Psychopharmacology and Psychiatry Updates Staying Well: LAIs vs. Oral Medications in Cannabis-Induced Psychosis
Mar 7, 2026
David A. Gorelick, clinical professor and addiction psychiatrist, joins to break down research on treating cannabis-induced psychosis. He recounts a large Swedish database study and which antipsychotic formulations cut hospitalization risk. He highlights differences between oral and long-acting injectables, names the medications that performed best, and discusses implications for discharge planning and real-world care.
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College Student Case Shows High Risk After Cannabis Psychosis
- A 20-year-old college student presented with paranoid delusions after daily high-potency cannabis use for six months leading to a diagnosis of cannabis-induced psychosis.
- About one-third of such patients later develop schizophrenia within a few years, highlighting the clinical urgency described by Richard Seeber.
Within-Subject Swedish Database Design Strengthens Evidence
- Mustanen and colleagues used Swedish national databases to follow 1,772 individuals with cannabis-induced psychosis for a mean of eight years, comparing on-medication versus off-medication periods within subjects.
- The within-subject design minimized selection bias and provided robust real-world evidence on long-term antipsychotic effectiveness, explained by David A. Gorelick.
Antipsychotics Lower Psychosis Substance and Medical Admissions
- Antipsychotic treatment reduced hospitalizations: ~25% for psychotic episodes, ~25% for substance use disorders, and nearly 50% for general medical conditions.
- Medical admissions involved GI, musculoskeletal, neurological, respiratory, and cardiovascular problems, showing broad health benefits.