the best cbd oil for psychosis

CBD for Schizophrenia: Helpful or Harmful?

If you have schizophrenia, or have a friend or family member with the condition, you know how much it can impact a person’s quality of life. There is a stigma around schizophrenia. And the truth is, we need better therapies to help people with the condition manage their symptoms and regain their lives.

Researchers have proposed that CBD, also known as cannabidiol, may be useful in managing the symptoms of schizophrenia. That proposition has led many to consider whether a person with schizophrenia can use CBD for their condition and, if so, where to find the best CBD products on the market that are high quality and safe to use. But before we get to that, we want to get a few facts straight.

Table of Contents

  • CBD for Schizophrenia: Just the Facts
  • Understanding Cannabis and CBD: Marijuana vs. Hemp
  • What is Schizophrenia?
    • Positive Symptoms Include:
    • Negative Symptoms Include:
    • Cognitive Symptoms Include:
    • Movement Disorders
    • Weight Gain
    • Animal Studies
    • Human Studies
    • Increasing Anandamide
    • Serotonin Receptors
    • PPARγ and Glycine Receptors

    CBD for Schizophrenia: Just the Facts

    Schizophrenia is a serious mental health disorder that causes a mix of what they call “positive symptoms” and “negative symptoms” like hallucinations and flat affect (more on that in a little bit). Antipsychotic medications are the primary treatment approach; however, they cause weight gain and other side effects and do not address negative symptoms at all.

    Emerging research has found that CBD can reduce both positive and negative symptoms of schizophrenia for some people, and it can do so with very few side effects. More research is needed, but the outlook is good for using CBD for schizophrenia in the future.

    Understanding Cannabis and CBD: Marijuana vs. Hemp

    It has been documented that smoking cannabis can cause psychotic symptoms in healthy people. And repeated cannabis use is associated with an increased risk of developing schizophrenia for some people. So how could the same plant that may increase the risk of developing psychotic symptoms and schizophrenia also be a possible therapy for schizophrenia?

    The answer to this question requires us to take a more in-depth look at the cannabis plant itself.

    First, it’s crucial to understand that the word “cannabis” actually describes a family of plants. This means there are different plants within this plant family. Two of these strains are the marijuana plant and the industrial hemp plant. Although they come from the same family, there are critical differences between the two plants—and those differences impact their effects on the brain and body. CBD oil, which is used in CBD products, is not derived from the marijuana plant; it’s extracted from the industrial hemp plant.

    This brings us to our second point—the plants’ composition. Cannabis plants contain hundreds of different active compounds known as phytocannabinoids. Two of these active compounds are CBD (cannabidiol) and THC (tetrahydrocannabinol).

    THC is the psychoactive component that’s found in high amounts in the marijuana plant, and it’s the feature of the plant that’s responsible for creating psychotic symptoms in some people. The industrial hemp plant contains only trace amounts of THC, and it’s high in CBD—which does not have any psychoactive effects.

    CBD products are purified and must contain less than 0.3% THC to be sold in the United States. This amount of THC will not cause a person to feel “high,” nor does it increase the risk of developing schizophrenia or psychotic symptoms. Side effects of CBD are generally very mild and may include fatigue, diarrhea, and nausea.

    What is Schizophrenia?

    Schizophrenia is a serious mental health disorder that affects the way a person thinks, behaves, and perceives the world. Some people with schizophrenia act as though they are living in a different reality than the one everyone else is.

    Although every person experiences a combination of different symptoms with different severity levels, there are three general sets of symptoms: positive, negative, and cognitive.

    Positive Symptoms Include:

    • Audio and/or visual hallucinations (such as hearing voices or seeing things that aren’t there)
    • Delusions (false beliefs such as having direct contact with God)
    • Abnormal, typically agitated, body movements
    • Abnormal thinking patterns

    Negative Symptoms Include:

    • Difficulty moving or engaging in activities (sometimes called catatonia)
    • A flat affect (seeming to be emotionally dulled)
    • Depressed mood
    • Limited speaking

    Cognitive Symptoms Include:

    • Difficulty paying attention or focusing
    • Not being able to use information right after learning it
    • Poor ability to use information they’ve learned to make decisions

    People with schizophrenia may have other symptoms such as anxiety, difficulty forming relationships, and trouble keeping a job due to the impact of their thoughts and behaviors. Some may also suffer from memory issues or a decreased ability to learn and make decisions.

