Ensuring safety in medical cannabis prescription: Stratified Risk Assessment and Psychiatric Screening as crucial step for an appropriate use

Medical cannabis preparations vary significantly in their composition, pharmacokinetics,and associated psychiatric risks. This manuscript highlights the need for a stratifiedapproach to assessing these risks, emphasizing the importance of differentiating between high-THC, low-CBD products and more balanced preparations, such as thosewith higher CBD content. Evidence suggests that while high-THC preparations increasethe likelihood of adverse effects, including anxiety, psychotic-like symptoms, andcognitive impairments, CBD-dominant products may offer a protective effect, mitigatingthe neuropsychiatric risks of THC. Furthermore, the inclusion of psychiatric screeningprotocols is proposed to identify and manage undiagnosed or prodromal psychiatricconditions, particularly affective and psychotic disorders, in patients prescribed medicalcannabis.