Can CBD work as a new kind of antipsychotic? | Research

The takeaway

Emerging evidence from preclinical, experimental, neuroimaging, and clinical studies suggests CBD has antipsychotic properties through mechanisms distinct from current medications.

People interested in CBD research, mental health treatment advances, or alternatives to traditional antipsychotic medications.

CBD operates through a non-D2 mechanism unlike all current antipsychotics

What the researchers found

CBD shows potential as a novel antipsychotic with a unique non-dopamine-D2 mechanism of action. Clinical evidence suggests possible benefits for positive, negative, and cognitive symptoms of psychosis, with a favorable safety and tolerability profile.

Why it matters

Current antipsychotics all work by blocking dopamine D2 receptors, causing significant side effects. A substantial number of patients don't respond adequately. CBD represents a fundamentally different pharmacological approach that could help treatment-resistant patients.

The numbers in context

Psychotic disorders like schizophrenia contribute substantially to the global burden of disease. D2 antagonists have been the mainstay since the 1950s, but a significant proportion of patients don't achieve adequate remission.

How the study worked

Narrative review synthesizing preclinical studies, human experimental and neuroimaging research, and clinical trials evaluating CBD's antipsychotic effects, safety, tolerability, and potential mechanisms.

What this study cannot tell us

This is a narrative review, not a systematic review or meta-analysis. The clinical evidence base for CBD as an antipsychotic is still limited, with few large-scale randomized controlled trials completed.

How to read the evidence

Moderate: review synthesizes multiple lines of evidence including some clinical trials, but large-scale RCTs are limited.

When this study was published

Published in 2019.

The bigger picture

If CBD proves effective as an antipsychotic, it would be the first new class of antipsychotic medication with a non-D2 mechanism in decades. This could transform treatment options for the millions of people living with psychotic disorders worldwide.

Questions still open

What is the optimal dose of CBD for antipsychotic effects? Can CBD be combined with traditional antipsychotics for enhanced benefit? Which specific patient populations would benefit most?

Common questions

Is CBD approved as an antipsychotic?

No. While research shows promise, CBD is not approved for treating psychosis. The evidence reviewed here is primarily from early-stage clinical trials and preclinical research.

How is CBD different from current antipsychotics?

All current antipsychotics work by blocking dopamine D2 receptors. CBD appears to work through entirely different mechanisms, which could mean fewer of the movement-related and metabolic side effects associated with D2 blockers.

Read the original research

Cannabidiol as a potential treatment for psychosis.

Therapeutic advances in psychopharmacology, 9, 2045125319881916

View on PubMed ↗Publisher’s paper ↗

Citation

Davies, Cathy; Bhattacharyya, Sagnik. (2019). Cannabidiol as a potential treatment for psychosis.. Therapeutic advances in psychopharmacology, 9, 2045125319881916. https://doi.org/10.1177/2045125319881916