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UNA VARIANTE MÁS POTENTE DE CANNABIS TRIPLICA EL RIESGO DE BROTES PSICÓTICOS

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PSIQUIATRÍA

ÁREAS TEMÁTICAS

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PSICOSIS

FUENTE: THE LANCET

FECHA: FEBRERO 2015

MADRID, 16 Feb. (EUROPA PRESS) –

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Investigadores del Kings College de Londres (Reino Unido) han descubierto que uno de cada cuatro brotes psicóticos causados por el cannabis están asociados a una variante de esta droga conocida como ‘skunk’ o mofeta, que según han visto triplica el riesgo de sufrir estos trastornos.

El trabajo, cuyos resultados publica la revista ‘Lancet Psychiatry’, sugiere que este mayor riesgo está asociado a una mayor presencia de tetrahidrocannabinol (THC), principal ingrediente psicoactivo que en otras variantes, como el hachís, está en niveles más bajos.

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A diferencia del ‘skunk’, el hachís contiene cantidades de otro químico llamado cannabidiol (CDB), y la investigación sugiere que puede actuar como un antídoto para el THC, contrarrestando los efectos secundarios que ocasiona.

Los brotes psicóticos causan delirios o alucinaciones que pueden estar relacionados también con otros trastornos psiquiátricos como la esquizofrenia o el trastorno bipolar.

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Los autores investigaron a 780 personas de las cuales algo más de la mitad (410) habían sido ingresadas por un brote psicótico causado por el consumo de esta sustancia, y vieron que el 24 por ciento de los brotes psicóticos registrados se produjeron en usuarios de esta variante. De hecho, el riesgo de psicosis era cinco veces mayor en quienes la consumían a diario.
En cambio, los autores vieron que el consumo de hachís no se asoció a ningún riesgo de psicosis. A diferencia del ‘skunk’, el hachís contiene cantidades de otra sustancia química llamada cannabidiol (CDB), y la investigación sugiere que puede actuar como un antídoto para el THC, contrarrestando los efectos secundarios que ocasiona.

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La investigadora Marta di Forti, una de las autoras del trabajo, ha explicado a la BBC que esta variante del cannabis puede considerarse ‘made in England’ ya que hay varios informes policiales que alertan de que Reino Unido se han convertido en un gran productor y exportador de esta sustancia.

Por ello, anima a los médicos a estar atentos ante estos síntomas para indagar si puede haber detrás el cannabis y, en ese caso, conocer el tipo y la frecuencia de consumo.

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Un portavoz del Ministerio británico del Interior ha reconocido que estos hallazgos respaldan el enfoque de que “las drogas como el cannabis son ilegales porque la evidencia científica demuestra que son perjudiciales”. “Este informe sirve para enfatizar cómo pueden destruir vidas y comunidades”, han defendido.

Acceso gratuito al texto completo.

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ARTICLES

Proportion of patients in south London with first-episode psychosis attributable to use of high potency cannabis: a case-control study Marta Di Forti, Arianna Marconi, Elena Carra, Sara Fraietta, Antonella Trotta, Matteo Bonomo, Francesca Bianconi, Poonam Gardner-Sood, Jennifer O’Connor, Manuela Russo, Simona A Stilo, Tiago Reis Marques, Valeria Mondelli, Paola Dazzan, Carmine Pariante, Anthony S David, Fiona Gaughran, Zerrin Atakan, Conrad Iyegbe, John Powell, Craig Morgan, Michael Lynskey, Robin M Murray

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Summary Background The risk of individuals having adverse effects from drug use (eg, alcohol) generally depends on the frequency of use and potency of the drug used. We aimed to investigate how frequent use of skunk-like (high-potency) cannabis in south London affected the association between cannabis and psychotic disorders.

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Methods We applied adjusted logistic regression models to data from patients aged 18–65 years presenting to South London and Maudsley NHS Foundation Trust with first-episode psychosis and population controls recruited from the same area of south London (UK) to estimate the effect of the frequency of use, and type of cannabis used on the risk of psychotic disorders. We then calculated the proportion of new cases of psychosis attributable to different types of cannabis use in south London.

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Findings Between May 1, 2005, and May 31, 2011, we obtained data from 410 patients with first-episode psychosis and 370 population controls. The risk of individuals having a psychotic disorder showed a roughly three-times increase in users of skunk-like cannabis compared with those who never used cannabis (adjusted odds ratio [OR] 2·92, 95% CI 1·52–3·45, p=0·001). Use of skunk-like cannabis every day conferred the highest risk of psychotic disorders compared with no use of cannabis (adjusted OR 5·4, 95% CI 2·81–11·31, p=0·002). The population attributable fraction of firstepisode psychosis for skunk use for our geographical area was 24% (95% CI 17–31), possibly because of the high prevalence of use of high-potency cannabis (218 [53%] of 410 patients) in our study.

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Interpretation The ready availability of high potency cannabis in south London might have resulted in a greater proportion of first onset psychosis cases being attributed to cannabis use than in previous studies. Funding UK National Institute of Health Research (NIHR) Specialist Biomedical Research Centre for Mental Health, SLaM and the Institute of Psychiatry at King’s College London, Psychiatry Research Trust, Maudsley Charity Research Fund, and th European Community’s Seventh Framework Program grant (agreement No. HEALTH-F2-2009-241909 [Project EU-GEI]). Copyright © Di Forti et al. Open Access article distributed under the terms of CC BY.

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Introduction Cannabis is the most popular illicit drug in the world. Uruguay was the first country to legalise its use and several US states have done so or are in the process of doing similar.1 Therefore, any harm caused by cannabis use should be quantified. Prospective epidemiological studies have consistently reported that use of cannabis increases the risk of schizophrenia-like psychosis.2,3 In the UK, the investigators of the 2012 Schizophrenia Commission4 concluded that cannabis use is the most preventable risk factor for psychosis, and research that aims to improve estimation of the drug’s contribution to illness development should be pursued. The aspects of exposure to cannabis (eg, age at first use, frequency of use, duration of use) that confer the greatest effect on risk of psychosis are unclear. Such information would be valuable for public education and to estimate the proportion of psychosis cases that could be prevented if harmful patterns of cannabis use were removed from the population. The few studies5,6 that have tried to estimate the effect of cannabis use on the number of new cases of psychosis in specific populations have been limited by the scarcity of accurate information on patterns of cannabis use. The risk of adverse effects for mental health and cognition posed by cannabis use has been suggested to depend on the potency of the type of cannabis used.7 For example, in a previous study8 of part of the population reported here, we noted that skunk-like types of cannabis, which contain very high concentrations of ∆-9-tetrahydrocannabinol (THC), seemed to have a greater psychotogenic effect than did hash (resin), which is known to contain much less THC. We analysed detailed data for history of cannabis use, aiming to: compare the patterns and types of cannabis used between patients with first-episode psychosis and a

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