CBD may help cannabis users with early psychosis by acting as an antipsychotic and counteracting THC harm
A review proposed that CBD could improve outcomes for people with recent-onset psychosis who also use cannabis, based on evidence that CBD has antipsychotic and anxiolytic properties and attenuates THC's psychotogenic, anxiogenic, and cognitive effects.
Quick Facts
What This Study Found
This review examined the potential of CBD as a treatment specifically for cannabis users with recent-onset psychosis, a population with currently poor outcomes and no specialized effective intervention.
Cannabis misuse is a major factor associated with poor outcomes after a first psychotic break and is especially common in individuals with recent-onset psychosis. Behavioral interventions aimed at reducing cannabis use have been unsuccessful in this population.
The review compiled evidence that CBD has a broad pharmacological profile including antipsychotic and anxiolytic effects, does not activate CB1 or CB2 receptors (unlike THC), and has at most subtle subjective effects.
Critically, CBD attenuates THC's harmful effects both acutely and chronically, including psychotogenic, anxiogenic, and cognitive impairments. Modern cannabis strains have low CBD concentrations, which may contribute to their higher psychosis risk.
The authors proposed that CBD treatment could improve the disease trajectory for this specific population by both treating psychotic symptoms and mitigating the ongoing harm from THC if patients continue using cannabis.
Key Numbers
Cannabis misuse is prevalent in schizophrenia and especially common in recent-onset psychosis. Modern cannabis strains have low CBD concentrations. CBD does not activate CB1 or CB2 receptors. Behavioral interventions for cannabis reduction have been unsuccessful in this population.
How They Did This
Narrative review synthesizing evidence on CBD's pharmacological profile, antipsychotic properties, neuroprotective effects, and capacity to attenuate THC's adverse effects, with focus on clinical implications for recent-onset psychosis with comorbid cannabis use.
Why This Research Matters
People with early psychosis who use cannabis represent a treatment-resistant group: behavioral interventions to stop cannabis use have failed, and continued use worsens outcomes. CBD potentially addresses both the psychosis and the cannabis harm simultaneously, offering a novel therapeutic strategy.
The Bigger Picture
This review represents a shift in thinking about treating dual-diagnosis patients: instead of trying to eliminate cannabis use (which has proven difficult), CBD could potentially reduce the harm from ongoing use while simultaneously treating the psychotic disorder.
What This Study Doesn't Tell Us
The proposal is based on indirect evidence combining separate findings on CBD as antipsychotic and CBD as THC-attenuator. No clinical trials had directly tested CBD in cannabis-using psychosis patients at the time. CBD's antipsychotic evidence, while growing, was still limited. The optimal dosing and treatment duration were unknown.
Questions This Raises
- ?Would a clinical trial confirm CBD's benefit specifically for cannabis-using psychosis patients?
- ?What CBD dose would be needed to counteract the THC levels from modern high-potency cannabis?
- ?Could CBD reduce cannabis use itself, or only mitigate harm?
Trust & Context
- Key Stat:
- CBD attenuates THC's psychotogenic, anxiogenic, and cognitive effects
- Evidence Grade:
- Narrative review proposing a therapeutic strategy based on converging indirect evidence, providing moderate rationale that awaits direct clinical testing.
- Study Age:
- Published in 2018. Several clinical trials of CBD for psychosis have reported results since, with mixed but generally encouraging findings.
- Original Title:
- The Potential of Cannabidiol Treatment for Cannabis Users With Recent-Onset Psychosis.
- Published In:
- Schizophrenia bulletin, 44(1), 46-53 (2018)
- Authors:
- Hahn, Britta
- Database ID:
- RTHC-01674
Evidence Hierarchy
Summarizes existing research on a topic.
What do these levels mean? →Frequently Asked Questions
Can CBD treat psychosis?
Growing evidence suggests CBD has antipsychotic properties. This review proposes it could be especially valuable for psychosis patients who also use cannabis, because CBD both treats psychotic symptoms and counteracts THC's harmful effects.
Why is cannabis use a problem for psychosis?
Cannabis misuse is one of the strongest predictors of poor outcomes after a first psychotic break. Behavioral interventions to reduce cannabis use in this population have consistently failed, making a medication-based approach like CBD potentially more practical.
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Cite This Study
https://rethinkthc.com/research/RTHC-01674APA
Hahn, Britta. (2018). The Potential of Cannabidiol Treatment for Cannabis Users With Recent-Onset Psychosis.. Schizophrenia bulletin, 44(1), 46-53. https://doi.org/10.1093/schbul/sbx105
MLA
Hahn, Britta. "The Potential of Cannabidiol Treatment for Cannabis Users With Recent-Onset Psychosis.." Schizophrenia bulletin, 2018. https://doi.org/10.1093/schbul/sbx105
RethinkTHC
RethinkTHC Research Database. "The Potential of Cannabidiol Treatment for Cannabis Users Wi..." RTHC-01674. Retrieved from https://rethinkthc.com/research/hahn-2018-the-potential-of-cannabidiol
Access the Original Study
Study data sourced from PubMed, a service of the U.S. National Library of Medicine, National Institutes of Health.
This study breakdown was produced by the RethinkTHC research team. We analyze and report published research findings without making health recommendations. All interpretations are based solely on the published abstract and study data.