Differential effects of cannabis constituents on schizophrenia-related psychosis: a rationale for incorporating cannabidiol into a schizophrenia therapeutic regimen
Frontiers in Psychiatry April 23, 2024 Kennadi Johnson, A. Weldon, Melissa A. Burmeister
Schizophrenia carries a high mortality rate and its psychotic symptoms, though treatable with antipsychotics, remain incurable. Medication adherence is poor, and many individuals with schizophrenia use cannabis, including its component cannabidiol (CBD). While delta-9-tetrahydrocannabinol (THC) can worsen psychosis and increase the risk of earlier-onset schizophrenia in genetically susceptible people, CBD may alleviate psychotic symptoms and reduce antipsychotic side effects. This review examines mechanisms behind schizophrenia-associated versus cannabis-induced psychosis, weighs evidence that THC exacerbates and CBD may ameliorate psychosis, and outlines approaches for safely incorporating CBD into schizophrenia treatment, noting that preclinical and clinical data remain inconclusive.