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CBD for Schizophrenia

What is Schizophrenia

Schizophrenia is a rare and serious chronic disorder in which the brain has trouble distinguishing fantasy from reality. When the condition is active, schizophrenia is characterized by vivid hallucinations, delusions, violent outbursts of episodes, trouble with thinking and concentration as well as a lack of motivation. There are four dominant types of schizophrenia, including:

Paranoid Schizophrenia Individuals in this category have paranoid tendencies, and usually exhibit eccentric behavior, feel connected to larger world events, and have an inappropriate or apathetic emotional response.

Catatonic Schizophrenia When schizophrenics are catatonic, their symptoms appear in a more physical way—almost like paralysis. They cannot move, speak, show emotion, or act on motivation.

Undifferentiated Schizophrenia This type of schizophrenia is more subdued and is an amalgamation of several different symptoms. Individuals may be mildly paranoid or confused, and overall devoid of emotional responses.

Schizoaffective Disorder Characterized by intense delusions, people with schizoaffective disorder often exhibit of mood disorders such as depression or mania.

Schizophrenia is a complex brain disorder with this complexity helping to explain why there are o many misconceptions about the disease. Most people with schizophrenia are not dangerous or violent, do not suffer from dissociate personality disorder and do not have to live in hospitals. With the correct treatment to manage symptoms, most people with schizophrenia allows them to perform as high-functioning individuals that hold jobs, have families of their own and play active roles in their communities.

Symptoms of Schizophrenia

During an episode of psychosis, another term for the condition where thoughts and emotions are impaired due to a mental disorder, the most common symptoms can include:

  • Hallucinatory visions
  • Delusion
  • Paranoia
  • Incoherent speech
  • Emotional numbness
  • Uncontrollable movements
  • Impaired cognition
  • Memory loss
  • Confusion
  • Disordered thoughts
  • Denial

For many with schizophrenia, the severity of the condition lessens with age as individuals are better able to manage symptoms.

Schizophrenia Medications & Treatments

Schizophrenia is incurable but treatable. Schizophrenia is manageable with a strict regimen of lifelong medications—the majority of which are antipsychotics that help to regulate dopamine levels in the brain. Medications include:

Pharmaceutical Interventions

  • Second-generation antipsychotics (SGAs) which is a class of medications is considered the front line defense, offering a lower dosage and fewer side effects than other options. Quetiapine, Risperidone, and Aripiprazole are just a few of these medications. If treatment via SGAs fails, doctors will then prescribe a more intense pharmaceutical.
  • First-generation antipsychotics (FGAs) are older antipsychotics usually only given if treatment with SGAs is unsuccessful. FGAs are considered a risky treatment because of their often severe side effects that can often lead to permanent movement disorders like tardive dyskinesia. Examples of these medications include Chlorpromazine, Fluphenazine, Haloperidol, and Perphenazine.

Non-Pharmaceutical Interventions
Many schizophrenia patients are in denial, reluctant, or unwilling to take their medications. Non-pharmacological treatments can help keep patients stable during times when they are not taking medications regularly. Some of these therapies and treatments also increase individuals’ motivation to adhere to medications. These can include:

  • Psychotherapy: Continued therapy can help people living with schizophrenia recognize damaging thought patterns, better cope with stress, and sense when psychotic episodes are coming on.
  • Communication and social skills training: Those with schizophrenia may lose or be unable to comprehend social skills, empathy, and communication. Improving these skills can help individuals better function as a member of society.
  • Vocational training or rehabilitation: There are options to help people with schizophrenia better prepare for and find jobs. Some communities even have programs in place to house, help, and hire schizophrenia patients.

CBD for Schizophrenia

Research & Scientific Evidence for using CBD for Schizophrenia

The data on cannabidiol (CBD) for schizophrenia is plentiful, consisting of both animal and human research. Unlike many other condition, there is also a solid body of evidence coming from human clinical trials and double-blind controlled randomized studies.

In a 2012, double-blind, randomized clinical trial published in Translational Psychiatry scientists evaluated efficacy and clinical relevance of previous findings of CBD vs Amisulpride, a potent antipsychotic, in acute schizophrenia.

