Remission of severe, treatment-resistant schizophrenia following adjunctive cannabidiol

Makiol, Christian; Kluge, Michael

doi:10.1177/0004867418815982

Cited by 14 publications

(11 citation statements)

References 3 publications

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“…Moreover, CBD was well tolerated and no side effects were reported [52]. Makiol and Klunge (2019 described a case of a 57-year-old woman with treatment-resistant schizophrenia, which persisted for 21 years [53]. On admission she had a total PANSS (Positive and Negative Syndrome Scale) score of 117 and a negative symptom score of 41.…”

Section: Resultsmentioning

confidence: 99%

“…On discharge, the PANSS total score decreased to 68 and negative symptom score to 21, which the authors indicated as accomplishment of remission criteria with only mild negative symptoms. CBD did not affect clozapine levels and was well tolerated apart from a mild hand tremor [53]. Leweke et al (2012) performed a double-blind randomized controlled trial in which 39 acutely psychotic inpatients were treated with either CBD ( N = 20) or amisulpride 800 mg ( N = 19) for four weeks [54].…”

Section: Resultsmentioning

confidence: 99%

“…Overall, acutely psychotic and early onset patients demonstrated reductions of positive and negative symptoms [51,54], while treatment resistant and chronic patients showed less promising improvement [56,57]. Even though Makiol and Kluge (2019) described a chronic schizophrenia patient who exhibited great clinical improvement (i.e., change of total PANSS score: 49) [53], the majority of the results suggest that CBD may be more effective in the early stage of psychotic disorders. This is in line with previous studies suggesting that immune dysregulation (i.e., microglial activation) is mainly involved in the early stage of psychotic disorders [67,68].…”

Section: Discussionmentioning

confidence: 99%

See 2 more Smart Citations

The Potential of Cannabidiol as a Treatment for Psychosis and Addiction: Who Benefits Most? A Systematic Review

Batalla

Janssen

Gangadin

et al. 2019

JCM

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The endogenous cannabinoid (eCB) system plays an important role in the pathophysiology of both psychotic disorders and substance use disorders (SUDs). The non-psychoactive cannabinoid compound, cannabidiol (CBD) is a highly promising tool in the treatment of both disorders. Here we review human clinical studies that investigated the efficacy of CBD treatment for schizophrenia, substance use disorders, and their comorbidity. In particular, we examined possible profiles of patients who may benefit the most from CBD treatment. CBD, either as monotherapy or added to regular antipsychotic medication, improved symptoms in patients with schizophrenia, with particularly promising effects in the early stages of illness. A potential biomarker is the level of anandamide in blood. CBD and THC mixtures showed positive effects in reducing short-term withdrawal and craving in cannabis use disorders. Studies on schizophrenia and comorbid substance use are lacking. Future studies should focus on the effects of CBD on psychotic disorders in different stages of illness, together with the effects on comorbid substance use. These studies should use standardized measures to assess cannabis use. In addition, future efforts should be taken to study the relationship between the eCB system, GABA/glutamate, and the immune system to reveal the underlying neurobiology of the effects of CBD.

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Section: Resultsmentioning

confidence: 99%

Section: Resultsmentioning

confidence: 99%

Section: Discussionmentioning

confidence: 99%

See 1 more Smart Citation

The Potential of Cannabidiol as a Treatment for Psychosis and Addiction: Who Benefits Most? A Systematic Review

Batalla

Janssen

Gangadin

et al. 2019

JCM

View full text Add to dashboard Cite

show abstract

“…Another promising novel antipsychotic agent is cannabidiol (CBD), a major ingredient of Cannabis sativa . CBD has demonstrated antipsychotic properties in small case studies ( Zuardi et al, 1995 ; Zuardi et al, 2006 ; Zuardi et al, 2009 ; Makiol and Kluge, 2019 ) and randomized, placebo-controlled clinical trials in acutely and non-acutely ill schizophrenia patients ( Leweke et al, 2012 ; McGuire et al, 2018 ). Moreover, first placebo-controlled, double-blind studies showed that CBD might also have beneficial effects in individuals in a Clinical-High-Risk (CHR) mental state for psychosis ( Bhattacharyya et al, 2018 ; Appiah-Kusi et al, 2020 ).…”

