Effects of haloperidol on the delta-9-tetrahydrocannabinol response in humans: a responder analysis
Δ-9-Tetrahydrocannabinol (Δ-9-THC) produces psychotomimetic effects in humans. However, the role of dopamine signaling in producing such effects is unclear. We hypothesized that dopaminergic antagonism would reduce the psychotomimetic effect of Δ-9-THC.
The objective of this study was to evaluate whether pre-treatment with haloperidol would alter the psychotomimetic and perceptual-altering effects of Δ-9-THC, measured by the Positive and Negative Syndrome Scale for Schizophrenia (PANSS) and the Clinician-Administered Dissociative Symptom Scale (CADSS) in humans.
In a two-test-day double-blind study, 28 healthy individuals were administered with active (0.057 mg/kg) or placebo oral haloperidol, followed 90 and 215 min later by intravenous administration of active (0.0286 mg/kg) Δ-9-THC and placebo, respectively. This secondary analysis was conducted because of the observation in other studies and in our data that a significant proportion of individuals may not have an adequate response to THC (floor effect), thus limiting the ability to test an interaction. Therefore, this analysis was performed including only responders to THC (n = 10), defined as individuals who had an increase of at least one point on the PANSS positive scale, consistent with prior human laboratory studies.
In the 10 responders, Δ-9-THC-induced increases in PANSS positive scores were significantly lower in the haloperidol condition (1.1 + 0.35) compared with the placebo condition (2.9 + 0.92).
This responder analysis showed that haloperidol did reduce the psychotomimetic effect of Δ-9-THC, supporting the hypothesis that dopaminergic signaling may participate in the psychosis-like effects of cannabinoids.
KeywordsCannabinoid Haloperidol Antipsychotic Dopamine Psychosis
We also acknowledge support from the (1) Department of Veterans Affairs, (2) National Institute of Drug Abuse, (3) National Institute of Alcoholism and Alcohol Abuse.
This research project was funded in part by grants from the National Institute of Mental Health (R25MH071584 to JPD).
Compliance with ethical standards
Conflict of interest
DCD has received in the past 3 years and currently receives research grant support administered through Yale University School of Medicine from Pfizer Inc. All other authors report no biomedical financial interests or potential conflict of interest.
- Aas M, Melle I, Bettella F, Djurovic S, Le Hellard S, Bjella T, Ringen P, Lagerberg T, Smeland O, Agartz I (2018) Psychotic patients who used cannabis frequently before illness onset have higher genetic predisposition to schizophrenia than those who did not. Psychol Med 48:43–49CrossRefGoogle Scholar
- D'Souza DC, Braley G, Blaise R, Vendetti M, Oliver S, Pittman B, Ranganathan M, Bhakta S, Zimolo Z, Cooper T, Perry E (2008) Effects of haloperidol on the behavioral, subjective, cognitive, motor, and neuroendocrine effects of delta-9-tetrahydrocannabinol in humans. Psychopharmacology 198:587–603CrossRefGoogle Scholar
- First MB, Gibbon M (2004) The structured clinical interview for DSM-IV axis I disorders (SCID-I) and the structured clinical interview for DSM-IV axis II disorders (SCID-II)Google Scholar
- Kuepper R, Ceccarini J, Lataster J, van Os J, van Kroonenburgh M, van Gerven JM, Marcelis M, Van Laere K, Henquet C (2013) Delta-9-tetrahydrocannabinol-induced dopamine release as a function of psychosis risk: 18F-fallypride positron emission tomography study. PLoS One 8:e70378CrossRefGoogle Scholar
- Sobell LC, Sobell MB (1992) Timeline follow-back Measuring alcohol consumption. Springer, pp 41–72Google Scholar