Zorrilla, I. 1, 2 , Nuñez, N. 1 , Barbeito, S. 1, 2 , Lopez-Peña, M. P. 1, 2 , Perez, P. 1 , Lopez, S. 1 , Haro, J. M. 3 , Gaviña, J. 1 , Garcia-Alocen, A. 1 & González-Pinto, A. M. 1, 2, 4
1 University Hospital of Alava
2 Cibersam
3 Sant Joan De Deu-SSM
4 University of the Basque Country
Objective: To examine whether bipolar disorder?s patients who stop using cannabis during manic/mixed episode have better clinical and functional outcomes than who continue using or have never used.
Methods: EMBLEM was a 2-year prospective observational study of bipolar disorder adults with manic/mixed episode. Data was collected at baseline, during first 12 weeks of treatment, and up to 24 months. Patients were classified into three cannabis use groups: current use; no current but previous use; and never users. Cannabis effects on outcomes were analyzed using regression models.
Results: 1,922 patients were analyzed 6.9% were current users, 4.6% previous, and 88.5% never users. Clinical outcomes differed significantly between the groups (P<.019): Group stopped using had highest remission (68.1%) and recovery (38.7%) lowest recurrence rates (42.1%) and relapses (29.8%). Logistic regression showed those who stopped using had similar clinical and functional outcomes to never users (all P>.05), whereas current users had lower recovery rates (P=.0035) and remission (P=.0138), higher recurrence (P=.0138), greater work impairment (P=.0156), and were more likely not to be living with partner (P=.0055) than never users.
Conclusions: Bipolar patients who stop using cannabis during manic/mixed episode have similar clinical and functional outcomes to never users, while continue using have higher risk of recurrence and poorer functioning.