Is CBD an Antipsychotic?

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Harry Anslinger's propaganda for marijuana prohibition often used insanity and psychosis to spark fear into the hearts of all Americans.  "Reefer Madness," a fictional movie from 1936 depicting marijuana-induced psychosis, only created more speculation and fear.  However, these opinions of marijuana were formed 60 years before the discovery of endocannabinoid system.  Over the last three decades, science and research have started to paint a much different picture of the infamous herb.

While tetrahydrocannabinol, or THC, clearly has psychoactive effects on the user and high doses may exacerbate psychosis in those with a predisposition to the illness, cannabidiol (CBD), on the other hand, may have the opposite effect according to recent research. Results have led researchers to ask, "Is CBD an Antipsychotic?"

What is Psychosis?

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Psychosis defined commonly as a severe mental health condition such as schizophrenia or bipolar disorder where thoughts and emotions to the point where the individual loses touch with reality. Hallucinations, paranoia, and delusions may characterize these disorders. According to the National Institute of Mental Health, three out of 100 people will experience a psychotic episode in their lifetime.

Psychosis is a symptom of a more significant problem, not an illness per se. As such, it's important to remember there are many mental disorders which can lead to a psychotic episode, such as:

  • Schizophrenia: a severe mental health disorder affecting how the individual thinks, feels and behaves. Patients may have difficulty determining what is real and what isn't.
  • Bipolar Disorder: a mental disorder characterized by periods of mania, depression, and excessive mood swings.
  • Schizoaffective Disorder: similar to schizophrenia, but with additional symptoms resembling mood disorders like bipolar disorder.
  • Delusional Disorder: irrational or intense beliefs which may be bizarre or seemingly impossible. Others may have expectations which are in the realm of possibility but still interfere with daily life.
  • Major Depression: some experiencing major depression may also experience moments of psychotic episodes.

Symptoms of Psychosis

The symptoms of psychosis are relatively benign when experienced alone or short term.  However, suffering from more than one symptom for several days or weeks should prompt concern.  Generally, individual's undergoing psychosis will display a sudden change in their thoughts, emotions, and behaviors.

Naturally, experiencing these types of symptoms over an extended period such as weeks or months implies a much broader problem:

  • Hallucinations: hearing or seeing things that aren't there
  • Paranoia: feeling as though someone is watching you
  • Disorganized: bizarre speech and writing
  • Behavior changes: inappropriate or uncharacteristic behaviors
  • Contorting: displays strange body movements or positions
  • Lack of emotion: feels indifferent or numb
  • Performance decline: work and school may suffer
  • Declining hygiene
  • Personality changes
  • Withdrawing from social situations
  • Irrational responses to loved ones
  • Trouble sleeping
  • Preoccupation or fears about strange or even fictitious things

Traditional Treatments

Traditionally speaking, treatment for psychotic episodes is limited to psychotherapy and antipsychotic medications. While there is good evidence so do does CBD have antipsychotic properties. Unfortunately, like most other pharmaceuticals, antipsychotic drugs can have a myriad of unwanted side effects, and long-term use can be damaging to the body. According to the FDA, these prescriptions can cause,

  • Drowsiness
  • Dizziness
  • Restlessness
  • Weight Gain
  • Constipation
  • Nausea
  • Vomiting
  • Blurred Vision
  • Low Blood Pressure
  • Tremors or tics
  • Seizures
  • Low White Blood Cell Count

Long-term use can cause tardive dyskinesia, a condition characterized by facial tics or muscle movements which do not have a cure. Additionally, antipsychotic medications can reduce motivation and pleasure in everyday life.

Is CBD an Antipsychotic?

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As medical science continues to advance in the field of cannabis, as well as the endocannabinoid system, researchers and physicians are starting to get a different look at the various compounds the plant provides and how they interact with the human body.  Since the discovery of the endocannabinoid system researchers have been racing to understand the full scope of impact the system has on multiple diseases and illnesses, including mental disorders.

The Research

In 2012, researchers at the University of Cologne in Germany published the results of a pre-clinical study on 39 people diagnosed with schizophrenia who were hospitalized during a psychotic episode.  Half of the patients were treated with an antipsychotic medication while the other half of the patients took cannabidiol or CBD.

At the end of the four-week, double-blind trial, both groups of patients showed significant improvement.  These results indicate CBD can work just as well as other antipsychotic medications.

In an interview with Time Magazine, co-author of the study, Daniele Piomelli, Professor of Pharmacology at the University of California-Irvine, stated the following:

"The results were amazing.  Not only was CBD as effective as standard antipsychotics, but it was also essentially free of the typical side effects seen with antipsychotic drugs."

GW Pharmaceuticals also tested CBD on 88 patients with schizophrenia who were not responding to traditional medications in 2015.  Results showed patients receiving CBD had a much more significant response as compared to those receiving a placebo.

Additionally, there were no serious adverse events associated with CBD.

GW's CEO, Justin Gover, stated in a press release, "We believe that the signals of efficacy demonstrated in this trial, together with a notably reassuring safety profile, provide GW with the prospect of new and distinct cannabinoid neuropsychiatric product pipeline opportunity. Similar to our approach for Epidiolex, we believe that our future research in this area may lie within pediatric orphan neuropsychiatric indications and we intend to explore this as a focus for future trials."

Most recently, in 2016, researchers from the Department of Psychiatry and Psychotherapy at Heidelberg University in Mannheim, Germany published a critical review of the evidence in Frontiers in Pharmacology which also showed promising results in both animal and human trials of cannabidiol in the treatment of schizophrenia.

The team concluded, Citing more than 115 previously published studies "cannabidiol seems to represent a mechanistically different and less side-effect prone antipsychotic compound for the treatment of schizophrenia."

Although more clinical trials are needed for conclusive evidence, this is a step in the right direction for the plant-based therapy. As with most types of cannabis-derived therapies, more research is necessary to honestly answer the question of whether or not CBD is an antipsychotic therapy.

As laws continue to change across the US and the world, allowing the expansion of research opportunities, expect to see cannabis and cannabinoid therapy on the forefront of medical breakthroughs.