CBD shows early promise for both psychosis and addiction, especially in early-stage illness | Research

The takeaway

A systematic review found CBD improved schizophrenia symptoms (particularly in early illness), showed positive effects on cannabis withdrawal and craving when combined with THC, and identified blood anandamide levels as a potential treatment response biomarker.

Psychiatrists, addiction specialists, and researchers studying CBD therapeutic applications.

Early-stage psychosis responds best

What the researchers found

CBD as monotherapy or adjunct to antipsychotics improved symptoms in schizophrenia patients, with particularly promising effects in early-stage illness. For substance use disorders, CBD+THC mixtures showed positive effects on short-term cannabis withdrawal and craving. Blood anandamide levels emerged as a potential biomarker for CBD treatment response in psychosis.

Why it matters

CBD is unique among cannabinoids in potentially treating both psychosis and addiction, two conditions that frequently co-occur and are notoriously difficult to manage together. Identifying who benefits most could make CBD treatment more targeted and effective.

The numbers in context

CBD improved psychosis symptoms in clinical studies, with stronger effects in early illness stages. CBD+THC reduced short-term cannabis withdrawal and craving. Anandamide blood levels identified as potential biomarker. No studies found on comorbid schizophrenia and substance use.

How the study worked

Systematic review of human clinical studies investigating CBD efficacy for schizophrenia, substance use disorders, and their comorbidity. Examined patient profiles most likely to benefit.

What this study cannot tell us

Limited number of clinical studies available. Most psychosis studies were small. Substance use disorder evidence mainly comes from cannabis use disorder, not other substances. No studies addressed the comorbidity directly.

How to read the evidence

Rated preliminary because while the systematic review methodology is rigorous, the underlying clinical studies are few and small.

When this study was published

Published in 2019. Additional clinical trials of CBD for psychosis and substance use disorders have been conducted since.

The bigger picture

The dual potential of CBD for psychosis and addiction could be transformative for patients who have both conditions, a common and treatment-resistant combination. The anandamide biomarker finding could enable precision medicine approaches.

Questions still open

Will CBD work as well in chronic psychosis as in early illness? Can anandamide levels predict CBD response reliably? Will the early substance use disorder results replicate in larger trials?

Common questions

Can CBD treat psychosis?

Early clinical evidence suggests CBD can improve schizophrenia symptoms, particularly in the early stages of illness, either alone or added to standard antipsychotic medication.

Does CBD help with cannabis addiction?

When combined with THC, CBD showed positive effects on reducing short-term withdrawal symptoms and craving in cannabis use disorder. Studies on other substance addictions are lacking.

What is the anandamide biomarker?

Anandamide is a natural endocannabinoid. Its blood levels may predict how well a patient will respond to CBD treatment for psychosis, potentially enabling more personalized treatment decisions.

Read the original research

The Potential of Cannabidiol as a Treatment for Psychosis and Addiction: Who Benefits Most? A Systematic Review.

Journal of clinical medicine, 8(7)

View on PubMed ↗Publisher’s paper ↗

Citation

Batalla, Albert; Janssen, Hella; Gangadin, Shiral S; Bossong, Matthijs G. (2019). The Potential of Cannabidiol as a Treatment for Psychosis and Addiction: Who Benefits Most? A Systematic Review.. Journal of clinical medicine, 8(7). https://doi.org/10.3390/jcm8071058