A member asked:

Does anyone have experience treating bipolar dz with cannabis? for a patient dong well is there any known risk of this treatment course?

39 doctors weighed in across 9 answers
Dr. Michelle King answered

Specializes in Psychiatry

No experience: But, this seems like a very bad idea, given the strong relationship between bipolar disorder, substance abuse and addictive disease. As a psychiatrist, I'd use more conventional medical treatment modalities, for safety reasons, and in the patient's best interests.

Answered 10/20/2017

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Dr. Cynthia Rector answered

Specializes in Psychiatry

Yes there is risk: There are some recent studies that cannabis may increase the risk of cycling into mania when compared with bipolar patients who don't use cannabis. Cannabis use and mania symptoms: A systematic review and meta-analysis Melanie Gibbs 1, Catherine Winsper 1, Steven Marwaha correspondence email, Eleanor Gilbert , Matthew Broome , Swaran P. Singh 1M

Answered 11/3/2018

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Dr. Elizabeth Finley-Belgrad answered

Specializes in Child Psychiatry

H/o psychosis a cont: I have no direct experience, but would suggest caution . H/O psychosis a contraindication to medical cannabis use. People with a functional polymorphism of catechol-O-methyltransferace genea genetically vulnerable to psychosis with cannabis use-this can easily be obtained with the "genesight" test offered to look for possible medication SE based on enzyme data.

Answered 10/6/2017

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Dr. Ankush Bansal answered

Specializes in Internal Medicine

Possibly risky: I think it could be beneficial for some symptoms but there's a few problems: 1) there isn't any research on this (partly due to the U.S. restricting any research with marijuana), 2) some types of marijuana may exacerbate anxiety or manic symptoms in some patients (different THC and CBD), and 3) it may be hard to gauge effectiveness.

Answered 1/28/2018

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Dr. Jessica Allan answered

Specializes in Internal Medicine

Careful: I had a patient with stable bipolar disease who became psychotic after smoking cannabis. She took off all of her clothes and jumped into the fountain. She had to spend 2 weeks on the Psych unit.

Answered 5/31/2017

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Dr. James Okamoto answered

Specializes in Family Medicine

None: I have no experience treating bipolar patients with cannabis, and doing so would probably put you at risk for malpractice in case of adverse outcome since it is "off label" - may help with anxiety but may also have adverse effects in psychiatric patients."Continued cannabis use and risk of incidence and persistence of psychotic symptoms: 10 year follow-up cohort study." BMJ. 2011 Mar 1. 342:d73

Answered 11/27/2017

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Dr. Su Fairchild answered

Specializes in Integrative Medicine

CBD: CBD is promising and does not give the 'high' associated with THC.

Answered 11/27/2017

1.9k views

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Dr. Jovita Anyanwu answered

Specializes in Internal Medicine

Many: States were medical Marijuana is legal it is reported by anecdotal evidence to be efficacious for Anxiety . I treat patients with Opioid addiction.Majority of them with anxiety disorder report significant benefit from Marijuana but doubt it's efficacy in bipolar disorder

Answered 10/11/2017

1.8k views

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Dr. Anatoly Belilovsky answered

Specializes in Pediatrics

Makes it worse?: Here is a review of effects of cannabis on bipolar disorder: https://www.ncbi.nlm.nih.gov/pmc/articles/PMC4504917/ "Our findings show that cannabis use is associated with decreased likelihood of long-term remission in bipolar spectrum disorders."

Answered 10/23/2017

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