Cannabis and psychosis: is there a role for Cannabidiol in the treatment of psychosis in young cannabis users?

Abstract

Background: Δ9-tetrahydrocannabinol (THC) and cannabidiol (CBD) have been the most studied and debated cannabinoids present in cannabis. The last decade has shown a notable increase in literature regarding CBD, recognizing its anti-inflammatory and neuroprotective effects. Although there is limited evidence regarding the use of CBD in psychiatric disorders’ treatment, studies so far available have reported therapeutic potential in substance use disorders (SUDs), psychosis and anxiety. Methods: Literature review, performing a research in MedLine for articles on the subject, written in English and Portuguese, published until 2019, resulting in a total of 108 selected publications. Results: CBD appears to reduce psychotic symptoms and cognitive impairment associated with cannabis use and decrease the risk of developing psychosis in this context. Early clinical studies using CBD as treatment in patients with psychotic symptoms confirm its potential as an effective antipsychotic compound with negligible side effects, with excellent safety profile and tolerability. Cannabidiol is also capable of modulating the neuronal circuits involved in SUDs, presenting the potential to reduce dependence in these individuals. Discussion: CBD is currently an emerging therapeutic agent that has shown potential efficacy in the treatment of psychotic disorders and SUDs, and may represent a more easily accepted and tolerable therapeutic agent for this particularly vulnerable population.