    Danielle from Ohio describes her experience of schizophrenia like this:

    “Maintaining friendships can be very complicated, and romantic relationships even harder. Since I’m quite emotionally detached, maintaining a romantic relationship with someone who doesn’t quite understand me can be hard. They tend to think I don’t care enough about them, when I just have a hard time showing that affection. I don’t talk much, and when I do I tend to be very repetitive with my words; I keep to myself, so others may become distant because of that. I’m very detached from others around me, even my own family. Most of my family will hug or nudge each other around playfully — they have this sort of physical connection with each other. I do not. I don’t really hug my family. I don’t even touch them; I just don’t feel that connection.”

    Danielle from Ohio

    What Causes Schizophrenia?

    The short answer is: No one really knows. Some believe that there can be genetic links as well as environmental factors like viruses, malnutrition, or family dynamic issues. As previously mentioned, repeated exposure to THC found in marijuana is also associated with the onset of schizophrenia in some people.

    Conventional Approach to Schizophrenia

    The main medications used in schizophrenia are classified as antipsychotics. These medications work by reducing the amount of dopamine in the brain. Too much dopamine is thought to cause psychotic symptoms.

    The downside to these medications is their severe side effects, which include movement disorders and weight gain.

    Movement Disorders

    These drugs are known to cause a condition called tardive dyskinesia (TD). TD causes uncontrollable twitching of the face and body, which often does not go away even if the medication is stopped!

    Weight Gain

    The majority of people on antipsychotics experience weight gain as well as higher blood sugar and blood pressure. These side effects can be detrimental to other areas of health, such as cardiovascular health and self-esteem.

    Other side effects include constipation, sexual dysfunction, dry mouth, blurred vision, and restlessness.

    Unfortunately, antipsychotic medications are not effective for negative symptoms. Without addressing these symptoms, a person may still suffer from issues with relationships, mood, and holding down a job.

    Novel approaches to schizophrenia are needed, and the high incidence of side effects such as weight gain and movement disorders calls for more effective therapies with fewer side effects.

    What We Know About CBD for Schizophrenia

    Unlike THC, which is known to cause psychotic symptoms in some people, CBD can protect against psychotic symptoms that are induced by THC. Researchers found that giving study participants CBD before they used cannabis containing THC reduced the number of psychotic symptoms that were experienced.

    Scientists have begun to study how CBD affects schizophrenia in both animal and human studies.

    What the Research Says About CBD for Schizophrenia

    Animal Studies

    Although schizophrenic symptoms are challenging to study in animals, researchers have looked at various aspects of mental health symptoms that are seen in schizophrenia.

    Animal studies have found that CBD can often help reduce abnormal social behavior as well as anxiety, both of which are seen often in schizophrenia patients.

    Human Studies

    There have been a few human studies on the use of CBD for schizophrenia—some of which were very recent and are still being peer-reviewed before they can be published.

    A double-blind, randomized clinical trial of CBD in acute schizophrenia found that it was just as effective as a traditional antipsychotic in reducing both positive and negative schizophrenic symptoms, but did not cause the numerous adverse side effects that the antipsychotic medication did.

    This study also found that CBD increased the amount of anandamide (also known as the “bliss molecule”) in the participants. Scientists believe that CBD’s effect on anandamide is how it reduces psychotic symptoms.

    How Can CBD Help with Schizophrenia?

    We are still not entirely sure how CBD affects psychotic symptoms; however, it is likely due to different mechanisms than traditional antipsychotic drugs.

    Most antipsychotic medications are geared at reducing dopamine levels, as high levels of dopamine have been associated with hallucinations and other psychotic symptoms seen in schizophrenia. However, CBD does not seem to affect dopamine levels.

    Increasing Anandamide

    There are a few theories on how CBD may help with schizophrenia. The first is that CBD inhibits the breakdown of anandamide. Researchers have found that people with both bipolar and schizophrenia have lower levels of this molecule in their spinal fluid. They also found that the levels correlate with the likelihood of developing a mental health disorder, including schizophrenia.

