Research Review

Research Review

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Research Review Australia provides clinical research updates. Covering top 10 research studies with commentary by well-known Australian experts. They are a great tool to help nurses keep up to date. Reviews are sent by email and cost nothing to subscribe.
Research Review

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Cannabidiol as an adjunctive therapy in schizophrenia
Authors: McGuire P et al.

Summary: This multi-centre, double-blind, randomised controlled trial followed on from promising animal studies to investigate the antipsychotic efficacy of cannabidiol (CBD) in schizophrenic patients. 88 patients were randomised 1:1 to receive either 1000mg/day CBD (n=43) or placebo (n=45) for 6 weeks in addition to their regular antipsychotic medication. Psychotic symptoms were quantified pre and post-treatment using the Positive and Negative Syndrome Scale (PANSS), the Brief Assessment of Cognition in Schizophrenia, the Global Assessment of Functioning scale and the improvement and severity scales of the Clinical Global Impressions Scale (CGI-I and CGI-S). CBD showed beneficial effects in patients with schizophrenia including decreased levels of positive  psychotic symptoms (PANSS: treatment difference=−1.4, 95% CI=−2.5, −0.2) and increased physician-rated “not as unwell” scores (CGI-S: treatment difference=−0.3, 95% CI=−0.5, 0.0). CBD was well
tolerated with no notable adverse effects.

Comment: It may seem counter-intuitive to many clinicians that a constituent from cannabis may actually be a useful adjunctive treatment in schizophrenia, as consistent data has shown that there is an increased risk in some people of developing a psychotic disorder from cannabis use. It is important to note that this is primarily associated with Tetrahydrocannabinol (THC), THC analogues, and THC-rich strains of cannabis.

There appears, however, to be a role for other cannabinoids such as CBD, which does not have a direct affinity with the psychotropic CB1 receptor. It is of note that this study revealed that CBD in fact reduced ‘positive’ symptoms of schizophrenia, which incidentally typify some of the symptoms that occur in high THC use (e.g. visual and auditory hallucinations, paranoia etc.). Further work is needed to assess this therapeutic approach in a longer-term study to assess whether a treatment effect is maintained. It is also of potential interest to see if other medicinal cannabis constituents may enhance this effect, and whether a low-THC full spectrum whole plant effect can achieve similar or more beneficial outcomes.

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The full article can be found in the American Journal of Psychiatry Click here>>