Cannabidiol (CBD) has emerged as a promising therapeutic agent for a variety of mental health conditions.
Here’s a quick rundown of the key facts:
- CBD is a non-intoxicating compound derived from the cannabis plant
- It has antipsychotic, anti-anxiety, and potential antidepressant effects
- CBD shows promise for schizophrenia, cannabis addiction, anxiety disorders, autism symptoms, and more
- But large, robust clinical trials are still needed to confirm many of CBD’s benefits
Source: J Cannabis Res
What is CBD and How Does It Work?
CBD is one of over 100 compounds found in cannabis called cannabinoids.
Unlike the main psychoactive compound tetrahydrocannabinol (THC), CBD does not produce a high or impairment.
Instead, CBD interacts with the endocannabinoid system, a network of receptors found throughout the body that help regulate processes like mood, pain perception, appetite, and more.
Specifically, CBD enhances signaling of the endocannabinoid anandamide.
Anandamide acts on CB1 receptors in the nervous system to reduce anxiety and psychotic symptoms.
CBD also acts on serotonin and vanilloid receptors to exert additional therapeutic effects.
Through these mechanisms, CBD produces an array of effects in the brain and body.
Preclinical studies show CBD has antipsychotic, anti-anxiety, analgesic, anti-seizure, and neuroprotective properties.
Now researchers are exploring if these benefits translate to human psychiatric disorders.
CBD for Schizophrenia
Schizophrenia is a chronic psychotic disorder affecting how a person thinks, feels, and behaves.
CBD has been researched most extensively for schizophrenia treatment.
Overall, CBD demonstrates potential in improving psychotic symptoms like hallucinations, delusions, and disordered thinking in schizophrenia.
For example, one 4-week study gave 40 schizophrenia patients 800 mg/day of CBD or a standard antipsychotic.
Both groups had comparable improvements in psychotic symptoms.
However, the CBD group had fewer side effects like involuntary movements.
CBD also shows preliminary benefits against cognitive impairment in schizophrenia.
A small study found a single 300 mg dose of CBD improved performance and brain activity on a cognitive test.
However, CBD’s schizophrenia benefits are inconsistent across studies so far.
Other trials found no significant psychosis improvement with CBD.
More research is still needed, especially on CBD’s long-term effects.
CBD for Cannabis Addiction
Cannabis use disorder is an increasing concern. CBD shows initial promise in helping with cannabis withdrawal and addiction treatment.
In multiple studies, the CBD-based drug Sativex (CBD + THC) reduced cannabis withdrawal symptoms like irritability, insomnia, and anxiety.
It also decreased cannabis usage over time in users wanting to quit.
For example, one study found patients taking Sativex stayed abstinent around 3 days during withdrawal versus less than 2 days for those taking a placebo.
CBD may help cannabis addiction by reducing anxiety and cravings.
In an early case study, a young cannabis withdrawal patient reported less anxiety and craving after taking CBD.
However, most research has involved Sativex, not pure CBD. More studies are needed on CBD specifically for cannabis withdrawal and addiction.
CBD for Anxiety Disorders
CBD is commonly used by consumers to relieve anxiety.
A handful of studies support CBD in treating specific anxiety disorders.
For social anxiety disorder, CBD shows particular promise.
In a simulated public speaking test, CBD reduced anxiety, cognitive impairment, and discomfort during speaking in patients with social anxiety.
Patients took a single dose of CBD before their speech.
Other early findings suggest potential benefits for PTSD and generalized anxiety disorder.
One case study found 5 months of CBD oil (25 mg/day) improved anxiety and sleep in a 10-year-old with PTSD.
Another chart review reported most adult anxiety patients had reduced anxiety scores after 1-3 months of CBD treatment.
But larger clinical trials are still needed to confirm CBD’s anti-anxiety effects, determine optimal dosing, and more.
CBD for Autism Spectrum Disorder
Many autistic children suffer from symptoms like hyperactivity, irritability, and anxiety.
An open-label CBD trial in 53 autistic children and young adults found major improvements in these areas after 2 months of treatment on average.
Nearly 70% of patients had less hyperactivity and irritability.
About 70% also had improved anxiety and nearly 50% experienced less sleep difficulties.
Most children received a dose of around 90 mg CBD and 7 mg THC daily.
Although very promising, this low-quality study can’t prove CBD’s benefits for autism.
Randomized trials are necessary to establish CBD’s efficacy and long-term safety for autism.
CBD for ADHD
Attention deficit hyperactivity disorder (ADHD) involves challenges with inattention, hyperactivity, and impulsivity.
One small placebo-controlled study found the CBD-based drug Sativex moderately improved ADHD symptoms like inattention, hyperactivity, and impulsivity in adults.
There were no severe side effects.
But there wasn’t a statistically significant benefit over placebo, likely due to the very small sample size.
More robust, high-quality research is needed around CBD for ADHD.
Unproven Uses of CBD
Evidence is very limited for CBD’s efficacy in other psychiatric disorders like bipolar disorder, Tourette syndrome, insomnia, and more.
For example, CBD failed to improve mania symptoms in two patients with bipolar disorder in one report.
But it hasn’t been specifically tested for bipolar depression yet.
Small studies have found improvement in tic frequency with Sativex in Tourette patients.
But these very low-quality reports can’t prove efficacy.
Overall, CBD shows little evidence of benefit currently for several disorders.
But absence of evidence doesn’t necessarily mean evidence of absence of effects.
CBD simply requires more thorough clinical research for these conditions.
Side Effects of CBD
Compared to medications like antipsychotics, CBD appears relatively safe and well-tolerated.
The World Health Organization concluded CBD has a good safety profile.
Reported side effects are generally mild.
In studies, some common CBD side effects included diarrhea, fatigue, and changes in appetite/weight. CBD can also cause drowsiness.
Notably, unlike THC, CBD doesn’t appear to have abuse liability or cause impairment.
However, long-term human studies are still needed to fully assess CBD safety, especially in children.
Main Takeaways: CBD has therapeutic potential
- CBD is a cannabis compound with promising mental health benefits like reducing psychosis, anxiety, and cannabis addiction.
- The strongest evidence supports CBD for schizophrenia, cannabis use disorder, social anxiety disorder, and autism symptoms.
- But CBD research is still in its infancy for most conditions. Large, high-quality human trials are needed.
- Compared to current psychiatric medications, CBD has a favorable side effect profile. But more research is still needed on its long-term safety.
- Overall, CBD displays huge potential as a psychiatric treatment. But patients should consult their doctor before using CBD products for mental health conditions.
In summary, CBD is emerging as a promising therapeutic agent for a variety of mental health conditions.
While findings are preliminary, CBD demonstrates notable antipsychotic, anti-anxiety, and anti-addiction effects in early research.
CBD may one day provide a new treatment option for schizophrenia, anxiety, substance abuse, autism, and more.
However, large randomized controlled trials are still needed to validate many of CBD’s benefits.
For now, patients should consult their healthcare provider before using CBD products to manage mental health disorders.
References
- Study: The therapeutic role of cannabidiol in mental health (systematic review)
- Authors: Rabia Khan et al. (2020)
