Is There a Place for Cannabidiol in Psychiatric Treatment?

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In this occasional feature on Psych Congress Network, members of the Psych Congress Steering Committee answer questions asked by audience members at Psych Congress meetings.

QUESTION: Is there a place for cannabidiol (CBD) in the treatment of psychiatric disorders?

ANSWER: Cannabidiol (CBD) is considered to be a nonpsychotomimetic and nonpsychoactive derivative of Cannabis sativa. It was patented by the US Department of Health and Human Services in 2003 as an antioxidant and neuroprotectant. CBD has a complex mode of action which includes inverse agonism (functionally an antagonist) of CB1 and CB2 cannabinoid receptors, mild monoamine uptake inhibition, and 5-HT1A agonism.1 Additionally, reviews based on preclinical and clinical research identify CBD as an anxiolytic, antipsychotic, anti-insomnia and antidepressant agent. Furthermore, it has putative anti-inflammatory, antidiabetic, analgesic, and neuroprotective properties.2

Adjunct use of CBD in schizophrenia is supported by the highest quality of evidence. A recent randomized controlled trial demonstrated superiority of adjunctive CBD to placebo in treating positive symptoms of schizophrenia, and a strong trend towards efficacy in addressing cognitive difficulties associated with this condition.3 A prior randomized active control study found that monotherapy with CBD had comparable effect to amisulpride (one of the most efficacious antipsychotics) on positive symptoms while demonstrating a clear advantage in treating negative symptoms of schizophrenia.4 Several open-label studies extend and support the benefits of CBD in psychotic disorders.

Preclinical and open-label studies have found that CBD also may be helpful in the treatment of anxiety, particularly social anxiety, using a public speaking paradigm.5 Mostly preclinical evidence from animal studies suggests there may be a reason to study CBD as an adjunct treatment for depression, while preliminary evidence points to its potential usefulness as a safer substitute for controlled substances used in treating psychiatric and pain disorders. While emerging evidence is encouraging, more studies utilizing rigorous scientific methodology and larger clinical samples need to be completed before we can endorse wider use of CBD in the treatment of psychiatric disorders.

— Vladimir Maletic, MD, MS, Clinical Professor of Psychiatry and Behavioral Science, University of South Carolina School of Medicine, Greenville

https://www.psychcongress.com/article/there-place-cannabidiol-psychiatric-treatment

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Everything takes so much time. Research is so slow. Id love to try out pharm grade cbd.

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No.

I tried pharmaceutical grade CBD for months and its a snake oil,

An expensive one.

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I could be wrong but I think GW pharma dropped it as a treatment for schizophrenia. They had been doing trials.

That only leaves Echo pharma still pursuing it.

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I find that CBD oil 10 mg in capsule form every morning helps with my generalized anxiety and arthritis pain. It really works. I get Plus CBD oil 10 mg, 60 capsules from CV Sciences Inc. Their phone number is: 855 758-7223 It costs me around $51 every two months. I don’t know if it helps with psychosis or not. All I know is that I’m not paranoid anymore. So, it must be working.

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From their website, it looks like GWP42003 is still a go for sz.

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I don’t know. Somebody from this site emailed them a while ago.

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Why would they discontinue research if results were positive?

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That’s a good question …

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I could find their phase 2 clinical trial of GWP42003 but nothing else.

There is a lot of research going on using cbd as an antipsychotic.

https://clinicaltrials.gov/ct2/results?cond=Psychosis&term=Cannabidiol&cntry=&state=&city=&dist=

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Up in Boulder, Colorado, with the strain Harmonia (7-9% THC and 9-12% CBD) I was actually able to tolerate the effects of the THC… it was even… pleasant!!

You might have more success looking at a strain like R4, with under 1% THC and over 20% CBD in the bud form… get the oil form then VAPE it (BIOAVAILABILITY: Oral: 13–19% Inhaled: 11–45% (mean 31%))

There was a study from… Israel?.. showing that pure, single-molecule CBD does NOT help psychiatric concerns.
You need a whole plant extract.

R4 is sold by Green Dragon Dispensary in Colorado, with many locations… they claim to be the source of the famous Charlotte’s Web strain, known for its success in treating intractable epilepsy.

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Thanks,

But I smoke weed all day, err’ day,

And its done nothing but make me too stoned to care about my symptoms,

Which sounds great, still is not a solution.

I’ve tried high CBD strains and achieved some pain relief, possibly less anxiety, that’s about it.

CBD is just not what we all hoped it was going to be.

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Hrm. It had a miraculous modulation of the THC experience for me.

Or maybe it was that cold, fresh mountain air.

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I’m happy you got some relief from it,

Regardless.

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Gentle reminder. This is about CBD as a treatment. Not listing strains for maximum non therapeutic pleasure.

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Hehe sorry it came across that way…
Frankly, I have no interest in THC, but the fact that I was able to tolerate it (due to the CBD), points to some POTENT antipsychotic effects from CBD.

Even a tiny dose of THC, without CBD, in the past, and I would be in a psych ward.

I didn’t have enough money to catch a cab to a city that had the PURE CBD strain… or else I would have tried that.

How about next time I head up to Colorado, I’ll make sure I can access the pure CBD and give it a real trial? It’s gotta be full-plant extract for psych benefit, and who knows what the online products really are…

@GoldenRex, if you got your CBD online, I DOUBT it was even in the running for actual therapeutic effects.

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I hesitate to get involved in this but …

Can’t this be like any other med where, assuming trials pan out, it still may not work for everyone?

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Given the complexity of psychosis//sz in terms of variants I doubt we’ll ever get something that works for everyone.

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Seems to me that Psychiatry and Infectious Diseases doctors really should be working together on the same teams, instead of dividing their efforts.

There’s simply too much overlap at the moment.

Vaccines + tox screenings + brain health / supplements

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Vanderbilts and Lundbecks upcoming muscarinic receptor M4 drug works on the endocannabinoid CB2 receptor, So really its CBD on steroids.

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