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Herbal medicines have been used to treat mental health disorders since ancient times. Many of the medications used in contemporary medicine originated from plants—salicylic acid from the willow tree, for example, and morphine from poppies. Numerous botanical treatments are useful in general psychiatry. This article discusses the most beneficial and commonly used herbal medicines to treat mental health concerns (

Americans spent $11.3 billion on herbal supplements in 2020, which represented a record increase in spending of 17.3% from 2019 to 2020.

 According to the 2020 COVID-19 consumer survey of the Council for Responsible Nutrition,

 among those who increased supplement intake, nearly a quarter cited mental health–related reasons, including stress and anxiety.

US consumers are spending the most money on the following herbs with mental health applications: cannabidiol (CBD), ashwagandha (

), turmeric, gingko, St. John’s wort (SJW), valerian, maca, and rhodiola. Several of these herbs also have applications for physical health, such as inflammation, cardiovascular disease, and physical performance.

The research evidence and consumer spending do not align. As psychiatrists, we can help guide our patients in making beneficial choices when they choose to take herbs.

Most of the psychotropic herbal medicines available over the counter are quite safe, with fewer adverse effects than conventional antidepressants or antianxiety agents.

 Yet not all are safe. For example, SJW could cause a switch to mania in bipolar disorder

; also, it should not be taken with certain other drugs due to potential interactions.

 Kava supplements made from the incorrect plant type and incorrectly processed have caused liver toxicity.

 Thus, it is important to know which herbal agents your patient may be taking and whether herbal medications may be interacting with conventional medications.

Herbal medicines are more complex than conventional medications, which may discourage psychiatrists from recommending them. Take heart: Most herbs are quite safe. It may be easiest to select 2 or 3 herbs, to start, and learn about them in depth. Alternately, choose to learn about the herbs your patients are already using and mixing with the conventional medications we may be prescribing.

Herbs’ complexity comes from the fact that they are whole plants rather than a single chemical active ingredient in a medication. A plant’s beneficial effect may be related to complex synergistic and polyvalent interactions among many of its own components or multiple plants. A plant or herbal combination may contain multiple molecules with different physiological effects, or it may modify the absorption or metabolism of other bioactive components, or it may reduce adverse effects. For example, adding black pepper to turmeric may dramatically enhance the absorption of turmeric into the bloodstream.

 Within a single plant, valerian has several different effects including anxiolysis, muscle relaxation, and sleep promotion; notably, valerian involves a number of compounds such as free GABA; benzodiazepine receptor-binding flavonoids; terpenes, which inhibit GABA breakdown and cause smooth muscle relaxation; and lignans, which inhibit serotonin binding.

Herbal medicines may work better because of the complex and synergistic interactions, yet that strength is an obstacle to standardized research, and it may worry clinicians. Comparing the results of studies on different preparations of the same herb produced by different manufacturers may be difficult. The exact chemical composition of an herbal preparation is dependent on many factors, described in 

Research on herbal medicines is elucidating the mental health effects and underlying mechanisms of action of many individual herbs, a few of which are discussed in this article. Herbal medicines may have antidepressant, anxiolytic, sedative, hypnotic, analgesic, and cognitive-enhancing effects, in addition to “adaptogenic” effects, that increase resilience to stress. Key mechanisms of actions of herbal medicines identified in research can be found in 

The use of SJW dates back to ancient times, and it is among the most researched herbal medicines for mental health. It is a first-line treatment for depression in several European countries.

 of 29 trials including 5489 adult patients found significant results from 18 studies in favor of SJW versus placebo. SJW appeared equivalent to selective serotonin reuptake inhibitors (SSRIs). A 2016 review

 of 35 studies involving nearly 7000 adult patients found that SJW monotherapy for mild-to-moderate depression was superior to placebo in improving depression symptoms, and it was about equivalent in effect to antidepressants. In research studies, the dose ranged from 300 mg to 1800 mg per day. Most preparations used in research contained standardized 0.3% hypericin and 2% to 5% hyperforin.

 SJW’s likely mechanism of action involves nonselective inhibition of serotonin, dopamine, norepinephrine, GABA, and L-glutamate uptake, and decreased degradation of neurochemicals. In addition, SJW modulates cortisol levels.

 SJW appears to be generally well tolerated, with adverse effects occurring in 0.1% to 5.7% of users (comparable with placebo).

 Most common adverse reactions involve reversible dermatological and gastrointestinal issues. Per the 2016 review of the 35 studies reviewed, 34 included safety data, and overall SWJ did not cause more adverse effects than placebo.

