The impact of cannabis use on vasomotor symptoms, mood, insomnia and sexuality in perimenopausal and postmenopausal women: a systematic review

Background: People with schizophrenia are more likely to develop cannabis use disorder (CUD) and experience worse outcomes with use. Yet as cannabis is legalized for medical and recreational use, there is interest in its therapeutic potential.Objectives: To conduct a systematic review summarizing the design and results of controlled trials using defined doses of THC and CBD in schizophrenia.Method: A keyword search of eight online literature databases identified 11 eligible reports.Results: One placebo controlled trial (13 stable patients without CUD) found that intravenous THC increased psychosis and worsened learning/recall. Two reports of a functional magnetic resonance (fMRI) study of smoked or oral THC in 12 abstinent patients with schizophrenia and CUD found no change in symptoms and cognition, and an amelioration of impaired resting state brain function in areas implicated in reward function and the default mode network. One 4 week trial in acutely psychotic inpatients without CUD (mean age 30 y) found 800 mg CBD to be similarly efficacious to amisupride in improving psychosis and cognition. Two 6 week studies of CBD augmentation of antipsychotics in stable outpatients reported mixed results: CBD 600 mg was not more effective than placebo; CBD 1,000 mg reduced symptoms in a sample that did not exclude cannabis use and CUD. A brain fMRI and proton magnetic resonance spectroscopy study of single dose CBD in a sample that did not exclude CUD and cannabis use found that CBD improved symptoms and brain function during a learning/recall task and was associated with increased hippocampal glutamate.Discussion: There is substantial heterogeneity across studies in dose, method of drug delivery, length of treatment, patient age, whether patients with cannabis use/CUD were included or excluded, and whether patients were using antipsychotic medication.Conclusion: There is insufficient evidence for an effect of THC or CBD on symptoms, cognition, and neuroimaging measures of brain function in schizophrenia. At this time, research does not support recommending medical cannabis (THC or CBD) for treating patients with schizophrenia. Further research should examine THC and CBD in schizophrenia with and without comorbid CUD and consider the role of CBD in mitigating symptom exacerbation from THC.

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Factors Moderating the Association between Cannabis Use and Psychosis Risk: A Systematic Review

Brain Sciences ◽

10.3390/brainsci10020097 ◽

2020 ◽

Vol 10 (2) ◽

pp. 97 ◽

Cited By ~ 4

Author(s):

Sanne J. van der Steur ◽

Albert Batalla ◽

Matthijs G. Bossong

Keyword(s):

Systematic Review ◽

Cannabis Use ◽

Future Research ◽

Genetic Profile ◽

Increased Risk ◽

Psychosis Risk ◽

Specific Factors ◽

Use Behavior ◽

Genetic Profiles ◽

The Impact

Increasing evidence indicates a relationship between cannabis use and psychosis risk. Specific factors, such as determinants of cannabis use or the genetic profile of cannabis users, appear to moderate this association. The present systematic review presents a detailed and up-to-date literature overview on factors that influence the relationship between cannabis use and psychosis risk. A systematic search was performed according to the PRISMA guidelines in MEDLINE and Embase, and 56 studies were included. The results show that, in particular, frequent cannabis use, especially daily use, and the consumption of high-potency cannabis are associated with a higher risk of developing psychosis. Moreover, several genotypes moderate the impact of cannabis use on psychosis risk, particularly those involved in the dopamine function, such as AKT1. Finally, cannabis use is associated with an earlier psychosis onset and increased risk of transition in individuals at a clinical high risk of psychosis. These findings indicate that changing cannabis use behavior could be a harm reduction strategy employed to lower the risk of developing psychosis. Future research should aim to further develop specific biomarkers and genetic profiles for psychosis, thereby contributing to the identification of individuals at the highest risk of developing a psychotic disorder.

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The Effects of Evening-Primrose Oil on Menopausal Symptoms: A Systematic Review and Meta-analysis of Randomized Controlled Trials

Current Women s Health Reviews ◽

10.2174/1573404816999200702162750 ◽

2020 ◽

Vol 16 (4) ◽

pp. 265-276

Author(s):

Karen Christelle ◽

Maryam Mohd Zulkfili ◽

Norhayati Mohd Noor ◽

Nani Draman

Keyword(s):

Systematic Review ◽

Postmenopausal Women ◽

Meta Analysis ◽

Cochrane Collaboration ◽

Menopausal Symptoms ◽

Musculoskeletal Symptoms ◽

Vasomotor Symptoms ◽

Evening Primrose Oil ◽

Evening Primrose ◽

Meta Analyses

Background: Evening primrose oil (EPO) has been a treatment option for reducing menopausal symptoms, but evidence for its use is inadequate. Objective: The study aimed to determine the effectiveness of EPO in treating menopausal symptoms among peri and postmenopausal women. Study design: This is a systematic review with meta-analyses of randomised clinical trials (RCTs). Methods: We searched CENTRAL, Medline, Embase and trial registries for relevant RCTs. The methodology and reporting were carried out grounded on references from the Cochrane collaboration and the preferred reporting items for systematic reviews and meta-analyses statement. Review Manager version 5.3.5 was used to perform all the statistical analyses. Results: Five RCTs, recruiting a total of 402 peri and postmenopausal women were identified. EPO did not reduce the frequency of daily vasomotor symptoms (MD 0.01 episodes, 95% CI -0.54 to 0.57, P=0.960), frequency of daytime hot flash episodes (MD -0.51 episodes, 95% CI -2.05 to 1.03, P=0.510), frequency of night sweat episodes (MD 0.33 episodes, 95% CI -0.48 to 1.13, P=0.430) and severity of vasomotor symptoms (SMD -0.45, 95% CI -1.56 to 0.66, P=0.420) in comparison to control. EPO was associated with a minimal reduction in the severity of overall menopausal symptoms in comparison to control (SMD -1.18; 95% CI-2.18 to -0.18, P=0.02). There were insufficient data to pool results for musculoskeletal symptoms, mood, sexuality, sleeping disorders and quality of life. Conclusion: EPO may reduce the severity of overall menopausal symptoms but is not effective to reduce the frequency and severity of vasomotor symptoms. The evidence quality ranged from very low to moderate. Further research is needed to enhance related evidence.

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