    Serotonin Receptors

    Another theory is that CBD stimulates 5-HTP receptors, which are typically mediated by serotonin. Some researchers believe that stimulating these receptors may help with the negative symptoms of schizophrenia. Many antidepressant drugs target serotonin.

    PPARγ and Glycine Receptors

    A third theory is that CBD affects PPARγ receptors and glycine receptors, which decrease inflammation and therefore, the disruption of critical neurological processes. Inflammation can cause changes in how the brain functions and communicates. This theory suggests that by reducing inflammation, CBD helps normalize brain functionality.

    In summary, researchers are beginning to understand the different ways CBD may affect the brain, but they are still in the discovery phase.

    A Summary of What the Research Says

    There have been a few human studies on CBD for schizophrenia, and more are underway.

    Clinical studies have found that CBD can reduce both positive and negative schizophrenic symptoms for some people with very few side effects.

    Animal studies have found that CBD can decrease anxiety and abnormal social behavior.

    Theories on how CBD may work to help manage schizophrenia symptoms for some people include: increasing anandamide, stimulating 5-HTP receptors, and decreasing inflammation through PPARγ and glycine receptors.

    Final Thoughts on Using CBD for Schizophrenia

    Research studies have been successful in reducing schizophrenic symptoms in many participants, and what’s more, CBD has far fewer side effects than traditional antipsychotic medications. CBD may very well have a place in managing schizophrenic symptoms; however, researchers still have their work cut out for them to uncover the exact mechanism of how CBD works for schizophrenia and how to best utilize it.

    Keep in mind that schizophrenia is a serious health condition, and any and all changes to medications and supplements should only be made by a licensed healthcare professional. If you are interested in trying CBD for schizophrenia, talk with your doctor first.

    And if you get the go ahead, you can then look at the wide variety of CBD products, from vaping oils to gummy bears or capsules, to find what may work best for you.

    CBD Oil for Schizophrenia & Psychosis: Can It Help?

    Schizophrenia is a neurological disorder affecting the perception of reality.

    We explore if CBD is safe & how it might help.

    Article By

    Schizophrenia causes disordered thoughts and speech, visual or auditory hallucinations, and a myriad of other symptoms that can vary from one person to the next.

    Researchers are continuously looking for new, effective treatment options for schizophrenia, and in recent years have turned their focus toward CBD — a powerful, medicinal (non-psychoactive) compound contained in the cannabis plant.

    In this article, we’ll discuss what we know so far about this debilitating mental health condition and how CBD can be used to support symptoms.

    MEDICALLY REVIEWED BY

    Updated on November 13, 2021

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    Can CBD Help With Schizophrenia?

    Schizophrenia is a complex psychiatric disorder involving many different confounding factors working together to produce symptoms. Schizophrenia is a serious chronic, debilitating psychotic disorder listed in the top 15 leading causes of disability worldwide according to the National Institute of Mental Health.

    This means that there is no single effective treatment for the disorder. Successful treatment, therefore, requires an all-encompassing approach. Everything from changes in diet and lifestyle to supplements and medications should be combined to manage the condition.

    CBD has been shown to offer some unique benefits that may be combined with other treatments to maximize the management of schizophrenia.

    While the mechanism of action for CBD remains unclear, the results so far have been promising.

    The potential benefits of CBD oil for schizophrenia include:

    • Alleviates anxiety & depression
    • Regulates neurotransmitter balance (dopamine, serotonin, & glutamate)
    • Increased blood flow to cortical regions of the brain
    • Improves sleep quality & duration
    • Regulates the vanilloid receptors (TRPV1)

    What is Schizophrenia?

    Schizophrenia is a diagnosable psychotic disorder involving delusions, hallucinations, disorganized speech, difficulty staying focused, lack of motivation, and disorganized or catatonic behavior. Diagnosis by a physician requires at least a month or two or more symptoms over at least six months, with at least one positive symptom and social/occupational dysfunction.

    Seeing a doctor early is important because schizophrenia must be carefully distinguished from other mood and psychotic disorders with similar symptoms, in order to optimize correct treatment and minimize long-term harm.

