Cannabis and Psychotropic Medication

Can I use cannabis while I take psychiatric medication?
​First, this topic is too broad to address in its entirety here. However, I will provide main points of interest on things I consider when treating clients who use cannabis.

Main Concern # 1​

• For clients who have experienced hallucinations, or who have a family history of hallucinations, delusions, or paranoia - I do not recommend use of cannabis at all. 
  • Studies have shown people who engage in daily use and/or use of high concentrations of THC have an increased risk for developing a psychotic disorder and unmasking of bipolar or schizophrenia (Di Forti et al, 2019; Marconi et al, 2016; Ortiz-Medina et al, 2018).

Main Concern # 2

• Cannabis can interact with psychiatric medication causing sleepiness, confusion, irritability and dizziness. 

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With that said, a lot of people use cannabis to alleviate anxiety, promote relaxation and fall asleep. Depending on the frequency of use, stopping abruptly may cause withdrawal (Bonnet & Preuss, 2017). Because of this, I believe in considering each client's unique presentation, meeting them where they are and not imposing a one-size-fits all approach to treatment. Often clients who start psychiatric medication find that once their medication starts to work, they no longer need to use cannabis as much or at all. 

References:

• Bonnet, U., & Preuss, U. W. (2017). The cannabis withdrawal syndrome: current insights. Substance Abuse and Rehabilitation, 8, 9–37. https://doi.org/10.2147/SAR.S109576
• Di Forti, M., Quattrone, D., Freeman, T. P., Tripoli, G., Gayer-Anderson, C., Quigley, H., Rodriguez, V., Jongsma, H. E., Ferraro, L., La Cascia, C., La Barbera, D., Tarricone, I., Berardi, D., Szöke, A., Arango, C., Tortelli, A., Velthorst, E., Bernardo, M., Del-Ben, C. M., Menezes, P. R., … EU-GEI WP2 Group (2019). The contribution of cannabis use to variation in the incidence of psychotic disorder across Europe (EU-GEI): a multicentre case-control study. The Lancet Psychiatry, 6(5), 427–436. https://doi.org/10.1016/S2215-0366(19)30048-3
• Marconi, A., Di Forti, M., Lewis, C. M., Murray, R. M., & Vassos, E. (2016). Meta-analysis of the Association Between the Level of Cannabis Use and Risk of Psychosis. Schizophrenia Bulletin, 42(5), 1262–1269. https://doi.org/10.1093/schbul/sbw003
• Ortiz-Medina, M. B., Perea, M., Torales, J., Ventriglio, A., Vitrani, G., Aguilar, L., & Roncero, C. (2018). Cannabis consumption and psychosis or schizophrenia development. The International Journal of Social Psychiatry, 64(7), 690–704. https://doi.org/10.1177/0020764018801690​