SJW is a potent inducer of CYP 3A4 and P glycoprotein, and it can lower the levels of many commonly used medications including oral contraceptives, methadone, and cyclosporine. It is best to check reference materials for possible SJW-medication interactions or even to avoid use with certain medications. Preparations that are < 4 mg of hyperforin may be safer and less likely to cause drug-herb interactions.

Rare, serious adverse effects include serotonin syndrome (when combined with an SSRI), induction to mania, and psychosis. A 2004 article reported 17 cases in the literature where SJW was associated with likely triggering mania or psychosis.

- The main concern about and obstacle to SJW use is concern for drug interactions.

- In clinical practice, you may find better adherence to SJW if you recommend a specific formulation and monitor the use of SJW as you would any other medication. Increase the dose gradually from 300 mg up to a maximum 1800 mg. Monitor for adverse effects, and if there is no benefit by 6 weeks, consider adding other augmenting agents or switching to a different agent.

Turmeric is a common cooking spice and a traditional Ayurvedic and Chinese medicine.

 A 2020 meta-analysis of 10 studies involving 530 participants found a significant and large effect size of curcumin for depressive symptoms based on 10 studies and on anxiety symptoms based on 5 studies.

 Curcumin was well tolerated. A meta-analysis

 of 6 trials lasting 4 to 8 weeks and involving 377 patients with depression showed turmeric’s significant benefit in reducing depressive symptoms compared with placebo. Three studies also reported significant antianxiety effects. A 6-week randomized controlled trial (RCT) of 108 male adults in China showed benefit for 1000 mg curcumin per day versus placebo as an augmentation to escitalopram.

 In addition, the study documented that curcumin decreased inflammatory cytokines (interleukin-1 beta and tumor necrosis factor alpha) and salivary cortisol, and increased brain-derived neurotrophic factor.

 Curcumin, a key component of turmeric, has anti-inflammatory, antioxidant, neuroprotective, and monoamine regulatory effects.

- Turmeric may be particularly useful for patients with depression and inflammation. When checking blood work, check high-sensitivity C-reactive protein, and if it is higher than 1 mg/L, consider adding turmeric to an antidepressant.

- Recommend formulations that are of high quality and contain black pepper extract to increase absorption.

The majority of research on saffron was conducted in Iran, where it has been used as a traditional treatment for mood for centuries. Its constituents safranal and crocin show antidepressant, anxiolytic, and hypnotic effects. Crocin may act through reuptake inhibition of dopamine and norepinephrine, and safranal via serotonin reuptake inhibitors. In addition, saffron has anti-inflammatory effects.

 A meta-analysis of 5 published high-quality RCTs showed a large effect size in favor of saffron versus placebo for depressive symptoms, and equal effect to antidepressant groups.

 In addition, a 12-week double-blind RCT (n = 60) of 50 mg per day of saffron was positive.

 However, the conducted studies were small and of short duration, and little research has been conducted at Western study sites.

- Look for a higher dose of saffron when selecting a supplement.

- Saffron can be used as monotherapy or adjunctive use for mild to moderate depression.

Lavender has been used in aromatherapy for anxiety.

 A 2021 meta-analysis of 17 articles showed significant benefit of lavender for decreasing depression symptoms.

 Nearly three-fourths of the studies in this meta-analysis were conducted in Iran, most studies involved aromatherapy, and 5 studies involved ingesting lavender. One study evaluated the effects of lavender essential oil (Silexan) on patients with mixed anxiety and depressive disorder, a condition with subsyndromal symptoms of anxiety and depression.

 In this study, 318 patients received 80 mg Silexan or placebo for 70 days. Silexan was beneficial for decreasing depression scores and improving quality of life. The main adverse effect was eructation.

- Select supplements with 80 mg to 160 mg of lavender essential oil per day in the form of soft gels.

- Weak evidence for monotherapy, more appropriate for adjunctive use in major depressive disorder and generalized anxiety disorder.

Another interesting herb is the cannabis plant (

), which contains delta-9-tetrahydrocannabinol (THC) and CBD. Currently, despite the very high spending on these by consumers, very little research is available to guide use. A review article published in 

 in 2019 of 83 studies, including 40 RCTs and 3067 participants, concluded that there is a lack of evidence that cannabinoids improve symptoms of depression, anxiety, attention-deficit/hyperactivity disorder, tics, posttraumatic stress disorder (PTSD), or psychosis.