    However, it’s a rare condition affecting

    1% of the US population, according to the American Psychiatric Association. They also note that approximately half of schizophrenia patients may also suffer from another mental or behavioral disorder.

    There are a lot of misconceptions in public understanding of this condition. Despite popular belief, most schizophrenics aren’t dangerous. They don’t all live in hospitals nor have split personalities. Many, albeit not most people, who have the condition can live reasonably normal lives — they often have jobs and families and can live independently.

    Schizophrenia affects both men and women equally, but symptoms tend to appear sooner in males than females. Men usually begin experiencing symptoms around their late-teens to mid 20s, while females typically start showing signs in their mid 20s or early 30s. It’s rarer for anybody under the age of 12, or over 40, to show symptoms of schizophrenia — but still possible.

    Schizophrenia itself isn’t deadly, but it’s often associated with other medical conditions that can lead to problems later in life — such as heart disease or diabetes. Patients, in general, are at higher risk of premature death from such preventable causes, also including metabolic and liver disease, and suicide.

    Three Phases of Schizophrenia

    1. Prodromal Phase

    This is the phase leading up to the first display of active psychotic symptoms, usually starting here with negative symptoms. “Negative” symptoms can be thought of as irregular social behaviors or speech/affect opposite of the norm (listed below). There is also some accompanying decline in daily functioning. If detected early enough, the onset and severity of schizophrenia can be significantly reduced and better managed in the long-term .

    In the prodromal phase, patients often experience a decline in social and cognitive functions like memory, judgement, attention, depression, anxiety, isolation, and learning difficulties. Patients may also have mood symptoms such as depression, anxiety, and suicidal thoughts which should be taken seriously.

    The prodromal phase can last anywhere from several weeks to several years [1].

    2. Active Phase

    During this phase, distinct positive symptoms become evident and perhaps more severe, involving delusions, hallucinations, and catatonic behavior. These “positive” symptoms may involve delusions, hallucinations, disorders of thought, and either agitation/aggression or catatonic behavior. This is when treatment is most important and when most schizophrenia diagnoses are made.

    3. Residual Phase

    In the residual phase, symptoms may begin to disappear, but patients are often left feeling “flat,” with poor motivation, low mood, and inability to focus or concentrate. Treatment during this phase is still important, directed toward controlling psychotic episodes and mood symptoms.

    In the long run, about 30% will improve or return to normal function, another 30% will be hospitalized intermittently, and another 30% will be institutionalized or incapacitated. Unfortunately,

    10% of patients are lost to suicide.

    Signs & Symptoms of Schizophrenia

    The symptoms of schizophrenia can be divided into three main categories:

    A) Positive (Psychotic) Symptoms
    • Delusions
    • Hallucinations
    • Disorganized speech
    • Disorganized behavior
    • Catatonic behavior
    • Psychosis
    B) Negative Symptoms
    • Changes in emotions
    • Flat affect
    • Apathy
    • Less emotional expression
    • Lack of energy (Anergia)
    • Asociality
    • Lack of detail in speech(Alogia)
    • Loss of motivation(Avolition)
    C) Cognitive Symptoms
    • Poor memory
    • Impaired judgement
    • Learning difficulties
    • Poor concentration

    What Causes of Schizophrenia?

    Unfortunately, there isn’t a single identified cause of schizophrenia. Research has linked the disorder with some different potential causes, including environmental influences, genetics (i.e. chromosome 6), changes in brain chemistry, and physical or emotional trauma.

    1. Dopamine Theory

    One of the leading theories for the causes of schizophrenia comes from early behavioral studies that found if you increase dopaminergic activity in certain brain pathways then psychotic symptoms appear (as in overdoses of cocaine, amphetamine, L-dopa).

    This mesocorticolimbic projection is now the primary target mechanism of antipsychotic drugs.

    In fact, all anti-psychotic medications work by blocking dopamine (D2) receptors in the brain to some degree — suggesting that schizophrenia is caused by too much dopamine in certain brain pathways.

    The trade-off is that either over-activating or blocking dopamine in certain brain areas may cause unpleasant side-effects, which can be addressed.

