Study: CBD From Marijuana May ‘Reset’ The Brain To Counteract Symptoms Of Psychosis
Petri dish containing medical cannabis. (Getty Royalty Free)
Cannabidiol (CBD), the non-intoxicating compound in marijuana, continues drawing attention as a potential treatment for disorders and illnesses ranging from epilepsy to cancer. Now a new brain imaging study suggests that a single dose of CBD can reduce symptoms of psychosis by “resetting” activity in three brain areas. If replicable, the study offers the first evidence-based explanation for how CBD works in the brain to counteract psychosis, with results that could help generate new treatments.
Psychosis is not a single condition or disorder, but is rather a symptom of other disorders characterized by detachment from reality. Seeing, hearing or believing things that aren’t real, including hallucinations, is typical of a psychotic episode. While the exact causes of psychosis aren’t known, it’s thought to be triggered by mental illness, trauma, substance abuse and extreme stress. Even lack of sleep can spark an episode.
While psychosis is most often associated with schizophrenia, it actually affects a much larger segment of the population. At least 100,000 people a year experience their first onset of psychosis in the U.S., according to the National Institute of Mental Health.
This was a small study of 33 participants who were experiencing psychotic symptoms. A smaller group of healthy participants served as a control group. Half the psychosis group was given one 600 mg oral dose of CBD (a dose that was “previously effective in established psychosis” according to the study), the other half received an identical placebo capsule. The control group didn’t receive any drug. Then all of the participants completed a memory task designed to engage three brain areas that have been linked to the onset of psychosis (specifically the striatum, medial temporal cortex, and midbrain) while their brains were examined with an fMRI scanner.
The scans showed abnormal activity in the brains of the participants experiencing symptoms, as compared to the healthy control group – that much was expected. But the brains of those who had taken a dose of CBD showed less severe abnormalities than the brains of those who had taken a placebo, suggesting that the compound was “resetting” abnormal activity in the key brain areas.
“The results have started unravelling the brain mechanisms of a new drug that works in a completely different way to traditional anti-psychotics,” said the study’s lead author Dr. Sagnik Bhattacharyya from the Institute of Psychiatry, Psychology & Neuroscience at King’s College, London.
The study did have limitations. Aside from being a small study with a methodology unable to account for every factor that might influence the outcome, the researchers also noted that they can’t be sure the results weren’t caused by “the rapid changes in cerebral perfusion that are known to occur with a single dose of psychoactive drugs.” In other words, they may have witnessed a short-term effect that won’t last. Quoting from the study: “It is also unclear whether the effects of CBD will persist after longer-term dosing.”
The next step, already underway, is a large-scale human trial to replicate the results and determine if CBD is a viable treatment. If successful, the drug would be immediately differentiated from other meds on the market—including some that have been around since the 1950s—that produce inconsistent results. Some of the most common meds also have notoriously severe side effects, including muscle tremors and overpowering sedation.
“There is an urgent need for a safe treatment for young people at risk of psychosis,” added Dr. Bhattacharyya. “One of the main advantages of cannabidiol is that it is safe and seems to be very well tolerated, making it in some ways an ideal treatment.”
The study represents another move forward for CBD as a treatment for brain-based disorders. Earlier this year, the US FDA approved the first drug comprised of CBD to treat severe forms of epilepsy. While CBD derived from cannabis is a Schedule 1 controlled substance under federal law in the US, hemp-derived CBD is more widely accessible, though its legality in terms of federal law is still murky at best.
Members of this research team conducted an earlier study showing that CBD seems to counterbalance the effects of tetrahydrocannabinol (THC), the psychoactive compound in marijuana that gets users high. THC has been linked to the onset of psychosis in some users and appears to mimic aspects of psychosis in the brain. If CBD turns out to be an effective anti-psychotic, these findings will highlight yet another striking paradox of a plant that science is only now really beginning to understand.
The study was published in JAMA Psychiatry.
In another potential research success for CBD, an initial study finds that the cannabis compound could be an effective treatment for psychosis.
Does CBD Oil Help With Schizophrenia?
Editor’s note: This article was updated on 1/5/2021.
Many people say CBD helps them manage health issues like pain, anxiety, sleep trouble, and PTSD. CBD is short for cannabidiol, a natural compound in cannabis (also known as marijuana) and hemp plants. It has the same chemical makeup as cannabis but doesn’t cause a high.
In 2018, the FDA approved a form of CBD to treat seizures in children. Scientists are also studying CBD oil — the most concentrated form — for dozens of other health conditions, including schizophrenia.
