Cannabis Use and Metabolic Syndrome Among Clients with First Episode Psychosis

Primary author: Erik Stiles
Co-author(s): Karl Alcover; Oladunni Oluwoye
Faculty sponsor: Michael McDonell, PhD

Primary college/unit: Elson S. Floyd College of Medicine
Campus: Spokane


Aim: We sought to explore the relationship between cannabis use and metabolic syndrome (MetS) among those with a first episode psychosis (FEP).

Background: Individuals diagnosed with a psychotic disorder are three times more likely to suffer from cardiovascular disease (CVD) than the general population. CVD accounts for approximately 16% of deaths among individuals diagnosed with schizophrenia-spectrum disorders.

Methods: We conducted a retrospective analysis of 404 participants enrolled in the Recovery After Initial Schizophrenia Episode – Early Treatment Program. Metabolic syndrome was defined according to the Adult Treatment Panel III guidelines. Using multiple logistic regression, we investigated the correlation between cannabis use and rate of metabolic syndrome. Demographics, time, baseline MetS and potential confounders were separated and analyzed. Finally, we explored the derangement of MetS components among cannabis users and abstainers.

Results: Cannabis users versus abstainers had similar rates of MetS at baseline (10% versus 13.7%, p=0.520). Those who used cannabis at any time during the study period tended to have lower triglycerides (OR=0.3, p=0.001) and higher high-density lipoprotein (OR=0.4, p=0.017). Cannabis users were less likely to develop MetS, relative to non-users (OR = 0.42, 95% CI [0.22-0.80], p=0.008). This effect remained after controlling for type of psychiatric medication (e.g., first- or second-generation antipsychotics, long-acting injectables).

Conclusions: Cannabis use may be associated with lower incidence of MetS in patients experiencing psychosis. Our findings may contribute to mitigating the elevated CVD risk in this population. Further research is indicated to explore and develop these observations.