Lurasidone Showed Promise for Cannabis-Induced Psychosis in Four Young Patients | Research

The takeaway

Four patients experiencing their first cannabis-induced psychotic episode were treated with lurasidone (74-128 mg/day), and all showed improvement in positive and negative symptoms, disruptive behavior, and functioning with no significant side effects.

Psychiatrists treating first-episode psychosis; researchers designing clinical trials for cannabis-induced psychosis.

All 4 patients achieved remission on lurasidone 74-128 mg/day

What the researchers found

All four patients improved across psychosis symptoms (positive and negative), disruptive behavior, and functional recovery. Target lurasidone doses ranged from 74-128 mg/day. No significant side effects were reported.

Why it matters

Cannabis-induced psychosis is increasingly common, but there is limited evidence on optimal antipsychotic choice. Lurasidone may be particularly suitable due to its favorable metabolic and sedation profile, which matters for young patients.

The numbers in context

4 patients with first cannabis-induced psychotic episodes. Lurasidone doses: 74-128 mg/day. All showed remission of positive and negative symptoms, reduced disruptive behavior, and return of functioning. No significant side effects reported.

How the study worked

Case series of four patients with first-episode cannabis-induced psychosis treated with lurasidone at a single center. Clinical improvement was assessed across multiple symptom domains.

What this study cannot tell us

Only four patients, no control group, single center. Case reports cannot establish efficacy. The improvement may reflect natural recovery from a self-limited psychotic episode rather than medication effect. No long-term follow-up reported.

How to read the evidence

Preliminary: uncontrolled case series of only four patients.

When this study was published

Published in 2022.

The bigger picture

First-episode psychosis often occurs in young people where medication side effects (weight gain, sedation, metabolic problems) can be particularly problematic. Lurasidone's relatively clean side-effect profile makes it an appealing option that deserves formal testing.

Questions still open

Would a randomized trial comparing lurasidone to other atypical antipsychotics confirm its advantages for cannabis-induced psychosis? What is the optimal duration of treatment? Does lurasidone affect cannabis use behavior itself?

Common questions

What is the best medication for cannabis-induced psychosis?

There is limited evidence to identify a best option. This case series suggests lurasidone may be effective with a favorable side-effect profile, but formal clinical trials are needed to compare it to other antipsychotics.

Is cannabis-induced psychosis the same as schizophrenia?

Not necessarily. Cannabis-induced psychosis is triggered by cannabis use and may resolve with abstinence. However, some cases may represent the unmasking of an underlying psychotic vulnerability, particularly in people with genetic risk.

Read the original research

Lurasidone use in Cannabis-Induced Psychosis: A Novel Therapeutic Strategy and Clinical Considerations in Four Cases Report.

International journal of environmental research and public health, 19(23)

View on PubMed ↗Publisher’s paper ↗

Citation

Ricci, Valerio; Martinotti, Giovanni; De Berardis, Domenico; Maina, Giuseppe. (2022). Lurasidone use in Cannabis-Induced Psychosis: A Novel Therapeutic Strategy and Clinical Considerations in Four Cases Report.. International journal of environmental research and public health, 19(23). https://doi.org/10.3390/ijerph192316057