Medical Cannabis for Schizophrenia Helps Healthy Sex Life

Sex and Schizophrenia

Jan 25, 2000 - © Ian Chovil


Many males with schizophrenia can tell you that the "swinging life of a bachelor" is not all it's cracked up to be. I have one friend about age 40 who had never had a girlfriend until a few years ago. He developed schizophrenia in high school, and never had the opportunity to catch up with his peers. He's 40 years old and still a virgin. Males with schizophrenia don't often get married, although I've never seen any analysis as to why not. Even when all the barriers are considered, poverty, social isolation, continuing negative and cognitive symptoms, non-employment, etc. you would still expect some marriage. Sexuality per se was never considered of any significance in psychosocial rehabilitation, never discussed at conferences, never discussed in psychiatrist offices, until quite recently. The only interest taken in patients' sexuality has been when it was socially inappropriate, criminal, or resulted in victimization of the patient.

There was no doubt conventional medications were having a major impact on people's sexuality. One prominent side effect of many medications is prolactin level increases. Prolactin elevation has a variety of sexual impacts in both male and females, none of them very desirable, although some women might not mind losing their menstrual periods. Sexual side effects just weren't considered important compared to the need to control psychotic symptoms.


With the introduction of atypical medication researchers are only now starting to investigate sexuality and it's importance to patients. Some researchers are finding that sexual side effects are a major reason for noncompliance. People would rather be psychotic than impotent. These researchers are finding that psychiatrists almost never initiate discussion of sexuality with patients, and patients are often too embarrassed to raise the subject themselves. Patients become noncompliant, relapse, and are rehospitalized, and the psychiatrist has no idea why. If anything the tendency would be to raise the dose of the medication in belief that an adjustment is needed.


There is an interesting debate going on now between Janssen which produces Risperidone and Eli Lilly which produces Olanzapine. Risperidone has a tendency to raise prolactin levels which causes considerable sexual side effects. Olanzapine has a tendency to cause weight gain sometimes quite a lot of weight. Each company is hoping that psychiatrists will see their rival's side effect as the greater evil. Which would you rather lose?


Although there is a beginning interest in sexuality as a component of patient satisfaction, it is only just beginning, and it is not entirely pure in intent. On the new atypicals, women are ovulating again and having unwanted pregnancies because no one is discussing birth control with them. The vast majority of men with schizophrenia do not have a satisfying sex life. The women are generally luckier because schizophrenia usually develops later in women and many are already married by then, although divorce is not uncommon in that population.

Historically people with schizophrenia were often segregated from the general population in day hospitals and group homes. Men and women with schizophrenia were much more likely to marry each other partly because they simply didn't have much contact with ordinary people of the opposite sex. There has never been a recognition of sexuality in people with schizophrenia. Sexuality was something to be prevented, end of story.


Part of this pervasive attitude results from the taboos of our society. We are very hung up when it comes to sexuality. We prosecute all manner of sexual offence, and our ideal role model simply doesn't have a sex life. Scandinavia took a much more balanced approach to the sexuality of disabled people. In fact someone receiving disability benefits in Scandinavia is allowed regular prepaid visits to one of the state approved brothels, in the same way someone in North America would receive a drug card to cover the cost of their prescriptions.


When you think of it we expect a lot from people with schizophrenia. They're expected to live solitary lives of poverty, ostensibly because they're disabled. Anybody would have a difficult time living a solitary life of poverty. In the Judeo-Christian bible the first thing God did after he created Adam, was to create a female partner for him. It is the natural course of human life to live with someone of the opposite sex. It is instinct, it is hormones, it is very human. There is virtually no recognition of sexuality in people with schizophrenia, except when male clients become sexually attracted to mental health workers, which they do on a regular basis across the continent. You can't blame them too much. They could justifiably say, like movie stars in old movies, "I'm not made of stone you know!".


One of the characteristic symptoms of depression is a loss of libido. People have no interest in sex when they are depressed, and it is something that often causes a lot of friction in couples where one experiences depressive episodes. About 40% of people with schizophrenia experience a major depressive episode, but it is often indistinguishable from the negative symptoms of schizophrenia. Forty percent attempt suicide at some point, often in a depressive episode. At the very least an interest in the opposite sex is a positive sign that the patient is not suffering from depression and is unlikely to attempt suicide. I can't help but

but wonder how many psychiatrists, case managers, and family members, would become concerned when the patient lost interest in the opposite sex. Would it even register as a possible symptom of depression? How many people died as a result?
With a new generation recovering so much better then people even ten years ago this will all change, but that won't hide the truth that I experienced ten years ago, that many people still experience today. An interst in sex is something to be encouraged in people with schizophrenia.

http://www.suite101.com/article.cfm/schizophrenia_retired/32299


Instead of discouraging people with schizophrenia from using medical cannabis to relieve stress, people should understand that cannabis contains an antipsychotic cannabidiol and also does not cause impotence as do most psychiatric pharmaceutical drugs;


The endogenous cannabinoid system has recently been shown of particular importance in the pathophysiology of acute schizophrenia. It interacts with various neurotransmitter systems in the central nervous system including the dopaminergic, glutamatergic and GABAergic system. While the psychedelic properties of the natural cannabis compound delta-9-tetrahydrocannabinol are widely known, there is some experimental and clinical evidence that other herbal cannabinoid compounds may have antipsychotic properties.

Based on these confounders we designed a four week, double-blind, controlled clinical trial on the effects of purified cannabidiol, a major compound of herbal cannabis, in acute schizophrenia and schizophreniform psychosis compared to the antipsychotic amisulpride. The antipsychotic properties of both drugs were the primary target of the study. Furthermore, side-effects and anxiolytic capabilities of both treatment strategies were investigated.

Cannabidiol significantly reduced psychopathological symptoms of acute psychosis after both, week two and four, when compared to the initial status. There was no statistical difference of this effect to the control condition. In contrast, Cannabidiol revealed significantly less side effects when compared to amisulpride.

This phase II clinical trial on the effects of Cannabidiol in acute schizophrenia and schizophreniform psychosis raises evidence for its antipsychotic properties that exceeds by far the evidence from open observations available up to now. Furthermore, it raises evidence that the endogenous cannabinoid system may provide a valid target in the search for new treatments for schizophrenia.

http://www.cannabis-med.org/studies/ww_en_db_study_show.php?s_id=171