Bipolar disorder and the endocannabinoid system

Shokouh Arjmand, Mina Behzadi, Kristi A Kohlmeier, Shahrzad Mazhari, Abdolreza Sabahi, Mohammad Shabani

Research output: Contribution to journal/Conference contribution in journal/Contribution to newspaperReviewResearchpeer-review

19 Citations (Scopus)

Abstract

OBJECTIVE: Bipolar disorder (BD) is a debilitating, lifelong neuropsychiatric illness characterised by unsteady mood states which vacillate from (hypo)mania to depression. Despite the availability of pharmaceutical agents which can be effective in ameliorating the acute affective symptoms and prevent episodic relapse, BD is inadequately treated in a subset of patients. The endocannabinoid system (ECS) is known to exert neuromodulatory effects on other neurotransmitter systems critical in governing emotions. Several studies ranging from clinical to molecular, as well as anecdotal evidence, have placed a spotlight on the potential role of the ECS in the pathophysiology of BD. In this perspective, we present advantages and disadvantages of cannabis use in the management of illness course of BD and provide mechanistic insights into how this system might contribute to the pathophysiology of BD.

RESULTS: We highlight the putative role of selective cannabinoid receptor 2 (CB2) agonists in BD and briefly discuss findings which provide a rationale for targeting the ECS to assuage the symptoms of BD. Further, data encourage basic and clinical studies to determine how cannabis and cannabinoids (CBs) can affect mood and to investigate emerging CB-based options as probable treatment approaches.

CONCLUSION: The probable role of the ECS has been almost neglected in BD; however, from data available which suggest a role of ECS in mood control, it is justified to support conducting comprehensive studies to determine whether ECS manipulation could positively affect BD. Based on the limited available data, we suggest that activation of CB2 may stabilise mood in this disorder.

Original languageEnglish
JournalActa Neuropsychiatrica
Volume31
Issue4
Pages (from-to)193-201
Number of pages9
ISSN0924-2708
DOIs
Publication statusPublished - Aug 2019

Keywords

  • Affect/drug effects
  • Bipolar Disorder/drug therapy
  • Brain/drug effects
  • Cannabinoids/therapeutic use
  • Cannabis
  • Endocannabinoids/physiology
  • Humans
  • Plant Extracts/therapeutic use
  • Receptor, Cannabinoid, CB1/antagonists & inhibitors
  • Receptor, Cannabinoid, CB2/agonists

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