"Aberrant" neuronal stimulation and "cannabis psychosis" - Hypothesis to a biological plausibility!

Abstract

Western democracies continue to 'legalize recreational cannabis use' after its 'medicinal approval', while India continues to debate whether to 'decriminalize' cannabis or not. One of the strongest arguments against cannabis decriminalization is cannabis dependence and the risk of psychosis, at-least in the vulnerable groups. Endocannabinoids are involved in neuronal proliferation and differentiation during 'patterning of the central nervous system '. Aberrant neurostimulation caused by repeated heavy exo-cannabinoid exposure may increase the probability of pro-psychotic experiences. Various animal and human studies have demonstrated increased but abnormal activation of cortical and subcortical areas due to chronic cannabis use. Some of these areas are involved in the pathogenesis of psychosis or schizophrenia. A review of the literature was done to hypothesize the possible role of cannabis to cause (orprecipitate) psychosis through repeated "aberrant neurostimulation". The 'aberrant neurostimulation model of cannabis psychosis' may explain pathogenesis, individual vulnerabilities and developing therapeutic strategies for this debated entity. In future, well designed placebo-controlled studies may find the answer with more confidence.