have reduced life expectancy partly due to metabolic/cardiovascular disease.

How the study worked

Narrative review of the literature on cannabis effects on appetite, weight, and metabolic parameters in both the general population and patients with psychosis.

What this study cannot tell us

Only one study directly examined cannabis metabolic effects in psychosis patients at the time of review. The general population evidence on long-term cannabis metabolic effects was conflicting. The narrative review format did not systematically assess evidence quality.

How to read the evidence

This is a narrative review with very limited direct evidence (one study) on the specific question of cannabis metabolic effects in psychosis patients.

When this study was published

Published in 2008. Some subsequent large epidemiological studies have paradoxically found lower rates of obesity and diabetes in cannabis users in the general population, adding complexity to this question.

The bigger picture

This review highlighted a gap in the literature: despite high rates of cannabis use among psychosis patients and well-known metabolic risks in this population, very little research had directly examined the metabolic impact of cannabis use specifically in psychosis patients.

Questions still open

Does chronic cannabis use meaningfully worsen metabolic outcomes in psychosis patients beyond what antipsychotics cause? Should metabolic monitoring be intensified for cannabis-using psychosis patients?

Common questions

Does cannabis make you gain weight?

Cannabis acutely increases appetite (the "munchies"), but the long-term effect on weight is unclear. In the general population, some studies find cannabis users are actually less likely to be obese, which is paradoxical. In psychosis patients, the one available study found increased weight.

Why are psychosis patients at higher metabolic risk?

Several factors contribute: antipsychotic medications often cause weight gain and metabolic changes, the illness itself affects stress hormones and activity levels, and lifestyle factors like diet and exercise may be affected by psychiatric symptoms.

Read the original research

The metabolic implications of long term cannabis use in patients with psychosis.

Epidemiologia e psichiatria sociale, 17(3), 221-6

View on PubMed ↗

Citation

Mushtaq, Farrah; Mondelli, Valeria; Pariante, Carmine M. (2008). The metabolic implications of long term cannabis use in patients with psychosis.. Epidemiologia e psichiatria sociale, 17(3), 221-6.