Cannabidiol as a potential treatment for psychosis

Abstract

Psychotic disorders such as schizophrenia are heterogeneous and often debilitating conditions that contribute substantially to the global burden of disease. The introduction of dopamine D2 receptor antagonists in the 1950s revolutionised the treatment of psychotic disorders and they remain the mainstay of our treatment arsenal for psychosis. However, traditional antipsychotics are associated with a number of side effects and a significant proportion of patients do not achieve an adequate remission of symptoms. There is therefore a need for novel interventions, particularly those with a non-D2 antagonist mechanism of action. Cannabidiol (CBD), a non-intoxicating constituent of the cannabis plant, has emerged as a potential novel class of antipsychotic with a unique mechanism of action. In this review, we set out the prospects of CBD as a potential novel treatment for psychotic disorders. We first review the evidence from the perspective of preclinical work and human experimental and neuroimaging studies. We then synthesise the current evidence regarding the clinical efficacy of CBD in terms of positive, negative and cognitive symptoms, safety and tolerability, and potential mechanisms by which CBD may have antipsychotic effects.

Reasons for cannabidiol use: a cross-sectional study of CBD users, focusing on self-perceived stress, anxiety, and sleep problems

“…In the UK, The Food Standards Agency (FSA) recommends limiting the daily dose of CBD to 70 mg (Cannabidiol (CBD) n.d. ). However, researchers have used doses up to 1200 mg without serious side-effects (Davies and Bhattacharyya 2019 ). Conversely, few clinical trials involving children with treatment-resistant epilepsy who received either 10 or 20 mg/kg of CBD (Epidiolex) for 12 weeks recorded side-effects, such as a reversible rise in liver enzymes (Devinsky et al 2018a ; Thiele et al 2018 ).…”

A single dose of cannabidiol modulates medial temporal and striatal function during fear processing in people at clinical high risk for psychosis

“…There are currently no licensed clinical interventions for people at clinical high risk for psychosis (CHR) 1 , 2 . One of the most promising candidate treatments is cannabidiol (CBD), a phytocannabinoid constituent of the cannabis plant 3 . While the main psychoactive cannabinoid in cannabis, delta-9-tetrahydrocannabinol (THC), has psychotomimetic 4 – 7 and potential anxiogenic effects, CBD is non-intoxicating and has both anxiolytic 8 , 9 and antipsychotic properties 10 – 12 .…”

“Tobacco Is the Chief Medicinal Plant in My Work”: Therapeutic Uses of Tobacco in Peruvian Amazonian Medicine Exemplified by the Work of a Maestro Tabaquero

“…The stated key indication to treat “problems of the mind,” together with the effects described by our informant as “opening of the psychic-mental,” suggest parallels to psychedelic-assisted therapies, a rapidly growing trend in current psychiatry research ( Tupper et al, 2015 ; Garcia-Romeu et al, 2016 ; Johnson et al, 2019 ). Such therapies involve the administration of psychoactive substances (e.g., psilocybin, ayahuasca) to treat mental health problems, with promising results reported for instance for mood, anxiety, addictive, or neurological disorders ( Baumeister et al, 2014 ; Thomas et al, 2017 ; Palhano-Fontes et al, 2018 ; Davies and Bhattacharyya, 2019 ; Butler et al, 2020 ). Although there is no doubt that tobacco is psychoactive, there has been debate as to the specific class of psychoactive substances it falls.…”