Schizophrenia Awareness Day – July 25th
Researchers believe that CBD (Cannabidiol) holds immense potential as a new treatment for individuals with psychosis.
What is Psychosis?
Psychosis is when you perceive or interpret reality in a very different way from people around you. The two main symptoms of psychosis are hallucinations, where a person hears, sees, feels, smells or tastes things that do not exist, and delusions, where a person has strong beliefs that are not shared by others, such as that someone is trying to control, harm or kill them, or that they are able to control the stock markets or the weather.
It’s sometimes possible to identify the cause of psychosis as a specific mental health condition, such as schizophrenia, bipolar disorder or severe depression, though psychosis can also be triggered by trauma, stress, drug and alcohol misuse, or side effects of a prescribed medication.
Existing antipsychotics are used to treat psychosis by blocking dopamine receptors in the brain. However, they don’t work for everyone and patients often stop taking their medication. In addition to this, antipsychotic medications can cause harmful side effects, such as rapid weight gain, dizziness, agitation, sleepiness, digestive problems, heart problems and neuromuscular effects, which are similar to the effects of Parkinson’s disease. Despite the possible side effects, for most people with psychosis, there is no other option but to take the medication.
That all said, growing research suggests that CBD (Cannabidiol) is one of the most promising new treatments for people with psychosis. Instead of impacting the dopamine system like existing antipsychotics, CBD works with the endocannabinoid system to regulate a range of our cognitive and physical functions, without major side effects or abuse potential (according to the World Health Organisation). Though further research is required to better understand CBD as a treatment for psychosis, including whether it can prevent the onset of psychosis in people at high risk of developing it, the science does suggest it is a promising new mechanism for treating psychotic disorders. Let’s look at this in more detail.
The Endocannabinoid System, illustrated.
CBD as an Antipsychotic
Early research from 2012 by the National Institute for Health Research (NIHR) concluded that CBD can prevent drug-induced paranoia in healthy individuals, and that it works by normalising activity in the hippocampus and striatum — the same parts of the brain that are most affected in patients with psychosis. These studies also suggest that CBD acts on a different chemical pathway in the brain to antipsychotic drugs.
A 2017 randomised control trial found that, after 6 weeks of treatment, compared with the placebo group, the CBD group had lower levels of positive psychotic symptoms and were more likely to have been rated as improved and as not severely unwell by the treating clinician. These findings suggest that CBD has beneficial effects in patients with schizophrenia.
A 2018 randomised clinical trial comparing 33 individuals at clinical high risk of psychosis and 19 healthy control individuals found that ‘CBD may partially normalise alterations in parahippocampal, striatal, and midbrain function associated with the CHR state. As these regions are critical to the pathophysiology of psychosis, the influence of CBD at these sites could underlie its therapeutic effects in psychosis.’
A more recent 2020 review of studies concluded that recent clinical trials added further evidence for an antipsychotic potential of cannabidiol, though further research is required to clarify the safety and efficacy of cannabidiol.
Upcoming Clinical Trial (2023)
In most recent news, Wellcome has awarded Oxford University’s Department of Psychiatry £16.5 million for a programme involving three clinical trials and 1,000 participants, which will investigate the effectiveness of Cannabidiol (CBD) in treating people with psychosis or psychotic symptoms. The programme, scheduled to start in 2023, will be the first to evaluate CBD in large numbers of people with psychosis or psychotic symptoms, and hopes to provide us with a new kind of treatment for psychosis.
The medication will be more than 99% Cannabidiol, and other constituents of Cannabis which could have adverse psychoactive effects, such as Tetrahydrocannabinol (THC), have been removed. To assess participants before and after treatment, the team will use a range of clinical, digital, cognitive, neuroimaging and blood measures to clarify how CBD acts to produce its effects, and to identify factors that predict the response to treatment.
In short, this programme will help us to find out if CBD is effective at treating psychosis at various stages by testing it at scale.
Can CBD Cause Psychosis?
Although THC has been linked to an increased risk for psychosis, CBD — the non-psychoactive compound from the same plant — shouldn’t cause psychosis. In fact, research suggests that CBD could be an antipsychotic, and therefore beneficial for those with psychosis.
To avoid contact with THC (and the risk of failing a drug test), make sure to purchase your CBD from a reputable UK brand with third-party lab tests and reports that show exactly what it contains. Broad-spectrum CBD contains all occurring compounds found in the hemp plant, but does not contain THC. This means that it produces the desired effects of CBD, without the risk of consuming THC.
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