Your COMT gene variant determines how much THC impairs your working memory

People with the Val/Val COMT genotype were most sensitive to THC-induced attention and working memory deficits, and pharmacologically inhibiting COMT with tolcapone reduced THC's cognitive effects but not its psychosis-like effects.

Ranganathan, Mohini et al.·Psychopharmacology·2019·Moderate EvidenceRandomized Controlled Trial
RTHC-02250Randomized Controlled TrialModerate Evidence2019RETHINKTHC RESEARCH DATABASErethinkthc.com/research

Quick Facts

Study Type
Randomized Controlled Trial
Evidence
Moderate Evidence
Sample
N=74

What This Study Found

Val/Val individuals showed the greatest THC-induced working memory and attention deficits. COMT genotype did not influence THC's psychotomimetic or subjective effects. Tolcapone (a COMT inhibitor) reduced THC-induced working memory deficits but not psychotomimetic effects, suggesting dopaminergic signaling selectively mediates cognitive but not psychotic effects of THC.

Key Numbers

74 subjects in sub-study I. Val/Val most sensitive to THC-induced cognitive deficits. Tolcapone 200 mg reduced THC working memory impairment. Neither COMT genotype nor tolcapone affected psychotomimetic effects.

How They Did This

Two sub-studies. Sub-study I: 74 healthy subjects genotyped for COMT Val/Met received IV THC (0.05 mg/kg) or placebo in a double-blind crossover. Sub-study II: Val/Val and Met/Met homozygous subjects received tolcapone 200 mg followed by IV THC or placebo on two additional days.

Why This Research Matters

This helps explain why some people experience significant cognitive impairment from cannabis while others do not. COMT genotype may be a useful predictor of vulnerability to THC's cognitive effects.

The Bigger Picture

This study elegantly separates the cognitive and psychotic effects of THC, showing they operate through different neurochemical pathways. This has implications for developing drugs that could protect against THC's harms.

What This Study Doesn't Tell Us

IV THC administration does not replicate typical cannabis use. Sample size was moderate. Only one COMT polymorphism was studied. Tolcapone has limited clinical use due to liver toxicity concerns.

Questions This Raises

  • ?Could COMT genotyping help identify people at greatest cognitive risk from cannabis?
  • ?Would other dopamine-modulating drugs also protect against THC's cognitive effects?
  • ?Does COMT genotype predict long-term cognitive outcomes in regular cannabis users?

Trust & Context

Key Stat:
Val/Val carriers most sensitive to THC cognitive impairment
Evidence Grade:
Moderate: double-blind, randomized, placebo-controlled design with genotype stratification, but moderate sample size.
Study Age:
Published in 2019.
Original Title:
Highs and lows of cannabinoid-dopamine interactions: effects of genetic variability and pharmacological modulation of catechol-O-methyl transferase on the acute response to delta-9-tetrahydrocannabinol in humans.
Published In:
Psychopharmacology, 236(11), 3209-3219 (2019)
Database ID:
RTHC-02250

Evidence Hierarchy

Meta-Analysis / Systematic Review
Randomized Controlled TrialGold standard for testing treatments
This study
Cohort / Case-Control
Cross-Sectional / Observational
Case Report / Animal Study

Participants are randomly assigned to treatment or placebo groups to test cause and effect.

What do these levels mean? →

Frequently Asked Questions

What is the COMT gene?

COMT (catechol-O-methyltransferase) is an enzyme that breaks down dopamine in the prefrontal cortex. The Val/Met polymorphism affects how quickly dopamine is cleared: Val/Val clears it fastest, Met/Met slowest.

Why did tolcapone help cognition but not psychosis?

This suggests THC's cognitive effects depend on dopaminergic signaling (which tolcapone modulates) while its psychosis-like effects operate through different pathways, possibly direct CB1 receptor activation.

Read More on RethinkTHC

Cite This Study

RTHC-02250·https://rethinkthc.com/research/RTHC-02250

APA

Ranganathan, Mohini; De Aquino, Joao P; Cortes-Briones, Jose A; Radhakrishnan, Rajiv; Pittman, Brian; Bhakta, Savita; D'Souza, Deepak C. (2019). Highs and lows of cannabinoid-dopamine interactions: effects of genetic variability and pharmacological modulation of catechol-O-methyl transferase on the acute response to delta-9-tetrahydrocannabinol in humans.. Psychopharmacology, 236(11), 3209-3219. https://doi.org/10.1007/s00213-019-05273-5

MLA

Ranganathan, Mohini, et al. "Highs and lows of cannabinoid-dopamine interactions: effects of genetic variability and pharmacological modulation of catechol-O-methyl transferase on the acute response to delta-9-tetrahydrocannabinol in humans.." Psychopharmacology, 2019. https://doi.org/10.1007/s00213-019-05273-5

RethinkTHC

RethinkTHC Research Database. "Highs and lows of cannabinoid-dopamine interactions: effects..." RTHC-02250. Retrieved from https://rethinkthc.com/research/ranganathan-2019-highs-and-lows-of

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.