Volume 162, Issues 1–3, March 2015, Pages 153–161
Review
- a Institute of Psychiatry, Department of Psychosis Studies, King's College London, 16 De Crespigny Park, London SE5 8AF, United Kingdom
- b Brain Center Rudolf Magnus, Department of Psychiatry, University Medical Center Utrecht, Heidelberglaan 100, 3584 CX Utrecht, The Netherlands
- Received 6 October 2014, Revised 20 January 2015, Accepted 21 January 2015, Available online 7 February 2015
Abstract
Despite
extensive study over the past decades, available treatments for
schizophrenia are only modestly effective and cause serious metabolic
and neurological side effects. Therefore, there is an urgent need for
novel therapeutic targets for the treatment of schizophrenia. A highly
promising new pharmacological target in the context of schizophrenia is
the endocannabinoid system. Modulation of this system by the main
psychoactive component in cannabis, Δ9-tetrahydrocannabinol (THC),
induces acute psychotic effects and cognitive impairment. However, the
non-psychotropic, plant-derived cannabinoid agent cannabidiol (CBD) may
have antipsychotic properties, and thus may be a promising new agent in
the treatment of schizophrenia. Here we review studies that investigated
the antipsychotic properties of CBD in human subjects. Results show the
ability of CBD to counteract psychotic symptoms and cognitive
impairment associated with cannabis use as well as with acute THC
administration. In addition, CBD may lower the risk for developing
psychosis that is related to cannabis use. These effects are possibly
mediated by opposite effects of CBD and THC on brain activity patterns
in key regions implicated in the pathophysiology of schizophrenia, such
as the striatum, hippocampus and prefrontal cortex. The first
small-scale clinical studies with CBD treatment of patients with
psychotic symptoms further confirm the potential of CBD as an effective,
safe and well-tolerated antipsychotic compound, although large
randomised clinical trials will be needed before this novel therapy can
be introduced into clinical practice.
Keywords
- Cannabidiol;
- Cannabis;
- Psychosis;
- Schizophrenia;
- Antipsychotic
- Corresponding
author at: Brain Center Rudolf Magnus, Department of Psychiatry,
A01.126, University Medical Center Utrecht, Heidelberglaan 100, 3584 CX
Utrecht, The Netherlands. Tel.:
+ 31 88 7552023.
Copyright © 2015 Elsevier B.V. All rights reserved.