 The single positive finding was that there was very-low-quality evidence that THC with or without CBD may help with anxiety for those who also have other medical conditions. A 2021 review noted that with only 8 very small studies at the time, there was insufficient evidence for clinicians recommending CBD or THC to manage mood disorders, anxiety, or PTSD.

 Clinically, many psychiatrists recommend CBD for anxiety and warn about the dangers of chronic THC use—yet, at this time, we do not have much research evidence to guide us.

In my clinical practice, I find that some patients find CBD without THC or with a minimal amount of THC (20:1 ratio of CBD to THC) useful for anxiety, sleep, and inflammation without significant adverse effects. The dose range of CBD is large, from approximately 5 mg to 45 mg for effect. Many patients prefer CBD in capsules for consistency of dose.

- Soft gel formulations of CBD at 15mg are good place to start and recommend to patients to start with one soft gel, if not effect take another one 30 min later, and another one 30 min later to determine the effective dose.

- Avoid confusion with hemp seed oil, which does not contain CBD.

- Select high quality brands or obtain through dispensaries.

Other promising herbs for the treatment of mental health disorders include ashwagandha with moderate evidence and galphimia with modest evidence for anxiety disorders. Gingko has week support for adjunctive treatment of negative symptoms in schizophrenia.

Herbal medicine is an important addition to our conventional medication toolbox. Herbs are generally well tolerated and affordable. For patients interested in using herbs, we have sufficient evidence to recommend several agents discussed in this article. It is important to ask patients what herbs and supplements they take and to assess for potential drug-herb interactions and adverse effects.

is a psychiatrist and psychotherapist at Mind Body Seven Psychiatry, and a clinical assistant professor at New York University.

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Herbal supplement sales in US increase by record-breaking 17.3% in 2020.

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Herbal medicine for depression, anxiety and insomnia: a review of psychopharmacology and clinical evidence.

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Hyperforin in St. John’s wort drug interactions.

Therapeutic roles of curcumin: lessons learned from clinical trials.

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A systematic review of St. John’s wort for major depressive disorder.

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Saffron (Crocus sativus L.) and major depressive disorder: a meta-analysis of randomized clinical trials.

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A double-blind, randomized and placebo-controlled trial of saffron (Crocus sativus L.) in the treatment of anxiety and depression.

18. Firoozeei TS, Feizi A, Rezaeizadeh H, et al. 

The antidepressant effects of lavender (Lavandula angustifolia Mill.): a systematic review and meta-analysis of randomized controlled clinical trials.

19. Kasper S, Volz H-P, Dienel A, Schläfke S. 

Efficacy of Silexan in mixed anxiety-depression—a randomized, placebo-controlled trial.

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Evidence for use of cannabinoids in mood disorders, anxiety disorders, and PTSD: a systematic review.

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Clinician guidelines for the treatment of psychiatric disorders with nutraceuticals and phytoceuticals: The World Federation of Societies of Biological Psychiatry (WFSBP) and Canadian Network for Mood and Anxiety Treatments (CANMAT) Taskforce.

Herbal medicines have been used to treat mental health disorders since ancient times, and continue to be useful today. 

Herbal Medicine: What Psychiatrists Need to Know

“Mr Brown,” a patient in his early 20s, has been readmitted to the psychiatric inpatient unit. Since his first presentation with a psychotic episode about 2 years ago, this is his third admission to the unit. All these hospital admissions have been involuntary in nature. There is a history of cannabis use since his teenage years, initially off and on but more regularly over the past 2 to 3 years. Mr Brown smokes about 20 cigarettes a day, drinks occasionally, and tried lysergic acid diethylamide (LSD) many years ago. He improved with treatment with second-generation antipsychotic medications in each of the previous admissions and remained well for a while in the community. However, he seems to become irregular in terms of taking medications and returns to using cannabis soon after discharge.

In each of the past 2 admissions, Mr Brown stopped coming for follow-up and stopped picking up his prescriptions a few months before the hospital admission. On further enquiry, it seems that Mr Brown started smoking marijuana initially with friends and still does so occasionally, but often uses it on his own nowadays. He finds that it helps him relax and sleep better, and he uses most days of the week when he has money. When asked about medication, Mr Brown expresses some concerns about putting something that is not natural into his body.

Presenting the Problem: Cannabis Use and Nonadherence

Medication nonadherence is a major challenge that affects every medical specialty. Estimates from the early 21st century indicate that the cost of nonadherence is around $100 billion per year in the Unites States alone.

