Citation

Lupke K, Gerard A, Murdoch B, Gundarpi N, Parker S. Australas. Psychiatry 2023; ePub(ePub): ePub.

Copyright

(Copyright © 2023, Royal Australian and New Zealand College of Psychiatrists, Publisher SAGE Publishing)

DOI

10.1177/10398562231222818

PMID

38126843

Abstract

The recent dramatic rise in the prescription of medicinal cannabis in Australia1 is not supported by growing evidence of its efficacy and effectiveness. The TGA guidance states, 'medicinal cannabis products containing THC are generally not appropriate for patients who have a previous psychotic or concurrent active mood or anxiety disorder'.2 However, despite the limited evidence to support its use in the management of mental disorders,3 anxiety is one of the most frequent indications for prescription.1 Furthermore, young people are more likely to be prescribed high-dose ∆9-tetrahydrocannabinol (THC) products than formulations where cannabidiol (CBD) is prioritised. These trends are concerning given the established risks of youth cannabis use on mental health outcomes and neurocognition.

At our Early Psychosis service, we have noted increasing referrals where medicinal cannabis has been contemporaneous with the onset of psychosis. Between 11/2022 and 07/2023, six of 67 patients referred had been using high concentrate prescribed THC in the preceding 3 months (own prescription (n = 5), family member prescription (n = 1)). Two of these consumers continued to obtain prescriptions after the onset of psychosis. Additionally, four consumers received a de novo prescription for high concentrate THC after psychosis onset. Prescriptions (most commonly THC (18%)/CBD (1%)) were mainly obtained through online services (66.7%); the indication was anxiety in all cases. Our opinion is that these prescriptions complicated the treatment and recovery from the first episode of psychosis.

Language: en