Objective:

The United States is in the midst of rapidly changing laws regarding cannabis. The increasing availability of cannabis for recreational and medical use requires that mental health clinicians be knowledgeable about evidence to be considered when counseling both patients and colleagues. In this review, the authors outline the evidence from randomized double-blind placebo-controlled trials for therapeutic use of cannabinoids for specific medical conditions and the potential side effects associated with acute and chronic cannabis use.

Methods:

Searches of PubMed and PsycInfo were conducted for articles published through July 2021 reporting on “cannabis” or “cannabinoids” or “medicinal cannabis.” Additional articles were identified from the reference lists of published reviews. Articles that did not contain the terms “clinical trial” or “therapy” in the title or abstract were not reviewed. A total of 4,431 articles were screened, and 841 articles that met criteria for inclusion were reviewed by two or more authors.

Results:

There are currently no psychiatric indications approved by the U.S. Food and Drug Administration (FDA) for cannabinoids, and there is limited evidence supporting the therapeutic use of cannabinoids for treatment of psychiatric disorders. To date, evidence supporting cannabinoid prescription beyond the FDA indications is strongest for the management of pain and spasticity.

Conclusions:

As cannabinoids become more available, the need for an evidence base adequately evaluating their safety and efficacy is increasingly important. There is considerable evidence that cannabinoids have a potential for harm in vulnerable populations such as adolescents and those with psychotic disorders. The current evidence base is insufficient to support the prescription of cannabinoids for the treatment of psychiatric disorders.

中文翻译：

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大麻和大麻素在精神病学中的风险和益处

客观的：

美国正处于快速变化的大麻法律之中。用于娱乐和医疗用途的大麻越来越多，这要求心理健康临床医生了解在为患者和同事提供咨询时要考虑的证据。在这篇综述中，作者概述了大麻素治疗特定疾病的随机双盲安慰剂对照试验的证据，以及与急性和慢性大麻使用相关的潜在副作用。

方法：

对 PubMed 和 PsycInfo 进行了搜索，以查找截至 2021 年 7 月发表的关于“大麻”或“大麻素”或“药用大麻”的文章。从已发表评论的参考列表中确定了其他文章。标题或摘要中不包含术语“临床试验”或“治疗”的文章不予审查。共筛选了 4,431 篇文章，其中 841 篇符合纳入标准的文章由两位或更多作者审阅。

结果：

目前美国食品和药物管理局 (FDA) 没有批准大麻素的精神适应症，并且支持大麻素用于治疗精神疾病的治疗性证据有限。迄今为止，支持超出 FDA 适应症的大麻素处方的证据对于治疗疼痛和痉挛是最有力的。

结论：

随着大麻素变得越来越容易获得，对充分评估其安全性和有效性的证据基础的需求变得越来越重要。有大量证据表明，大麻素可能对青少年和精神病患者等弱势群体造成伤害。目前的证据基础不足以支持大麻素处方用于治疗精神疾病。