 Although adherence may be described as the extent to which an individual changes their health behavior to comply with medical advice, deviations from that, termed nonadherence, may either be partial or complete. Partial nonadherence may include taking medication at incorrect doses or times, while complete nonadherence involves discontinuation of the medicine altogether. 

In the context of psychiatric disorders, it is estimated that 75% of patients will discontinue taking their prescribed medications over the course of 1 year.

 Psychiatric treatment regimens are usually complex and costly, and can run for long, sometimes indefinite periods.

Additionally, illness features, such as lack of insight and cognitive deficit in certain psychiatric conditions, may play a role in nonadherence.

 Other consistently reported risk factors of nonadherence include medication adverse effects, illness beliefs, the doctor-patient relationship, illness attitudes, and substance misuse, including cannabis misuse.

 Nonadherence to treatment may increase the risk of relapse for most serious mental illnesses as well as the risk of suicide, violence, and all-cause mortality.

 Additionally, nonadherence may increase the financial strain on health care systems through increased hospital admissions and emergency room visits.

Given the substantial impact of nonadherence, it is particularly important to focus on its modifiable risk factors. In the context of severe mental illnesses such as psychotic disorders, antipsychotic medications are the mainstay of treatment, but poor adherence often affects their effectiveness.

 Although a number of factors affecting adherence to medication treatment has been described in those with psychosis, they are not always amenable to intervention. In particular, illness-related factors such as poor insight and cognitive deficit may be inextricably linked to nonadherence in a way that is difficult to disentangle and intervene.

On the other hand, meta-analytic evidence—from 15 studies reporting on more than 3000 patients—suggests that substance misuse, specifically cannabis misuse, may be one of the most consistently reported risk factors for nonadherence that may arguably also be modifiable.

 A subsequent prospective study investigating individuals with first-episode psychosis suggested that the effect on medication nonadherence was most pronounced for cannabis, while the use of nicotine, alcohol, and other illicit drugs did not seem to have a substantial independent effect.

As cannabis is the most frequently used illicit substance worldwide, with up to two-thirds of individuals experiencing a first episode of psychosis reporting its use, cannabis use is a particularly important therapeutic target to address the challenge of medication nonadherence in psychosis. The relationship between cannabis misuse and treatment adherence has also been studied to a lesser extent in bipolar disorder and other diagnoses. 

In a recent nationwide study in the United States of patients with bipolar disorder, the risk of nonadherence in patients with cannabis use disorder was nearly one-and-a-half times that in those without cannabis use.

 Cannabis use has also been found to be associated with medication nonadherence across a range of conditions in adolescents.

In this article, we will focus mainly on the effect of cannabis use on adherence to medications in those with psychosis—the condition with most of the reported evidence.

Although the association between cannabis use and nonadherence in those with psychosis seems clear, why must practicing clinicians bother? We know that in those with psychosis, cannabis use is associated with an increased risk of relapse

 Growing evidence now suggests that 1 potential pathway through which cannabis use may increase the risk of poor outcome in those with psychosis may be by increasing nonadherence to medication treatment.

Indeed, in a prospective observational study of 245 patients with first-episode psychosis, up to a third of the detrimental effects of cannabis use on outcome in psychosis was shown to be mediated through its effect on nonadherence with medication treatment.

 Consistent with this, in an independent sample of more than 2000 patients with first-episode psychosis, up to 50% of the harmful effects of cannabis use on hospital admission were found to be mediated by cannabis use contributing to failure of antipsychotic treatment.

Although this study did not disentangle failure of treatment with antipsychotics as a result of nonresponse from that due to nonadherence, collectively these studies indicate that cannabis use may contribute to poor outcome in psychosis by adversely affecting adherence to antipsychotic medications and by making them less effective.

Approaches to Mitigating the Effects of Cannabis Use on Nonadherence and Outcomes in Psychosis

A typical patient may present with a history of psychotic illness associated with cannabis use, as described in the vignette. Here we summarize some of the key aspects of assessment and treatment planning that may be useful in such a scenario.

At the risk of stating the obvious, it is worth reiterating that the key to formulating an effective management strategy is a good understanding of the circumstances around cannabis use behaviors as well as a detailed history of medication treatment. Understanding from the patient’s perspective how effective the medications might have been and their reasons for discontinuation or irregular use, including any adverse effects experienced, is particularly important, as is their understanding of the nature and expected course of treatment for their condition. Do they have any specific concerns regarding medications? Do they sometimes forget to take them, or are they unsure why they need to continue medications even after they start feeling better?

