Uso terapêutico dos canabinoides em psiquiatria

Abstract

OBJETIVO: Revisar os principais avanços no potencial uso terapêutico de alguns compostos canabinoides em psiquiatria. MÉTODO: Foi realizada busca nos bancos de dado PubMed, SciELO e Lilacs e identificados estudos e revisões da literatura sobre o uso terapêutico dos canabinoides em psiquiatria, em particular canabidiol, rimonabanto, Δ9-tetraidrocanabinol e seus análogos. RESULTADOS: O canabidiol demonstrou apresentar potencial terapêutico como antipsicótico, ansiolítico, antidepressivo e em diversas outras condições. O Δ9-tetraidrocanabinol e seus análogos demonstraram efeitos ansiolíticos, na dependência de cannabis, bem como adjuvantes no tratamento de esquizofrenia, apesar de ainda carecerem de mais estudos. O rimonabanto demonstrou eficácia no tratamento de sintomas subjetivos e fisiológicos da intoxicação pela cannabis e como adjuvante no tratamento do tabagismo. Os potenciais efeitos colaterais, de induzir depressão e ansiedade limitaram o uso clínico deste antagonista CB1. CONCLUSÃO: Os canabinoides têm demonstrado que podem ter amplo interesse terapêutico em psiquiatria, porém mais estudos controlados são necessários para confirmar estes achados e determinar a segurança destes compostos.

Effects of cannabinoid drugs on the deficit of prepulse inhibition of startle in an animal model of schizophrenia: the SHR strain

“…Similarly, in mice submitted to a CFC task, THC exerted biphasic effects on fear-coping strategies, with lower and higher doses favoring active and passive responses, respectively (Metna-Laurent et al, 2012). This profile was also detected in clinical studies which observed that low and moderate THC doses had anxiolytic and euphoric properties, while higher doses produced anxiogenic responses (for review, see Crippa et al, 2010). These variable effects, depending on the dose, could be due to the wide neuroanatomical distribution of the endocannabinoid system and its modulatory effects on both GABAergic and glutamatergic neurons (Moreira and Lutz, 2008; Fogaca et al, 2012; Metna-Laurent et al, 2012).…”

“…Cannabidiol, one of the major constituent of Cannabis sativa (Grlie, 1976), is devoid of the typical psychotomimetic effects of the plant (Zuardi, 2008; Crippa et al, 2010; Zuardi et al, 2010). Several clinical studies revealed that this component does induce central effects (Zuardi et al, 2010) including antipsychotic properties (Zuardi et al, 2006, 2010, 2012; Leweke et al, 2007).…”

Cannabinoids and Vanilloids in Schizophrenia: Neurophysiological Evidence and Directions for Basic Research

“…CBD, in turn, has been shown to be a promising antipsychotic (Crippa et al, 2010; Zuardi et al, 2012). Despite controversies, CBD is known to ameliorate hyperlocomotion and PPI deficits in acute models of schizophrenia (Zuardi et al, 2012).…”

Pharmacological treatment of anxiety disorders: Current treatments and future directions

“…Existing studies of CBD for anxiety are few and largely uncontrolled. In two recent studies, low-dose CBD was associated with decreased subjective anxiety (Crippa et al, 2011; Crippa, de, Zuardi, & Hallak, 2010), suggesting that it may help anxious patients confront anxiety-provoking situations (Bergamaschi et al, 2011). In a small placebo-controlled, double-blind study of CBD in patients with social phobia, patients who received CBD immediately before completing a simulated public speaking task reported reduced anxiety, cognitive impairment, and negative self-evaluations during the task compared to patients who received placebo (Bergamaschi et al, 2011).…”