5.4 How does cannabis use disorder impact schizophrenia treatment?
When schizophrenia and Cannabis Use Disorder coexist, treatment must address both conditions simultaneously, focusing on managing symptoms, reducing cannabis use, and supporting long-term recovery to improve overall well-being.
How to manage CUD effects in people with schizophrenia?
Access to psychiatric care is essential to diagnose and address both conditions effectively. Psychological counseling can help individuals develop healthier coping strategies and reduce reliance on cannabis.
For those with severe CUD, quitting cannabis entirely is often the best approach. However, a gradual reduction in use – rather than abrupt cessation – can help ease withdrawal symptoms, improve treatment adherence, and reduce the risk of relapse.
Although cannabis intoxication typically resolves without medical intervention, providing a calm environment and symptom-specific treatments – such as medication for rapid heartbeat or anxiety – can enhance patient comfort.
Should cannabidiol (CBD) be used in schizophrenia treatment?
Currently, CBD is not recommended for treating schizophrenia.
While cannabidiol (CBD) is being researched for its potential therapeutic effects, combining it with antipsychotic medications may lead to unwanted side effects due to drug-drug interactions.
Both CBD and many antipsychotics are metabolized by the same liver enzymes, which can interfere with their effectiveness. This competition can either increase side effects or reduce the effectiveness of antipsychotic medications.
Until more research confirms its safety and benefits, the usage of CBD in schizophrenia treatment should be taken with caution.
How to reduce cannabis use and improve medication adherence in schizophrenia?
Cannabis use is a major factor that can lead to medication nonadherence in psychiatric patients.
For those with both schizophrenia and CUD, the key management strategies include:
Encouraging patients to gradually reduce cannabis use by switching to lower-potency strains and decreasing frequency.
Prescribing antipsychotics with partial dopaminergic agonist mechanisms, rather than firstgeneration antipsychotics, as they may improve outcomes for individuals with schizophrenia and CUD.
A recent observational study found that newer antipsychotic medications not only helped reduce schizophrenia symptoms but also improved selfreported struggles with cannabis use.
Enhancing medication adherence through digital reminders and carefully balancing medications to ensure they are effective and well-tolerated.
By combining medical support with behavioral strategies, patients with schizophrenia and CUD can experience better symptom management and improved quality of life.
Key takeaways for caregivers
• Reducing or eliminating cannabis use can help prevent or improve schizophrenia symptoms.
• While some patients believe cannabis helps, research consistently shows it increases the risk of psychosis, relapse, and worsened outcomes.
• Other factors (genetics, urban living, trauma) may contribute to schizophrenia, but cannabis is a major risk factor.
• Understanding why individuals with schizophrenia use cannabis can help caregivers offer better support and interventions.