Limited insight and acceptance of having an illness and need for treatment are more commonplace in this context and challenging to intervene. However, they may be accompanied by other specific concerns that may be more amenable to intervention. Hence, a specific lookout for such potential intervention targets that may be more readily addressed may be useful. 

A strong therapeutic alliance—wherein the doctor-patient relationship is characterized by trust, empathy, acceptance, and a nonjudgmental approach—is really critical to ensuring detailed disclosure of information not just on cannabis use, but on key parameters of use that may serve as intervention targets, such as the amount, frequency, continuity, type of cannabis used, typical triggers or circumstances of use, as well as any benefits perceived or experienced. For example, does it help initiate sleep, reduce anxiety, or deal with painful emotions or other stress?

It may also be worth inquiring about any withdrawal symptoms or cravings that may play a role in maintaining cannabis use behavior. Depending on the length of illness, as part of eliciting history, it may be useful to construct a longitudinal account of the illness course together with the patient, with the aim of demonstrating a repeating sequence of cannabis use behaviors followed by or associated with partial or complete medication nonadherence. One would aim for this to facilitate a shared understanding of how such a course of events leads to a repeating cycle of relapse of psychosis and hospitalization with or without restriction of their liberty and/or other traumatic consequences. Where applicable and practicable, assay of plasma level of antipsychotics may further inform treatment-planning, particularly where nonadherence may be a consideration.

The main purpose of this endeavor really is to prepare the ground for subsequent discussions on the need to address cannabis use behaviors and find alternative strategies that may serve the same purpose as cannabis use (eg, alleviate difficulties in sleep initiation) or may help overcome factors (eg, cravings, withdrawal symptoms) that may maintain its use. Often, this may not be feasible in the immediate aftermath of admission, when the focus may need to be on stabilizing the mental state so that the patient is able to engage meaningfully with the above.

What might one do with such information as above? The 

 summarizes the key intervention targets, objectives, and strategies in a graphical format. 

Working toward complete abstinence from cannabis may be ideal and perhaps should be the eventual goal, as there is evidence that discontinuation of use may be associated with a risk of medication nonadherence or relapse of psychosis that is comparable to patients who have never used cannabis.

However, there is also some evidence that the harms of cannabis use on medication adherence and outcomes in psychosis are most prominent in those using high-potency forms of cannabis on a regular basis, in particular daily users,

 and those using less potent forms of cannabis or using less frequently and less regularly may have comparable risk of relapse to those who have stopped using cannabis altogether.

 Therefore, a less than perfect objective of changing from more potent to less potent forms of cannabis or less frequent and less regular use may still be a worthwhile pursuit in an individual patient.

How does one choose the right antipsychotic for patients with psychosis with ongoing comorbid cannabis use? There is not a lot of evidence to inform decision-making in this regard,

 although a recent review of available evidence points toward potential advantages with clozapine compared to any other antipsychotic in terms of cannabis use, and risperidone compared to olanzapine for craving.

However, one needs to be mindful of the modest evidence base in this area and exercise clinical judgement. One may also be guided by whether there is actual treatment nonresponse or partial response, as opposed to partial or complete nonadherence contributing to suboptimum outcomes. This may inform strategies to switch medications or those focused on improving adherence.

An important underpinning approach in treatment planning may be to aim for a simplified treatment regime that provides an optimum balance of adverse effects and desired response for the patient in order to promote the best adherence. Given that medication adherence may be a key challenge, long-acting injectable preparations may be considered, although the evidence in support is also modest.

 Other strategies to improve adherence may also be worth considering,

 as well as customized adherence enhancement strategies used in conjunction with long-acting injections.

Where feasible, medication-focused approaches may also be supported by psychosocial approaches directed at cannabis use behaviors in general. Although there is some indication that some of these approaches may be useful in reducing symptom severity and cannabis use behaviors in the shorter term, there is less clear evidence of their impact on longer-term outcomes of psychosis or cannabis use.

Cannabis use is an important and preventable risk factor for medication nonadherence in psychiatric patients. A strong therapeutic alliance and focused history taking is essential to address this. In addition to intervention approaches recommended for individuals with psychosis and comorbid substance use, certain specific strategies that may be considered include a focus in the short term in helping patients switch to lower-potency cannabis and encouraging less frequent use, complemented with strategies to augment medication adherence through the use of digital reminders, long-acting antipsychotics, and rationalizing medications to provide an optimum balance of efficacy and tolerability that is acceptable to the patient.

is a professor of translational neuroscience and psychiatry in the Department of Psychosis Studies, Institute of Psychiatry, Psychology and Neuroscience, at King’s College London. 

is affiliated with the Institute of Psychiatry, Psychology and Neuroscience at King’s College London.

