Differential effects of cannabis constituents on schizophrenia-related psychosis: a rationale for incorporating cannabidiol into a schizophrenia therapeutic regimen

The safety analysis of lurasidone based on the real-world data of FAERS database

BACKGROUND

To assess lurasidone's real-world safety via retrospective analysis of post-marketing adverse reactions.

RESEARCH DESIGN AND METHODS

Signal mining was carried out by retrieving the adverse events (AEs) associated with lurasidone from the FDA Adverse Event Reporting System (FAERS) database spanning from the first quarter of 2011 to the fourth quarter of 2023. Disproportionality analyses including Reporting Odds Ratio (ROR), Proportional Reporting Ratio (PRR), Bayesian Confidence Propagation Neural Network (BCPNN), and empirical Bayesian geometric mean (EBGM) were used to assess the presence of significant associations between lurasidone and AEs.

RESULTS

From the 10,176,406 reports collected in the FAERS database, a total of 12,451 reports of lurasidone-related AEs were identified, which focused on Psychiatric disorders (n = 8950), notably, akathisia and parkinsonian rest tremor are strongly associated with lurasidone; Breast engorgement, galactorrhea, breast discharge, and umbilical cord around neck and new ocular AEs including oculogyric crisis, excessive eye blinking, and blepharospasm, have not been mentioned in the specification. The most common and most severe PT reported was off-label use, followed by suicidal ideation.

CONCLUSIONS

This study reveals known and unexpected AEs about lurasidone, related to the eye, lactating women and life-threatening threats, and underscores the need for ongoing post-marketing surveillance of lurasidone.

IUPHAR review - Novel therapeutic targets for schizophrenia treatment: A translational perspective

Schizophrenia is a severe and debilitating psychiatric disorder that profoundly impacts cognitive, emotional, and social functioning. Despite its devastating personal and societal toll, current treatments often provide only partial relief, underscoring the urgent need for innovative therapeutic strategies. This review explores emerging approaches that target the complex neurobiological underpinnings of schizophrenia, moving beyond traditional dopamine-centric models. Among these, some novel drugs still employ multimodal mechanisms, simultaneously targeting dopaminergic and serotonergic systems to enhance efficacy and tolerability. Given the well-documented excitatory/inhibitory imbalance in schizophrenia, significant efforts have been directed toward addressing NMDA receptor hypofunctionality. However, strategies targeting this pathway have yet to demonstrate consistent clinical efficacy. In contrast, therapies targeting the cholinergic system have shown greater promise. For instance, the xanomeline-trospium combination, which modulates muscarinic receptors, has recently gained approval, and other molecules with similar mechanisms are currently under development. Beyond these approaches, novel strategies are being explored to target innovative pathways, including neuroplasticity, neuroinflammation, and mitochondrial dysfunction. These efforts are often designed as part of a combinatorial strategy to enhance the efficacy of currently available antipsychotic drugs. Despite significant progress, challenges remain in translating experimental discoveries into effective clinical applications. Future research should prioritize biomarker-driven approaches and precision medicine to optimize individualized treatment outcomes. By integrating these emerging therapeutic targets, schizophrenia treatment may evolve toward a more comprehensive and personalized approach, addressing the disorder's full spectrum of symptoms and improving patient quality of life.

Adverse events associated with the use of cannabis-based products in people living with cancer: a systematic scoping review

PURPOSE

To summarise the extent and type of evidence in relation to adverse events (AEs) associated with the use of cannabis-based products (CBP) in people living with cancer.

METHODS

The Joanna Briggs Institute (JBI) methodology for scoping reviews was applied. A search was performed in MEDLINE (Ovid), Embase (Ovid), CINAHL (EBSCOhost), Scopus, Web of Science Core Collections and AMED (Ovid) from their inception to 7 May 2023. Primary studies reporting AEs associated with any form of natural or synthetic CBP use in any cancer care setting and location were included.

RESULTS

One hundred fifty-two studies were included, with the most prevalent being randomised controlled trials (RCTs) (n = 61), followed by non-randomised controlled trials (n = 26) and case reports (n = 23). CBP was mainly used in gastrointestinal, liver, or peritoneal cancer (n = 98) and haematological or lymphoid cancer (n = 92), primarily to manage nausea and vomiting (n = 78) and cancer pain (n = 37). The most common CBP ingredients were combinations of THC and CBD (n = 69), synthetic THC (n = 47), single compounds of THC (n = 42) and CBD (n = 16) with diverse forms, administration routes and doses. The primary methods of administration were oral (n = 94) and inhalation (n = 54). A broad range of AEs were reported; the most common were related to the nervous system (n = 118), psychiatric (n = 101) and gastrointestinal system (n = 81). Diverse patient characteristics, significant under-reporting and low-quality reporting were observed in many studies.

CONCLUSIONS

More rigorous research designs that prioritise comprehensive, standardised reporting of AEs and CBP use are required to fully elucidate the safety profile of CBP use in cancer care.