Aripiprazole led to shorter hospital stays than risperidone for teens with cannabis-related psychosis
In a chart review of 110 hospitalized adolescents with cannabis use disorder and psychosis, those prescribed aripiprazole had significantly shorter hospital stays than those on risperidone.
Quick Facts
What This Study Found
Adolescents prescribed aripiprazole had a mean length of stay of 5.8 days compared to 9.7 days for risperidone (p=0.002). The length of stay index was also significantly lower for aripiprazole (0.79 vs. 1.4, p=0.004).
Key Numbers
110 adolescents. Aripiprazole: mean stay 5.8 days, index 0.79. Risperidone: mean stay 9.7 days, index 1.4. Both differences significant (p=0.002 and p=0.004 respectively).
How They Did This
Retrospective chart review of 110 adolescents (ages 13-21) hospitalized for psychosis with co-occurring cannabis use disorder. Compared outcomes between those prescribed risperidone versus aripiprazole. Nonrandomized quality improvement project.
Why This Research Matters
Co-occurring cannabis use and psychosis in adolescents is increasing, and clinicians lack evidence to guide antipsychotic choice for this specific population. These preliminary data suggest aripiprazole may resolve acute symptoms faster.
The Bigger Picture
The pharmacology may matter here: aripiprazole is a partial dopamine agonist while risperidone is a full antagonist. Cannabis-induced psychosis may respond differently to these mechanisms than primary psychotic disorders.
What This Study Doesn't Tell Us
Nonrandomized design with potential selection bias in medication choice. Retrospective chart review. Cannot control for illness severity, cannabis use patterns, or other medications. Single-center data.
Questions This Raises
- ?Would a randomized trial confirm aripiprazole superiority in this population?
- ?Does the mechanism of cannabis-induced psychosis make it more responsive to partial dopamine agonism?
Trust & Context
- Key Stat:
- Aripiprazole: 5.8 days vs. risperidone: 9.7 days hospital stay (p=0.002)
- Evidence Grade:
- Nonrandomized retrospective comparison. Useful signal but prone to selection bias and confounding.
- Study Age:
- Published 2023.
- Original Title:
- Program Evaluation to Aid Choice of Aripiprazole or Risperidone for Hospitalized Adolescents with Cannabis Use Disorder and Psychosis.
- Published In:
- Journal of child and adolescent psychopharmacology, 33(8), 332-336 (2023)
- Authors:
- Thurstone, Christian(5), Loh, Ryan, Foreman, Kristina, Thurstone, Christian A, Wolf, Chelsea
- Database ID:
- RTHC-04983
Evidence Hierarchy
Looks back at existing records to find patterns.
What do these levels mean? →Frequently Asked Questions
Which antipsychotic is better for cannabis-induced psychosis in teens?
This preliminary study suggests aripiprazole may resolve symptoms faster than risperidone, based on shorter hospital stays. However, this was not a randomized trial, and the medication choice was made by treating clinicians who may have selected differently based on patient characteristics.
Why might aripiprazole work differently than risperidone for cannabis psychosis?
Aripiprazole is a partial dopamine agonist, meaning it modulates rather than fully blocks dopamine signaling. Since cannabis affects dopamine pathways, this partial agonism may be better suited to cannabis-related psychosis than the full dopamine blockade of risperidone. This is speculative and needs further study.
Read More on RethinkTHC
Cite This Study
https://rethinkthc.com/research/RTHC-04983APA
Thurstone, Christian; Loh, Ryan; Foreman, Kristina; Thurstone, Christian A; Wolf, Chelsea. (2023). Program Evaluation to Aid Choice of Aripiprazole or Risperidone for Hospitalized Adolescents with Cannabis Use Disorder and Psychosis.. Journal of child and adolescent psychopharmacology, 33(8), 332-336. https://doi.org/10.1089/cap.2023.0053
MLA
Thurstone, Christian, et al. "Program Evaluation to Aid Choice of Aripiprazole or Risperidone for Hospitalized Adolescents with Cannabis Use Disorder and Psychosis.." Journal of child and adolescent psychopharmacology, 2023. https://doi.org/10.1089/cap.2023.0053
RethinkTHC
RethinkTHC Research Database. "Program Evaluation to Aid Choice of Aripiprazole or Risperid..." RTHC-04983. Retrieved from https://rethinkthc.com/research/thurstone-2023-program-evaluation-to-aid
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.