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Editor’s Note: In part one of our two-part CBD for psychosis symptoms series, we discussed how the compounds in CBD (cannabidiol) interact with the body. CBD works with the body’s biological endocannabinoid system (ECS) to bring balance and return the body to homeostasis. In part two, we’ll discuss the possible dangers of medically prescribed antipsychotics. Additionally, we’ll explain why CBD is one of the best natural choices for patients with psychosis.

Traditional Psychosis Treatment And Side Effects

The traditional medication route, widely used for many years, are first-generation “typical” antipsychotics. Antipsychotics come with a commitment to follow a specific dosage protocol and often have many side effects. Antipsychotics have documented improvement for symptom reduction in those with the most severe symptoms. In traditional mental health treatment settings, antipsychotics are the primary form of therapeutic medication provided. Newer, antipsychotics are known as “second-generation atypical.” Although there is evidence in the medication’s efficacy for treating acute psychotic episodes, around 80 percent will relapse within five years of a treated first episode, partly due to discontinuation of the medication

Every Person Is Unique

Each person has a unique brain chemistry profile and responds differently to antipsychotic medication. Typical antipsychotics and their adverse effects have been associated with movement disorders such as tremors, rigid body movements, muscle spasms, and restlessness. Antipsychotic medication adverse side effects include weight gain, drowsiness, hyperglycemia, pulmonary embolism, myocarditis, and low libido. The U.S. Food & Drug Administration has more information on specific antipsychotics and adverse results. Dr. Nikola Djordjevic, MD, board-certified family physician, co-founder of MedAlertHelp and medical advisor at LoudCloudHealth, describes the benefits of CBD for psychosis symptoms this way:

The reason CBD stands a chance to help those suffering from psychosis is that it doesn’t work as conventional antipsychotics do. Instead, CBD travels through the already-present endocannabinoid pathways in our body to target the condition in an entirely different way. CBD is naturally anti-convulsive and operates more as a sedative, the effects being comparable to other sedating medications that can be prescribed for psychosis. Although CBD isn’t the cure-all that it’s marketed to be, it certainly has a place in the realm of psychiatric treatment. Research is still underway to determine the efficiency of CBD as a standalone therapy for mental illness, so far the outlook is good.

Dr. Djordjevic provides optimistic insight on the potential value of using CBD, as a tool in psychiatric treatment. 

CBD Use With Psychosis Symptom Treatment

The study, Cannabidiol as a Potential New Type of an Antipsychotic: A Critical Review of the Evidence, concluded that the mechanism by which CBD exerts its antipsychotic properties is by inhibiting FAAH (fatty acid amide hydroxylase) which is responsible for degrading anandamide — a fatty acid neurotransmitter. With less FAAH, the duration of anandamide will be lengthened, which will result in greater CB1 receptor signaling. Studies show that elevations of anandamide in cerebrospinal fluid is correlated with reduced psychotic symptoms. This represents a completely new mechanism in the treatment of schizophrenia.

The Bliss Molecule

Anandamide is known as the “bliss molecule” for good reason. Its name is derived from the Sanskrit word ananda, meaning “happiness, joy, bliss.” Anandamide is a neurotransmitter and endocannabinoid first identified in 1992. It is a key element to experiencing a sense of well-being. It’s also essential in down-regulating both physical and psychological pain response. Biochemically, anandamide exerts an overall modulatory effect on the brain reward circuitry. According to the British Journal of Pharmacology, impaired neurogenesis is often associated with mental unfitness. By targeting the cannabinoid system, as a regulator of neurogenesis, anandamide may provide quality improvement in mood.  According to the Neurohacker Collective article, “What is Neurogenesis?”:

Adult hippocampal neurogenesis, in theory, provides a continuous source of new neurons to support cognitive processes, especially when combined with other existing neuroplastic capacities. The use of cognitive functions and personal experiences result in learning and the formation of new memories. This activity-dependent synaptic remodeling allows the brain to shape connectivity based on current experience and, consequently, make neuronal networks more effective in new cognitive contexts.

Ongoing studies may continue to provide additional evidence that endocannabinoid signaling and hippocampal neurogenesis work as a neuroprotectant and improve the imbalances of psychosis symptoms. 