Bhattacharyya is supported by grants from the National Institute for Health Research (NIHR) Efficacy and Mechanism Evaluation scheme, the NIHR Mental Health Biomedical Research Centre at South London and Maudsley National Health Service (NHS) Foundation Trust and King’s College London, and Parkinson’s UK.

The views expressed are those of the author(s), and not necessarily those of the NHS, the NIHR, or the Department of Health.

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The Impact of Cannabis Use on Medication Adherence: A Particular Focus in Psychosis

John J. Miller, MD, shares why it is important to differentiate between CBD and THC when discussing cannabis 

2022 Annual Psychiatric Times™ World CME Conference

is Medical Director, Brain Health, Exeter, New Hampshire; Editor in Chief,

; Staff Psychiatrist, Seacoast Mental Health Center, Exeter; Consulting Psychiatrist, Exeter Hospital, Exeter; Consulting Psychiatrist, Insight Meditation Society, Barre, Massachusetts.

CBD and THC? What's the difference and why does it matter? 

Cannabis: Separating the Conversation on CBD and THC

Medication nonadherence has been one of the major barriers in patient care for psychiatrists managing patients with chronic mental health disorders.

 This has resulted in multiple negative outcomes including a protracted course of illness, worsening disease symptoms severity, risk of relapse suicide risk, illness exacerbation, mortality, and frequent hospitalizations.

 In addiction, medication nonadherence-related hospital readmissions increased the health care cost burden of the early 21st century to more than $100 billion per year, continuing to rise annually.

 However, one of the modifiable risk factors for medication nonadherence with possible interventions gaining traction is substance use disorder (SUD), particularly 

Cannabis is one of the most frequently used drugs worldwide, and CUD has been rising substantially globally, especially in the Americas and Asia.

 CUD has become a growing problem in the United States since the passing of legislation permitting the medical use of cannabis in more than 33 states and recreational use in 11 additional states as of 2020.

 The overall percentage of patients who are nonadherent to their psychotropic medication was estimated to be 49% (56% with schizophrenia, 50% with major depressive disorders, and 44% with bipolar disorders).

patients with first-episode psychosis who use cannabis

 were more prone to medication nonadherence and illness relapses compared to those who stopped using substances.

 A systematic review of 3678 patients with psychiatric illnesses also found cannabis users to have 2.5 times higher medication nonadherence to antipsychotic medications compared to non-cannabis users.

Nonadherence is very challenging to tackle in the clinical setting, given its high prevalence. 

 is usually identified after multiple relapses, misinterpretation data of medication efficacy, and several changes to prescription medications.

 However, there is evidence that cannabis use can be an early warning sign for future nonadherence and may be a good source for early intervention before a patient relapses.

Typically, a urine drug screen (UDS) is done for screening patients who might have been using 

 for several weeks in cases of chronic cannabis use. Delta-9-tetrahydrocannabinol (THC) and other cannabinoids metabolites can be detected in the urine of chronic heavy users of cannabis for up to 6 weeks. However, other active cannabinoids such as cannabidiol have less sensitivity to testing. What is crucial for clinicians to know is that a therapeutic alliance between the physician and the patient is key to managing patients with cannabis use and medication nonadherence.

Despite the availability of UDS tests, physicians should feel comfortable asking their patients about history of drug use utilizing techniques such as motivational interviewing. The interaction of cannabis and psychotropic medications should be described in clear terms to patients. Evidence has shown that the efficacy of antipsychotics in patients with psychosis and comorbid cannabis use is limited in the treatment of psychosis.

Cannabis use disorder and nonadherence: How can we best educate patients? 

Cannabis

Herbal Medicine: What Psychiatrists Need to Know

The Impact of Cannabis Use on Medication Adherence: A Particular Focus in Psychosis

Cannabis: Separating the Conversation on CBD and THC

The Impact of Cannabis Use on Medication Nonadherence in Psychiatry

August 8 is National CBD Day 2022

Cannabis Legalization: What Psychiatrists Need to Know

Is Cannabis Use Increasing Schizophrenia?

How to Talk to Teenagers About Substance Use

Cannabis Confusion

Addressing Myths and Facts About Cannabis Use