Review argues CBD could be ideal for early-phase psychosis where minimizing side effects is a clinical priority

CBD has demonstrated antipsychotic effects in clinical studies and has a relatively benign side effect profile compared to standard antipsychotics. For clinical high-risk individuals, no licensed treatments exist, and for first-episode psychosis, all licensed medications act via dopamine D2 receptors. CBD acts through different mechanisms, potentially offering a novel approach for patients who do not respond to or cannot tolerate standard treatments.

Narrative review examining CBD's potential as a treatment in clinical high-risk and first-episode psychosis stages, covering mechanisms of action, clinical trial evidence, adverse effects, patient acceptability, and ongoing trials.

Early phases of psychosis represent a critical window where treatment experiences shape long-term outcomes. A treatment with fewer side effects could improve engagement and prevent the treatment avoidance that leads to chronic illness.

The convergence of CBD's antipsychotic properties, favorable side effect profile, and high patient acceptability positions it as a potentially transformative addition to early psychosis treatment, pending clinical trial confirmation.

Clinical trial evidence for CBD in psychosis is still limited. Optimal dosing unknown. Long-term effects not established. CBD is not currently approved for psychosis. Recreational cannabis use may confound outcomes in young patients.