In both the scientific community as well as in our own, a lot of people question if Cannabidiol, better known as CBD, is a viable treatment option for psychosis- and the truth is, the answer is not yet known but research is ongoing. As the scientific community does its part to find the answers for us, it is important we take a moment to understand the research that we do have so far. If you or someone you love lives with symptoms of psychosis, you may have already looked into CBD as a potential alternative yourself, as CBD is becoming more and more mainstream. So, let’s break it down.
As we know, medical CBD is used to treat a wide variety of ailments, including pain, nausea, anxiety, depression, low appetite, insomnia, muscle spasms, autism, multiple sclerosis, epilepsy and other seizure disorders, inflammatory bowel diseases, and other conditions. The list goes on! With that said, research suggests CBD may also have the potential to reduce psychotic symptom severity and improve cognitive ability in patients experiencing psychosis.
What is psychosis?
Psychosis is an umbrella term that refers to symptoms of delusions, hallucinations, and disorganized thinking that demonstrate a detachment from reality. Chronic, or ongoing, psychosis is associated with diagnoses such as Schizophrenia, Schizoaffective disorder and Delusional disorder. Psychosis can mean sensing something that isn’t there or believing in something that isn’t reality. It can also mean having thoughts that don’t make sense or seem unclear. Sometimes, psychosis looks and sounds obvious: for instance, someone who might be yelling “FIRE!” and claiming to smell smoke, where there is no smell or apparent cause for alarm to others. Feelings of anxiety and paranoia can accompany episodes of psychosis and cause extreme distress in the person experiencing it.
A lot of times, though, psychosis might not appear so overtly. Symptoms might display in ways other than agitation or yelling. Someone experiencing psychosis might tell you in detail about how they worked for the FBI for 20 years (when they are only, say, 30), or how they are going to Oxford University next fall (they are intelligent, but you do not recall them even mentioning an application). Another example would include someone experiencing feelings of anxiety due to the belief they are being watched, and acting on that belief. Episodes of psychosis manifest differently in different people, and can sometimes even pass as reality.
What is the relationship between CBD and psychosis?
Because psychotic symptoms can be so individualized as well as unpredictable, much research has concluded that Tetrahydrocannabinol (THC), the intoxicating cannabinoid found in cannabis, may have the potential to exacerbate psychosis. However, CBD may be another story. Due to research still being young, “there is currently encouraging, albeit embryonic, evidence for medicinal cannabis in the treatment of a range of psychiatric disorders” (Sarris et al., 2020).
CBD is known to have natural antipsychotic, anti-inflammatory and anxiolytic properties. In a clinical setting, CBD has been shown to fight psychosis, as it is associated with an improvement in acute symptoms as well as fewer side effects and inconsistencies than traditional antipsychotic medications. Compared to common traditional antipsychotic medications, which are notorious for producing a variety of adverse side effects, the therapeutic impact of CBD for many seems like a promising alternative that comes at virtually little to no cost.
Some research suggests CBD may help to reduce abnormal brain activity associated with symptoms and have the ability to ‘reset’ the brain, normalizing the brain into a state of equilibrium (Bhattacharyya et al., 2018). According to the 2018 study, just one 600mg dose of CBD has the power to partially manipulate specific regions of the brain and counteract psychosis (Bhattacharyya et al., 2018). Another recent study suggests that CBD use in those living with Schizophrenia helps to decrease the severity of symptoms over time (Khan et al., 2020). In addition, CBD for Schizophrenia has “particularly promising effects in the early stages of illness” (Batalla et al., 2019).
While some research has shown some promise for CBD in relation to psychosis, more research is needed to determine the therapeutic effects of CBD on psychosis. It might be wise to also consider anecdotal evidence regarding the use of CBD for treating symptoms of psychosis while scientific research slowly increases.
The science regarding the effects of CBD on psychosis generates hope, but it is still in its juvenile stages. It remains unclear as to whether CBD can be an effective long-term solution to treating symptoms of psychosis. It is important to remember that because each individual is different, effects of CBD can vary, and CBD may need to be used as an adjunct in order to produce results. More research is needed and ongoing; according to Batalla et al. (2019), “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”.
While the effects of CBD as a treatment for psychosis remain unclear, CBD definitely has versatile medical implications that continue to astound researchers. What we do know is that CBD has not been shown to necessarily exacerbate psychosis, and it is clear that the beneficial properties of CBD could conceivably be utilized to yield safer, more tolerable alternatives to traditional antipsychotic medications. However, further research is required to more accurately dismantle and assess the advantages and disadvantages of CBD for psychosis.
For more information on CBD and mental health, check out:
Batalla, A., Janssen, H., Gangadin, S.S., Bossong, M.G. (2019). The Potential of Cannabidiol as a Treatment for Psychosis and Addiction: Who Benefits Most? A Systematic Review. J Clin Med; 8(7):1058. doi: 10.3390/jcm8071058. PMID: 31330972; PMCID: PMC6678854. https://pubmed.ncbi.nlm.nih.gov/31330972/
Bhattacharyya, S., Wilson, R., Appiah-Kusi, E., et al. (2018). Effect of Cannabidiol on Medial Temporal, Midbrain, and Striatal Dysfunction in People at Clinical High Risk of Psychosis: A Randomized Clinical Trial. JAMA Psychiatry; 75(11): 1107–1117. doi:10.1001/jamapsychiatry.2018.2309
Davies, C. & Bhattacharyya, S. (2019). Cannabidiol as a potential treatment for psychosis. Ther Adv Psychopharmacol;9:2045125319881916. doi: 10.1177/2045125319881916. PMID: 31741731; PMCID: PMC6843725. https://pubmed.ncbi.nlm.nih.gov/31741731/
DiSalvo, D. (2018). Study: CBD from marijuana may ‘reset’ the brain to counteract symptoms of psychosis. Forbes. https://www.forbes.com/sites/daviddisalvo/2018/08/31/study-cbd-from-marijuana-may-reset-the-brain-to-counteract-symptoms-of-psychosis/#3db8daf06a36
Hahn, B. (2018). The Potential of Cannabidiol Treatment for Cannabis Users With Recent-Onset Psychosis. Schizophrenia bulletin, 44(1): 46–53. doi:10.1093/schbul/sbx105
Khan, R., Naveed, S., Mian, N. et al. (2020). The therapeutic role of Cannabidiol in mental health: a systematic review. Journal of Cannabis Research, 2(2). https://doi.org/10.1186/s42238-019-0012-y
McGuire, P., Robson, P., Wieslaw, J.C., et al. (2017). Cannabidiol (CBD) as an adjunctive therapy in schizophrenia: a multicenter randomized controlled trial. The American Journal of Psychology, 175(3): 225-231.
Sarris, J., Sinclair, J., Karamacoska, D., Davidson, M., Firth, J. (2020). Medicinal cannabis for psychiatric disorders: a clinically-focused systematic review. BMC Psychiatry; 20(1):24. doi: 10.1186/s12888-019-2409-8. PMID: 31948424; PMCID: PMC6966847. https://pubmed.ncbi.nlm.nih.gov/31948424/
About the author
Caroline Platzman is a Behavioral Health Counselor working with adults diagnosed with schizophrenia. She is passionate about mental health, journalism, nonprofit advocacy, and public relations. Caroline is also a dedicated guitarist and artist in her free time.