Section: Introductionmentioning

confidence: 99%

Cannabidiol and Amisulpride Improve Cognition in Acute Schizophrenia in an Explorative, Double-Blind, Active-Controlled, Randomized Clinical Trial

et al. 2021

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Cannabidiol (CBD), a principal phytocannabinoid constituent, has demonstrated antipsychotic properties in recent clinical trials. While it has also been suggested a promising candidate for the treatment of neurodegenerative disorders, it failed to demonstrate efficacy in cognitive impairments associated with schizophrenia as an add-on treatment (600 mg/day for 6 weeks) in 18 chronically ill patients co-treated with a variety of psychopharmacologic drugs. Here, we report on the results of parallel-group, active-controlled, mono-therapeutic, double-blind, randomized clinical trial (CBD-CT1; ClinicalTrials.gov identifier: NCT00628290) in 42 acute paranoid schizophrenic patients receiving either CBD (up to 800 mg/day) or amisulpride (AMI, up to 800 mg/day) for four weeks in an inpatient setting with neurocognition as a secondary objective. Twentynine patients (15 and 14 in the CBD and AMI group, respectively) completed two cognitive assessments at baseline and the end of the treatment period. We investigated the following cognitive domains: pattern recognition, attention, working memory, verbal and visual memory and learning, processing speed, and verbal executive functions. When applying the Bonferroni correction for multiple testing, p < 0.0004 would indicate statistical significance. There was no relevant difference in neurocognitive performance between the CBD and the AMI group at baseline, and we observed no post-treatment differences between both groups. However, we observed improvements within both groups from pre-to post-treatment (standardized differences reported as Cohen’s d) in visual memory (CBD: 0.49, p = 0.015 vs. AMI: 0.63, p = 0.018) and processing speed (CBD: 0.41, p = 0.004 vs. AMI: 0.57, p = 0.023). Furthermore, CBD improved sustained attention (CBD: 0.47, p = 0.013, vs. AMI: 0.52, p = 0.085), and visuomotor coordination (CBD: 0.32, p = 0.010 vs. AMI: 0.63, p = 0.088) while AMI led to enhanced working memory performance in two different paradigms (Subject Ordered Pointing Task–AMI: 0.53, p = 0.043 vs. CBD: 0.03, p = 0.932 and Letter Number Sequencing–AMI: 0.67, p = 0.017 vs. CBD: 0.08 p = 0.755). There was no relevant correlation between changes in neurocognitive parameters and psychotic symptoms or anandamide serum levels. This study shows that both CBD and AMI improve neurocognitive functioning with comparable efficacy in young and acutely ill schizophrenia patients via an anandamide-independent mechanism.

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“…For instance, a recent study demonstrated that when individuals with SZ were given adjunctive CBD to their current antipsychotic treatment, there was an increased tolerability profile and efficacy of positive and cognitive symptom management [ 34 ]. Moreover, it has been suggested that CBD adjunctive therapy may be particularly suitable in patients that exhibit antipsychotic resistance after a case study reported the full remission of an individual with severe, antipsychotic resistant SZ following adjunctive CBD [ 35 ]. As such, CBD may complement antipsychotic treatments due to its different mechanism of action [ 35 ].…”

Section: Introductionmentioning

confidence: 99%

Sex-Specific Cannabidiol- and Iloperidone-Induced Neuronal Activity Changes in an In Vitro MAM Model System of Schizophrenia

Thériault

St-Denis

Hewitt

et al. 2021

IJMS

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Cortical circuit dysfunction is thought to be an underlying mechanism of schizophrenia (SZ) pathophysiology with normalization of aberrant circuit activity proposed as a biomarker for antipsychotic efficacy. Cannabidiol (CBD) shows potential as an adjunctive antipsychotic therapy; however, potential sex effects in these drug interactions remain unknown. In the present study, we sought to elucidate sex effects of CBD coadministration with the atypical antipsychotic iloperidone (ILO) on the activity of primary cortical neuron cultures derived from the rat methylazoxymethanol acetate (MAM) model used for the study of SZ. Spontaneous network activity measurements were obtained using a multielectrode array at baseline and following administration of CBD or ILO alone, or combined. At baseline, MAM male neurons displayed increased bursting activity whereas MAM female neurons exhibited no difference in bursting activity compared to sex-matched controls. CBD administered alone showed a rapid but transient increase in neuronal activity in the MAM networks, an effect more pronounced in females. Furthermore, ILO had an additive effect on CBD-induced elevations in activity in the MAM male neurons. In the MAM female neurons, CBD or ILO administration resulted in time-dependent elevations in neuronal activity, but the short-term CBD-induced increases in activity were lost when CBD and ILO were combined. Our findings indicate that CBD induces rapid increases in cortical neuronal activity, with sex-specific drug interactions upon ILO coadministration. This suggests that sex should be a consideration when implementing adjunct therapy for treatment of SZ.

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Remission of severe, treatment-resistant schizophrenia following adjunctive cannabidiol

Cited by 14 publications

References 3 publications

The Potential of Cannabidiol as a Treatment for Psychosis and Addiction: Who Benefits Most? A Systematic Review

The Potential of Cannabidiol as a Treatment for Psychosis and Addiction: Who Benefits Most? A Systematic Review

Cannabidiol and Amisulpride Improve Cognition in Acute Schizophrenia in an Explorative, Double-Blind, Active-Controlled, Randomized Clinical Trial

Sex-Specific Cannabidiol- and Iloperidone-Induced Neuronal Activity Changes in an In Vitro MAM Model System of Schizophrenia

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