CBD Selection and Dosage

Dr. Thomas G. O’Brien II, MS, DO, PC, and Executive Director for Health Education Learning Program (HELP) suggests the following CBD selection and dosage while treating patients with chronic pain, behavioral conditions, and psychosis symptoms:

For the entourage effect, a full-spectrum CBD oil over isolates. A very concentrated CBD oil, at least 50-60mg per ML. Also, to buy from a company that has quality assurance measures in place, serial and lot numbers on the packages. CBD should not be taken in the evening. The majority of the population can not tolerate CBD at bedtime. They will have difficulty with getting asleep until the CBD becomes subtherapeutic. I have a very small percentage of patients, 1 percent, who have a paradoxical reaction and can fall asleep with high CBD in their system. Thus, I tell my patients, no CBD after 4-5 p.m., depending on what time they go to bed.

While it is best to start dosages around 25-50mg to start, CBD doses up to 300 mg have led to an increase in neurogenesis. But as per Dr. O’Brien‘s suggestion, it is best to seek professional assistance when making the decision to transitioning into using CBD.

Interaction Of THC vs CBD And Psychosis Symptoms

There is a well-documented correlation between the use of THC (Tetrahydrocannabinol) and psychosis, although it’s not yet understood. One published paper extensively reviewed the association between THC and psychosis. The paper concluded that the use of natural and synthetic THC “can produce a full range of transient symptoms, cognitive deficits, and psychophysiological abnormalities that bear a striking resemblance to some of the features of schizophrenia.”

Exposure to dose-related THC in adolescence, increased the risk for psychosis outcomes in later life.  THC in marijuana may be the triggering factor in symptoms of psychotic mental illnesses. Studies have shown that some young people with a predisposition for mental illness may be drawn to it at an early age. This is mostly due to believed self-medicating. On the other hand, heavy use, as well as earlier and longer exposure, have been linked to early onset psychosis. They further concluded that in individuals with an existing psychotic disorder, the use of THC may cause symptoms to intensify, trigger a relapse, and negate the course of positive action.  Taking CBD is a different story. A systematic review of the antipsychotic properties of CBD in humans concluded:

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 of 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 idea is to enable the endocannabinoid system to run in tip-top shape. This will contribute to the body’s overall homeostasis. 

CBD For Psychosis Symptoms

King’s College London’s study suggests that using cannabidiol has the ability to assist in re-adjusting the brain activity to normal functioning levels. In individuals suffering from psychosis, CBD may help normalize the “cross talk” in regions of the brain, otherwise known as connectors, affiliated with psychosis. Dr. Sagnik Bhattacharyya, from the Institute of Psychiatry, Psychology & Neuroscience (IoPPN) says, “One of the main advantages of cannabidiol is that it is safe and seems to be very well tolerated, making it in some ways an ideal treatment.” These findings are incredibly reassuring as we move forward with treating psychosis with CBD and avoiding the harsh adverse side effects of the traditional “typical” and “atypical” antipsychotics. 

Natural Treatment Choices For Mental Health

Research continues to uncover the use of cannabidiol in the psychiatry field. Current studies are underway in the advancements of using CBD for psychosis symptoms. The outlook is increasingly moving in a positive direction. Fortunately, medical professionals are becoming open to utilizing CBD as an additive to mental health programs. The aim is to build an entire wellness dynamic to obtain an optimal level of comfort. And, without having to add too many adverse effects in the process. CBD has been gaining more exposure for psychiatrists and individuals with mental health disruption. That’s because of its potential as a treatment for mental illness.  Laura Geftman, LCSW and Founder CEO of The Calm, Cool & Collected adds:

While many psychiatrists and other mental health providers alike are hopeful that CBD can help manage their clients’ symptoms, some have begun to recognize the increasing amount of anecdotal evidence and support their clients’ desire to engage in the use of cannabinoid therapy. Others remain hesitant and await further research about efficacy and effectiveness. If interested in pursuing this type of treatment, be sure to engage with a mental health provider who is well informed about cannabis and can support your needs.

With the rise of functional medicine and holistic care treatments, CBD is one of the more accepted tools in the wellness toolbox. Additionally, the continuation of research and education in the area of mental health will aid professionals looking at the individual from a system’s oriented, approach. Mel TMel T is a freelance, investigative writer from New York. She has an energetic pull to discover the deeper meaning of emotions and psychoneuroimmunology. You can find her communicating with animals, working on production sets, a student of martial arts, and stealthily capturing wildlife in a photo.

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