The study was a therapeutic-exploratory, double-blinded, mono-center, randomized, parallel-group, controlled clinical trial of cannabidiol vs Amisulpride. Subjects included 42 men and women age 18–50 years who had a diagnosis of schizophrenia or schizophreniform psychosis according to the DSM-IV criteria. Patients were randomized (1:1) to receive either cannabidiol or Amisulpride starting with 200 mg per day each and increased stepwise by 200 mg per day to a daily dose of 200 mg four times daily (total 800 mg per day) each within the first week. Treatment was maintained for another 3 weeks for a total of 28 days.

The results showed that both interventions led to significant clinical improvement, but CBD displayed a markedly superior side-effect profile. They also found that the CBD treatment was accompanied by a “significant increase in serum anandamide levels, which was significantly associated with clinical improvement. The results suggest that inhibition of anandamide deactivation may contribute to the antipsychotic effects of CBD, potentially representing a completely new mechanism in the treatment of schizophrenia”.

Supporting these findings, a 2015 review published in European Neuropsychopharmacology, investigators reviewed data concerning the use of CBD as intervention as described in experiments with psychosis models, psychotic symptoms or psychotic disorders as outcome measures.

From the evidence, they concluded that CBD has potential as an effective antipsychotic treatment and that CBD is capable of modulating psychosis like behaviors in both dopaminergic and glutamatergic animal models of psychosis. In addition, the data suggests that the vanilloid (TRPV1) receptor is also likely to play an important role in CBD action. Similarly, imaging studies provided various clues on a potential antipsychotic effect of CBD while biological models explain the potential antipsychotic effects of CBD. The latter ranges from interference with endocannabinoid system (ECS) functioning by inhibition of FAAH activity, to immunological properties of CBD that might moderate immunological processes involved in the pathophysiology of psychotic disorders.

The researchers concluded that, given the high tolerability and superior cost-effectiveness, CBD may prove to be an attractive alternative to current antipsychotic treatment.

In another, more recent double-blind trial from 2018 and published in the American Journal of Psychiatry, clinicians investigated the safety and effectiveness of CBD for treating patients with schizophrenia.

In this parallel-group trial, patients with schizophrenia were randomized in a 1:1 ratio to receive CBD (1000 mg/day; N=43) or placebo (N=45) alongside their existing antipsychotic medication. Participants were assessed before and after treatment using the Positive and Negative Syndrome Scale, the Brief Assessment of Cognition in Schizophrenia, the Global Assessment of Functioning scale, and the improvement and severity scales of the Clinical Global Impressions Scale.

After 6 weeks of treatment, compared with the placebo group, the CBD group had lower levels of positive psychotic symptoms and were more likely to have been rated as improved. Patients who received CBD also showed greater improvements, although just falling short of statistical significance, in cognitive performance and overall functioning, concluding that CBD is a safe and effective treatment for patients with schizophrenia.

Anecdotal Evidence

The anecdotal evidence from people with schizophrenia shows that many people are finding symptom relief when using CBD, either in conjunction with anti-psychotics, or on its own. For some, CBD reduces the severity of their symptoms, especially in relation to paranoia and auditory hallucinations.

CBD as a Complementary Treatment for Schizophrenia

Mental disorders characterized by psychosis like schizophrenia are often characterized by additional symptoms such as anxiety and depression. CBD can reduce symptoms associated with depression and anxiety. In addition, CBD’s calming properties can help mediate insomnia and other types of sleep difficulties that promotes REM sleep, not only improving overall mental resilience but also improve cognitive difficulties. Similarly, CBD can also be beneficial when used in conjunction with psychotherapeutic interventions like CBT, EMDR and mindfulness practices. However, CBD should not be taken in conjunction with other medications without consulting the treating physician first as CBD may negatively interact with these.

Bottom Line

From the research currently available, the data is highly suggestive of CBD having powerful anti-psychotic effects, with good evidence from clinical, double-blind human trials. Scientists hypothesize that CBD’s efficacy in treating schizophrenia primarily stems from its ability to enhance anandamide signaling, modulate ECS functioning through the inhibition of FAAH activity, as well as the immunological processes involved in the pathophysiology of psychotic disorders. When considering using CBD for schizophrenia, always consult a medical practitioner before as they can monitor dosage, symptom severity and other clinical parameters. In addition, CBD is contraindicated with use with certain medications, so they can ensure that your CBD treatment is both safe and effective.

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Researchers are continuously studying the ways that it can lessen symptoms of psychosis—one recent study even found CBD improved the cognitive function of individuals with schizophrenia over time