Psychotic disorders such as schizophrenia are heterogeneous and often debilitating conditions.
The introduction of dopamine D2 receptor antagonists in the 1950s revolutionized the treatment of psychotic disorders .And they remain the mainstay of the therapeutic arsenal against psychosis.
CBD as an Antipsychotic
However, traditional antipsychotics have several side effects and a significant proportion of patients do not achieve adequate remission of symptoms. It is, therefore, necessary to develop new treatments. Cannabidiol , a non-toxic has emerged as a potential new class of antipsychotics with a unique mechanism of action.
A recent analysis concluded that patients with psychosis had significantly higher levels of anandamide endocannabinoid in cerebrospinal fluid and blood. This high endocannabinoid tone observed at all stages of the disease, from prodrome to chronic psychosis. While the endocannabinoid system plays a role in psychotic pathophysiology. It is interesting to note that the pharmaceutical compounds that modulate this system may have therapeutic value.
So,it is important to note that CBD has a different mechanism of action from dopamine receptor antagonists . Therefore, is a completely new class of antipsychotics . This would be associable with many advantages. First, by avoiding dopamine receptor antagonism, adverse effects such as extrapyramidal symptoms and high prolactin can be avoidable. Second, if CBD acts by different molecular pathways to existing antipsychotics, it could be useful not only as a monotherapy but also potentially as adjunctive therapy alongside existing antipsychotics, with potential additional efficacy gains.
Evidence of the Antipsychotic Potential of CBD
The accumulated evidence regarding the antipsychotic potential of CBD comes from several different sources. Also,these include preclinical studies, in healthy human volunteers comparing the neurocognitive effects of THC and CBD. Also,studies to determine whether CBD can block or reduce the symptomatic effects of THC.
Basically,Hyperlocomotion is considered a model of positive psychotic symptoms and can be treated with antipsychotics. Consequently,CBD reduces amphetamine-induced hyperlocomotion (dopamine agonist) and ketamine (N-methyl-d-aspartate receptor antagonist (NMDA)) without inducing catalepsy, suggesting that it has antipsychotic-like beneficial effects without harmful motor side effects, with a profile similar to that of atypical antipsychotic clozapine.
Experimental studies in Humans
Therefore,Neuroimaging studies on which CBD can act to produce its antipsychotic and anxiolytic effects in vivo, complement our knowledge of the antipsychotic potential of CBD.
Besides,THC and CBD prove to have opposite effects on regional brain activation in a variety of cognitive tasks in healthy individuals. It is interesting to note that this phenomenon observed in areas of the brain where patients with psychosis have dysfunction and during tasks famous to be weaker with cannabis use.
Early clinical trials suggest that CBD is safe, and may have antipsychotic effects in patients with psychosis. There are some indications that CBD may be particularly effective in the early stages of the disorder, such as in patients at high clinical risk and those with the first episode of psychosis.
In short,Neuroimaging research suggests that CBD may exert its therapeutic effects by modulating brain function in areas known to be impaired in patients with psychosis according to various cognitive paradigms. Since CBD has antipsychotic effects without directly affecting dopamine receptors, it may represent a new type of treatment for psychosis.