    For example, blocking dopamine receptors in one area produces Parkinsonian-like effects and involuntary muscle spasms. Too little dopamine activity in the frontal cortex is thought to cause the negative and cognitive symptoms.

    First generation anti-psychotics are effective at blocking psychotic symptoms, however, they often come with many other side effects. Second generation (or “atypical”) anti-psychotics are better at avoiding the side-effect pathways, and also block a greater number of serotonin receptors.

    2. Brain Structure Abnormality Theory

    Neuroimaging studies have shown that patients with differing symptoms have physiological abnormalities (such as reduced blood flow) in different areas of the brain.

    For example, patientshave been shown to have abnormalities in the thalamus — the area of the brain tasked with filtering and processing sensory signals such as sight, sound, or touch. Other studies have found that patients show signs of reduced neurons, which may be related to the faulty, overactive C4 pruning gene researchers found on chromosome 6.

    All of these different factors suggest that schizophrenia can be caused by dysfunctions in many different areas of the brain. Symptoms will be determined by the parts of the brain that are most affected.

    Low doses of cannabis improve blood flow to regions of the brain involved with regulating mood, sociability, and cognition — potentially reducing psychotic symptoms associated with schizophrenia [10].

    3. Glutamate Theory

    Glutamate is the most abundant neurotransmitter in the brain, and the one responsible for neural excitement. One theory regarding schizophrenia involves inappropriate glutamate activity and NMDA receptor expression alteration in the brain. This theory could be used to explain many of the symptoms associated with the condition. Additionally, the psychoactive drug phencyclidine (PCP) is known for producing acute, schizophrenia-like psychosis through activation of the glutamate receptors in the brain [8].

    This has led some medical researchers to suggest schizophrenia involves similar over- or underactivation of glutamate in certain areas of the brain.

    Studies show that synthetic cannabinoids reduce PCP-induced schizophrenic symptoms in rats [9].

    4. Anandamide Excess Theory

    Other research findings suggest schizophrenic patients have significantly higher levels of anandamide in their blood [4]. Follow up studies show high levels of anandamide present in the cerebrospinal fluid of actively psychotic, schizophrenic patients who have never been treated. Interestingly, researchers now pose that high anandamide may not be the cause, but is actually a homeostatic compensation to fight the disease state.

    In a double-blind, randomized clinical trial, CBD was shown to improve psychotic symptoms by improving anandamide signalling. CBD was just as effective as the potent, second generation antipsychotic amisulpride at reducing symptoms — but had less unpleasant side effects.

    CBD inhibits the enzyme FAAH from degrading anandamide, suggesting the endocannabinoid system is somehow altered in schizophrenia, but may now play a new role in treatment.

    Similar studies report dysfunctional CB1 receptor activity in schizophrenic patients, especially in regions of the brain relating to cognition and memory — two functions highly compromised in schizophrenia [5, 6].

    Patients with schizophrenia are more likely to be negatively affected by THC — which is a well-known CB1 receptor agonist [7].

    This, of course, makes schizophrenia challenging to treat because there are so many different factors to take into account. It also explains why some patients respond to treatment, and others don’t.

    5. Other Potential Causes
    • Severe or long-term stress
    • Substance abuse, particularly in adolescence
    • Genetic factors
    • Viral infection
    • Developmental problems
    • Autoimmune disorders
    • Neurodegenerative disorders

    Treatment Options for Schizophrenia

    The most effective treatments for schizophrenia have an all-encompassing approach. Medications, lifestyle coaching, psychiatric care, and group therapy are all necessary aspects of treatment for this condition.

    With early and proper treatment involving antipsychotic medications, most of the symptoms of schizophrenia can be reduced or eliminated, and episodes of active-phase schizophrenia become less frequent.

    Unfortunately, all of these medications come with potentially negative side-effects, especially in the long term. Sudden, abnormal or painful muscle movements, diabetes, and heart complications are especially common in people taking these medications. There’s also a risk of CBD interacting with medications, so always talk to your doctor first.

    However, side effects can be addressed with your doctor and managed if they appear. Families should seek support for their affected loved ones and themselves, with assistance like home care and ensuring patients can access and maintain treatment long-term.