What the Experts Say
Joseph Pierre, MD, a psychiatrist and professor at the University of California, Los Angeles, says CBD’s potential role in schizophrenia treatment starts with tetrahydrocannabinol (THC), the compound in cannabis that causes a high. THC can cause psychotic symptoms in some people, he says. And long-time cannabis users, especially those who start when they’re young, may be more likely to get a disorder like schizophrenia.
“Since CBD opposes some of the effects of THC in the brain, it makes sense it could be useful in treating psychotic disorders,” Pierre says. “There’s also some evidence that CBD has properties similar to antipsychotic drugs.”
But Pierre says people with schizophrenia shouldn’t try CBD on their own. The risks and benefits aren’t clear, and products sold without a prescription don’t always contain what they claim.
He also notes that the FDA doesn’t regulate CBD products.
“We have many FDA-approved medications from plant sources,” Pierre says. “For example, the heart medication digoxin is derived from the foxglove plant. But if someone needs digoxin, I wouldn’t recommend they go pick some foxglove, bake it into a brownie, and eat it.”
Peter Bongiorno, ND, a naturopath and acupuncturist in New York, recommends CBD for some people as part of an approach that includes lifestyle changes, balanced hormones, and lower levels of inflammation. He urges those who take other medicines or who have mental health conditions to “work with someone who has experience with CBD.”
What to Know About CBD and Schizophrenia
If you have schizophrenia but antipsychotic medications don’t work for you or have serious side effects, you might be tempted to give CBD oil a try. But there are some important things to keep in mind.
Because of its link to schizophrenia or psychotic episodes, THC is strictly off-limits if you have schizophrenia or if it runs in your family. So it’s crucial to know what you’re getting. That’s not easy, because the market is flooded with products. Many don’t contain what the label claims, and the terms may be confusing.
- Full-spectrum CBD oil comes from the whole hemp plant. It contains all the compounds called cannabinoids, including traces of THC (0.3% or less). It’s a small amount, but you should still skip this one.
- Broad-spectrum CBD oil doesn’t contain THC but has all the other cannabinoids. Bongiorno says they may help CBD work better.
- Pure CBD oil means 100% CBD. “Pure CBD products are supposed to only have CBD, but unfortunately, even those sold in dispensaries sometimes contain THC or don’t contain any CBD at all,” Pierre says.
- Hempseed oil is tricky. To avoid legal trouble, some manufacturers label CBD oil as hemp oil. Hempseed oil is made from hemp seeds and contains no CBD.
Do your research
Find out how the company grows, tests, and processes its CBD products.
- Check the certificate of analysis, or COA. This shows that each batch is tested by an independent lab. It should say exactly what’s in the product and what isn’t, like toxic metals and pesticides. You can find the CoA online, by email, or with the product. If not, steer clear.
- Ask about sources. The best CBD usually comes from organic plants grown on small farms in the U.S. and Canada.
How much to take
“If you’re going to use CBD for mental health, ask your practitioner for a high-quality version,” Bongiorno says. The amount you take can vary. “The studies tend to use pure CBD, which requires a higher dose. I use CBD with other cannabinoids at lower doses.”
CBD is normally very safe but can have side effects in some people. The most common are dry mouth, feeling dizzy or irritable, anxiety, diarrhea, and nausea. There’s a chance of liver damage at very high doses.
CBD can affect how your body handles other medicines. This means you may have higher or lower amounts in your blood than you should. Penn State University researchers found 60 drugs that interact with CBD or cannabis. Be extra careful if you take blood thinners, heart medicine, or drugs that weaken your immune system after transplant surgery. Pierre says that even some psychiatric medicines, including antipsychotics, could interact with CBD. If you take any prescription meds, ask your doctor if CBD is safe to use.
Gallup.com: “14% of Americans Say They Use CBD Products.”
Joseph Pierre, MD, acting chief of Community Care Systems at the VA West Los Angeles Healthcare Center and clinical professor in the Department of Psychiatry and Behavioral Sciences, UCLA.
National Center for Complementary and Integrative Health: “Cannabis (Marijuana) and Cannabinoids: What You Need to Know.”
Kendra Mark, founder 2Rise Naturals.
Peter Bongiorno, ND, naturopath and acupuncturist, InnerSource Natural Health and Acupuncture, New York City and Long Island.
Epidiolex.com: “Epidiolex: A treatment innovation.”
Journal of Clinical Medicine Research: “Dosage, Efficacy and Safety of Cannabidiol Administration in Adults: A Systematic Review of Human Trials.”
Pennsylvania State University, College of Medicine, Department of Pharmacology: “NTI Meds to be Closely Monitored when Co-administered with Cannabinoids.”
Scientists are studying CBD oil for schizophrenia and dozens of other health conditions. Here’s what to know if you have schizophrenia and are thinking of trying CBD.