Tag: Han

Reading of the Week: Cannabis – With Papers from Lancet Psych and JAMA Psych; Also, Dr. Kaliamurthy on How the Weed Got Too Strong

From the Editor

Cannabis was the only thing that helped him sleep, my patient explained. He also described positive information he had found online. He then asked: Will it affect my psychosis?

In a new review published in The Lancet Psychiatry, Wayne Hall (of The University of Queensland) and his co-authors look at cannabis use and major mental disorders. The topic isn’t new, of course, but their approach is impressive: they draw on many types of studies (epidemiological, genetic, experimental, and preclinical) to try to establish the connection – or the lack of connection – between daily cannabis use and psychosis, bipolar disorder, anxiety, and depression. “There is credible evidence that regular cannabis use plays a contributory causal role in psychosis.” We discuss the paper and its implications.

How have cannabis and alcohol misuse changed over time? In the second selection, from JAMA Psychiatry, Beth Han (of National Institutes of Health) and her co-authors use a US dataset with almost 190 000 participants, and show a sharp rise in cannabis use disorder. “More effective cannabis use disorder treatments are needed.”

Finally, in the third selection, Dr. Sivabalaji Kaliamurthy (of Howard University) writes about cannabis in an essay for The New York Times. He notes a big increase in the potency of cannabis and describes his worries as a physician, particularly about adolescent users. “The question now is whether we are willing to regulate and enforce product safety, especially to protect the most vulnerable among us.”

DG

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Reading of the Week: Antidepressants & Side Effects – the New Lancet Paper; Also, Medical Cannabis & Addiction, and AI Hallucinations

From the Editor

What are the physical side effects of antidepressants? In a new, impressive Lancet study, Toby Pillinger (of King’s College London) and his co-authors attempt to answer that old question with a new approach: the first systematic review and meta-analysis. They drew on 168 RCTs that measured physical health effects of antidepressants, including almost 59 000 participants and comparisons of 30 antidepressants. “We found strong evidence that antidepressants differ markedly in their physiological effects, particularly for cardiometabolic parameters.” We consider the paper and its implications.

How safe is cannabis for those taking it for medical purposes? Dr. Beth Han (of NIMH) and her colleagues report findings from a US survey in a new JAMA Psychiatry brief report, focusing on cannabis use disorder (CUD). They report that cannabis use wasn’t less addictive when used for medical reasons. “Clinicians should consider addiction risk before recommending medical cannabis and, if they do, should monitor for CUD emergence.”

The BMJ runs humorous articles in its Christmas issue. The journal doesn’t disappoint this year. Dr. Roberto A. Correa Soto (of the Universidad de los Andes) and his co-authors write about AI hallucinations and doctor BS (yes, you read that correctly). Frankly, the paper is worth reading for the profanity alone. “Both doctors and large language models (LLMs) are driven to produce misinformation – ‘bullshit’ and ‘hallucinations’ – owing to a shared pressure to provide answers, prioritising the appearance of competence over accuracy.”

There will be no Readings for the next three weeks. 

DG

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