Cannabis use is associated with younger age at onset of bipolar disorder, poor outcome, and more frequent manic episodes, but the effects of cannabis on cognition are less clear. Contrary to reports among non-psychiatric patients, cannabis may improve cognition among people with bipolar disorder. Nevertheless, no study to date has systematically tested the acute effects of cannabis on cognition in bipolar disorder. Therefore, the investigators propose to determine the effects of oral cannabinoid administration on cognitive domains relevant to bipolar disorder, e.g., arousal, decision making, cognitive control, inhibition, and temporal perception (sense of timing). In addition, the investigators will evaluate different doses of the two major components of cannabis, cannabidiol and ∆9-tetrahydrocannabinol, and compare them to placebo on these neurocognitive measures. The investigators will also test the effects of acute exposure to cannabinoids on cerebrospinal levels of anandamide and homovanillic acid - markers of endocannabinoid and dopamine activity in the brain, respectively. These studies will provide information that effectively bridges the fields of addiction and general psychiatry, informing treatment development for co-morbid substance abuse and psychiatric disorders.
Study Type
INTERVENTIONAL
Allocation
RANDOMIZED
Purpose
BASIC_SCIENCE
Masking
TRIPLE
Enrollment
19
one-time oral administration of 5 mg dronabinol
one-time oral administration of 600 mg Epidiolex
one-time oral administration of placebo
UC San Diego Medical Center
San Diego, California, United States
Score on Iowa Gambling Task
This is an experimental measure and not a scale with specific anchor points. Lower scores reflect increased risk-taking
Time frame: one day
Score on Progressive Ratio Test
This is an experimental measure and not a scale with specific anchor points. Higher scores indicate increased willingness to work for a reward
Time frame: one day
Scores on Probabilistic Learning Task
This is an experimental measure and not a scale with specific anchor points. Measures decision-making strategies such as win-stay, lose-shift.
Time frame: one day
Scores on Continuous Performance Task
This is an experimental measure and not a scale with specific anchor points. Higher scores reflect better attention and ability to discriminate important information from unimportant information
Time frame: one day
Percent Prepulse Inhibition (PPI)
This is a physiological measure and not a scale with specific anchor points. Higher percent PPI reflects better sensorimotor gating
Time frame: one day
motor activity in the human Behavioral Pattern Monitor
This is an experimental measure and not a scale with specific anchor points. Subjects' behavior in an open field (a room filled with novel objects) is quantified over a 15-minute period via amount of motor activity as measured by a wearable accelerometer. Increased motor activity reflects increased tendency to engage in exploratory behavior.
Time frame: one day
object interactions in the human Behavioral Pattern Monitor
This is an experimental measure and not a scale with specific anchor points. Subjects' behavior in an open field (a room filled with novel objects) is quantified over a 15-minute period via video ratings that quantify number of interactions with novel objects. Increased object interactions reflects increased novelty-seeking behavior.
Time frame: one day
cerebrospinal fluid levels of anandamide
Reflects increased availability of the endogenous cannabinoid anandamide in the brain
Time frame: one day
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