    Communities should provide opportunities for employment and assisted/independent living, giving patients a base from which to set and achieve goals.

    Treatment for Schizophrenia May Include:
    • Lifestyle coaching
    • Dietary changes
    • Addiction treatment
    • Antipsychotic medications
    • Psychiatric therapy
    • Group therapy
    Medications Often Used For Schizophrenia:
    • Clozapine (Clozaril)
    • Olanzapine (Zyprexa)
    • Ziprasidone (Geodon)
    • Aripiprazole (Abilify)
    • Risperidone (Risperdal)
    • Quetiapine (Seroquel)
    • Haloperidol (Haldol)

    What the Research Says: CBD Oil for Schizophrenia

    Over the past decade, there’s been a growing interest in the use of CBD for treating schizophrenia.

    This research started following a case report released in 1995 highlighting the improvement in a schizophrenic patient who was unresponsive to the standard antipsychotic medication haloperidol [3]. In 2012, the results of the clinical study highlighted above on CBD vs amulisopride and enhanced anandamide signalling was published.

    Even more recently, the pharmaceutical company GW Pharmaceuticals Plc recently ran a series of clinical trials on a new CBD-based drug it’s been developing called Sativex®. One of these studies explored whether or not CBD was able to relieve symptoms of schizophrenia in patients who were unresponsive to standard antipsychotic medications [2].

    The GW Pharmaceuticals study was a phase 2, double-blind clinical trial conducted across 15 different hospitals in the UK, Romania, and Poland. Patients in the study were randomly put into either a treatment group (using 1000 mg per day of CBD split into two doses) or a control group (using a placebo).

    At the end of the six-week trial, the CBD group showed modest improvements in schizophrenic symptoms. The most substantial improvements from the study involved motor speed and executive functioning.

    The most significant finding in this research was that CBD didn’t appear to rely on dopamine receptor modulation — which is the primary target for current schizophrenia treatments. Instead, researchers in this study suggested the mechanism of action to be through inhibition of fatty acid amide hydrolase (FAAH), inhibition of adenosine reuptake, vanilloid receptor activation (VR1), and serotonin (5HT1A) receptor activation [2].

    They concluded by stating that: “Because CBD acts in a way different from conventional antipsychotic medication, it may represent a new class of treatment for schizophrenia.”

    More clinical trials are scheduled to explore the use of CBD for schizophrenia in larger populations and longer duration of treatment.

    Results of the GW Pharmaceuticals Research Study:

    (Source: McGuire et al., 2017)

    THC vs. CBD for Schizophrenia

    High-THC and low-CBD extracts have been associated with a higher risk of psychotic episodes [11]. Other studies have shown that cannabis containing a high level of CBD and a level of low THC is associated with a lower risk of psychotic episodes [12].

    Other studies have shown that CBD offered improvement in symptoms of schizophrenia to a similar degree as amisulpride — an antipsychotic medication [13]. CBD also had fewer side-effects.

    The differences between CBD and THC and their effect on schizophrenia is very important — and likely to be the reason behind the conflicting evidence for cannabis users and schizophrenia. Some patients find relief from symptoms with cannabis use; others experience dramatically worsened symptoms after using cannabis.

    It is not recommended, but if using cannabis for schizophrenia, make sure you pay attention to the THC content. Additionally, only choose products with low or “not detectable” THC concentrations when buying CBD.

    Key Takeaways: Using CBD for Schizophrenia

    Schizophrenia is a highly complex neurological disorder that continues to puzzle medical researchers. However, there are several significant theories about the underlying causes of schizophrenia.

    Some patients respond very well to medications; others do not.

    Although CBD may improve the side-effects of the condition using several different models of schizophrenia (clinical and PCP-induced), there is also evidence that other cannabinoids — namely THC — can worsen schizophrenia.

    For this reason, it’s recommended that you only use CBD for schizophrenia under the close watch of a medical professional. It’s also recommended that you only use CBD products that are entirely void of THC. Additionally, research suggests that a high dose (1000 mg per day) of CBD is needed to produce even modest improvements in symptoms.

    Patients and families are encouraged to seek further support and resources from their doctor, and groups like NAMI and the American Psychiatric Association.