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Study breakdown

Heavy cannabis use was linked to lower BDNF levels in first-episode psychosis patients but not in healthy volunteers

Cross SectionalModerate evidence
The takeaway

In antipsychotic-naive first-episode psychosis patients, heavy cannabis use was associated with lower brain-derived neurotrophic factor (BDNF) levels, a relationship not seen in healthy controls.

Psychiatrists treating early psychosis, neuroscience researchers studying BDNF, and clinicians advising psychosis patients about cannabis use.

Cannabis-BDNF link found in psychosis patients but not healthy controls

What the researchers found

Among 70 drug-naive first-episode psychosis patients and 57 healthy volunteers, cannabis use was associated with reduced BDNF levels only in the psychosis group. Heavy cannabis use also correlated with younger age in patients. In healthy volunteers, cannabis use was linked to tobacco use but not to BDNF levels.

Why it matters

BDNF supports neuron health and plasticity. Finding that cannabis lowers BDNF specifically in psychosis patients suggests a biological mechanism by which cannabis may worsen outcomes in vulnerable individuals.

The numbers in context

70 first-episode psychosis patients (antipsychotic-naive). 57 healthy volunteers. High cannabis use was associated with lower BDNF in patients but not controls. High cannabis use also correlated with younger age in patients.

How the study worked

Cross-sectional study of 70 antipsychotic-naive first-episode psychosis patients and 57 healthy volunteers. Blood samples analyzed for BDNF by ELISA. Substance use, clinical diagnosis, and demographic variables collected via structured clinical interview.

What this study cannot tell us

Cross-sectional design cannot determine causation. Peripheral BDNF levels may not reflect brain BDNF. Cannabis use was self-reported. Relatively small sample sizes.

How to read the evidence

Cross-sectional study with a meaningful comparison group, but small sample and cannot establish causation.

When this study was published

2020 study. Adds to growing evidence on differential effects of cannabis in psychosis-vulnerable populations.

The bigger picture

The selective effect in psychosis patients, but not healthy volunteers, suggests that the biological context matters. The same exposure may have different neurobiological consequences depending on underlying vulnerability.

Questions still open

  • Does cannabis-related BDNF reduction contribute to worse psychosis outcomes? Would BDNF levels recover if patients stopped using cannabis? Is the relationship specific to certain cannabis components like THC?

Common questions

What is BDNF?
Brain-derived neurotrophic factor (BDNF) is a protein that supports nerve cell growth, survival, and plasticity. Low BDNF levels have been linked to several psychiatric and neurological conditions.
Why were these patients antipsychotic-naive?
Studying patients before they started antipsychotic medication eliminates the confounding effect of these drugs, which can independently affect BDNF levels.

Read the original research

Cannabis use influence on peripheral brain-derived neurotrophic factor levels in antipsychotic-naïve first-episode psychosis.

European archives of psychiatry and clinical neuroscience, 270(7), 851-858

Citation

Toll, A; Bergé, D; Burling, K; Scoriels, L; Treen, D; Monserrat, C; Marmol, F; Duran, X; Jones, P B; Pérez-Solà, V; Fernandez-Egea, E; Mané, A. (2020). Cannabis use influence on peripheral brain-derived neurotrophic factor levels in antipsychotic-naïve first-episode psychosis.. European archives of psychiatry and clinical neuroscience, 270(7), 851-858. https://doi.org/10.1007/s00406-020-01117-y

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