Cannabis for Healthcare
We know that cannabis has been used as some form of medicine for over 5,000 years all over the world. However, it has been prohibited in most of Europe and the US since the 1920s. Then, back in 1996, California became the first US state to legalize medical marijuana use. Now, in many states and countries across the planet is a schedule 2 drug, which means doctors can prescribe this natural remedy.
Currently, any evidence that backs the medical benefits is arguably at its strongest for treating conditions such as epilepsy, multiple sclerosis, and neuropathic pain.
In each case, reports from animal or human testing show that cannabis or its derivatives have a more profound effect than any placebos administered, at least for some symptoms. However, there is a lack of evidence from premium-quality, randomized controlled trials.
With interest growing into the medical benefits that cannabis offers, and continuing momentum towards global legislation for medicinal purposes
the possibility for therapeutic use to treat psychiatric conditions is becoming an important topic.
Cannabinoids
There are over 100 cannabinoids present in the hemp and cannabis plants. THC is probably the most well known and prevalently psychoactive of these. THC is the compound in cannabis responsible for giving users a ‘high’ feeling. Although a body of evidence has linked regular THC usages to an increased risk of developing psychosis. There is also evidence with associations of psychiatric conditions and depression related to THC abuse.
High quality CBD, on the other hand, is a ‘non-psychoactive’ and could potentially be beneficial for people who have psychosis, depression, anxiety, sleep disorders, and any other psychiatric conditions. The evidence for these claims is still emerging, as only a few human trials have currently been completed. However, this is changing as companies such as ourselves here at Enecta continue to fund science and trials around the benefits of CBD for human healthcare, both physical and mental.
Scientific Studies
A paper was published by (McGuire et al. 2018) of CBD as an adjunct to antipsychotic treatment in people with schizophrenia. It’s a significant new piece of research for several reasons:
- Up to now, much of the evidence regarding the antipsychotic effects of CBD is derived from studies with animals or healthy participants.
- Only a few double-blind trials so far have included patients with active psychosis.
- The others (Leweke et al. 2012, Boggs et al. 2018) featured reduced sample sizes and lower doses (600mg and 800mg per day, respectively).
- Leweke et al. compared CBD to Amisulpride and revealed that both had similar effects on psychotic symptoms. However, CBD showed had fewer side-effects.
- Boggs et al. also tested CBD against placebo as a supplementary to an existing antipsychotic treatment. They found no statistically significant effects after six weeks.
Methods
A recent randomized, double-blinded controlled trial of CBD as a treatment for psychosis (McGuire et al., 2018), required 88 participants to receive either 1,000 mg/day of CBD or a placebo alongside the antipsychotic treatment they were taking at the time for six weeks.
The participants were assessed at the baseline of the treatment and when the treatment had finished. Their psychotic symptoms were measured with the Positive and Negative Syndrome Scale (PANSS) and also the Scale for the Assessment of Negative Symptoms (SANS).
The way their illness affected them on a day-to-day basis and their perceived improvement from the medication they were given was measured using the Global Assessment of Functioning (GAF), and their improvement scores were analyzed using the Clinical Global Impressions Scale (CGI-I).
The cognitive functioning of all participants was assessed using the Brief Assessment of Cognitive in Schizophrenia (BACS). Participants’ waist measurement, weight cholesterol levels, and BMI were also taken, and along with any negative events, were used to assess the tolerability and safety of CBD.
Results
Participants were an average of 40.8 years old, and 51 (58%) were male. 94% of participants had schizophrenia, and the rest had schizoaffective disorder, schizophreniform disorder, or delusional disorder. Baseline outcome measures identified were similar between all groups, regardless of their specific diagnosis.
At the end of treatment, participants receiving CBD:
- Had a minor improvement in their positive symptoms of psychosis.
- Unfortunately, their negative symptoms remained statistically the same.
- All participants were increasingly likely to be rated as slightly improved and less severely unwell by their doctors or psychologists.
- CBD had a beneficial impact on cognition, but these results were not quite statistically significant.
- CBD was generally well tolerated by all participants, and there was no significant change in cholesterol or weight measures in either of the groups.
- Rates of adverse effects almost identical between placebo and CBD groups.
Conclusions
McGuire et al. discovered that CBD had a modest, but beneficial, impact on positive psychotic symptoms and the severity of illness when delivered as a supplemental treatment to existing antipsychotic treatments.
Additionally, they reported an improvement to general cognition and the impact of patients’ conditions on the way they lived day-by-day, which, although even though is just approaching statistical significance, may reveal possible beneficial effects. However, there was no impact on patients with negative psychotic symptoms.
Overall, results suggest that CBD has a positive impact on the treatment of certain types of psychosis, including schizophrenia, when delivered in conjunction with other pharmaceutical medications. That said, the effects seem to be modest and limited to positive symptoms related to psychosis.
