Why medical cannabis is not prescribed for schizoaffective disorder in the UK

Medical cannabis laws in the UK

Medical cannabis has been legal in the UK since November 2018, allowing access to potentially millions of eligible patients. Current legislation permits specialist doctors to prescribe cannabis-based medicines for the treatment of conditions where there is evidence of their potential efficacy. However, there are some important restrictions.  

For example, medical cannabis can only be considered when conventional therapies have failed to provide adequate relief. Moreover, certain conditions are typically considered unsuitable for medical cannabis treatment. These include schizophrenia, bipolar disorder and schizoaffective disorder.

What is schizoaffective disorder?

Schizoaffective disorder is a mental health condition characterised by psychosis and mood-related symptoms. As a result, it may influence the thoughts, emotions, and actions of the person affected. Patients with schizoaffective disorder experience psychosis alongside manic symptoms (manic type), depressive symptoms (depressive type), or both (mixed type). 

Common psychotic symptoms can include hallucinations and delusions. For example, some people experiencing psychosis may see or hear things that aren’t there or experience disoriented or thoughts that may not feel like their own. Individuals experiencing schizoaffective disorder may also experience:

• Disconnection from their emotions
• Difficulty concentrating
• A lack of motivation or interest in things they usually enjoy

The cause of schizoaffective disorder is not fully understood, but some experts believe it may be influenced by brain chemistry and genetics, as well as the occurrence of trauma and stressful events.

Treating schizoaffective disorder

Clinicians may consider various treatments for schizoaffective disorder, depending on the symptoms experienced by the individual; however, treatment will typically include a combination of medication and psychotherapy (such as cognitive behavioural therapy). Medications that are commonly used in the management of schizoaffective disorder include:

• Antipsychotic medications to manage symptoms of psychosis or mania
• Antidepressants to treat depressive symptoms
• Mood stabilisers to help manage mood symptoms

Schizoaffective disorder is a complex condition that requires careful management. As such, patients may be prescribed a combination of medications to best manage their specific symptoms. Furthermore, emotional support from friends and family, as well as healthcare professionals, is often crucial in the effective management of the condition. 

What is the difference between schizophrenia and schizoaffective disorder?

As their names suggest, schizophrenia and schizoaffective disorder are both mental health conditions that share some characteristics. However, they also have some key differences. For example, while schizoaffective disorder involves mood-related symptoms such as mania or depression, schizophrenia does not.

Medical cannabis and schizoaffective disorder

Cannabis-based medicines can be useful in the treatment of a wide range of physical and mental health conditions. Products containing cannabidiol (CBD) and/or THC may be considered in the treatment of anxiety and depression, which may also occur alongside schizoaffective disorder. However, in many countries, including the UK, they are not deemed suitable for patients experiencing, or with a history of, psychosis or mania. 

For decades, links have been tentatively made between cannabis use and the development of psychosis. Indeed, the findings of a number of studies appear to support this link. 

For example, a 2019 study, published in The Lancet, found that “daily cannabis use was associated with increased odds of psychotic disorder compared with never users”. Furthermore, the researchers noted a positive correlation between the incidence of psychosis and the expected concentration of THC in the different types of cannabis available across the included study sites. 

This study and others like it have yet to prove the causal relationship between psychosis and cannabis (and in particular, THC). Indeed, some argue that this correlation may be due to individuals who are vulnerable to developing psychosis being more likely to use cannabis.

Nonetheless, due to the potential risks involved, it is generally advised that individuals with a history of psychosis avoid cannabis use, both in a recreational and medicinal setting. As such, cannabis-based medicines are not currently considered to be a suitable treatment option for patients with schizoaffective disorder.

Final thoughts

Schizoaffective disorder is a complex mental health condition that requires careful management using both medical and psychotherapeutic approaches. 

While cannabis-based medicines may prove useful in managing symptoms shared with other conditions, such as anxiety and depression, the potential risk of worsening psychotic symptoms generally makes medical cannabis therapy unsuitable for individuals living with schizoaffective disorder.

Thorough patient screening and responsible prescribing of cannabis-based medicines remain of the utmost importance to ensure the safety and wellbeing of our patients.