Many people say CBD helps them manage health issues like pain, anxiety, sleep trouble, and PTSD. CBD is short for cannabidiol, a natural compound in cannabis (also known as marijuana) and hemp plants. It has the same chemical makeup as cannabis but doesn’t cause a high.
In 2018, the FDA approved a form of CBD to treat seizures in children. Scientists are also studying CBD oil — the most concentrated form — for dozens of other health conditions, including schizophrenia.
Joseph Pierre, MD, a psychiatrist and professor at the University of California, Los Angeles, says CBD’s potential role in schizophrenia treatment starts with tetrahydrocannabinol (THC), the compound in cannabis that causes a high. THC can cause psychotic symptoms in some people, he says. And long-time cannabis users, especially those who start when they’re young, may be more likely to get a disorder like schizophrenia.
“Since CBD opposes some of the effects of THC in the brain, it makes sense it could be useful in treating psychotic disorders,” Pierre says. “There’s also some evidence that CBD has properties similar to antipsychotic drugs.”
But Pierre says people with schizophrenia shouldn’t try CBD on their own. The risks and benefits aren’t clear, and products sold without a prescription don’t always contain what they claim.
“We have many FDA-approved medications from plant sources,” Pierre says. “For example, the heart medication digoxin is derived from the foxglove plant. But if someone needs digoxin, I wouldn’t recommend they go pick some foxglove, bake it into a brownie, and eat it.”
Peter Bongiorno, ND, a naturopath and acupuncturist in New York, prescribes CBD for some people as part of an approach that includes lifestyle changes, balanced hormones, and lower levels of inflammation. He urges those who take other medicines or who have mental health conditions to “work with someone who has experience with CBD.”
If you have schizophrenia but antipsychotic medications don’t work for you or have serious side effects, you might be tempted to give CBD oil a try. But there are some important things to keep in mind.
Because of its link to schizophrenia or psychotic episodes, THC is strictly off-limits if you have schizophrenia or if it runs in your family. So it’s crucial to know what you’re getting. That’s not easy, because the market is flooded with products. Many don’t contain what the label claims, and the terms may be confusing.
Do your research
How much to take
“If you’re going to use CBD for mental health, ask your practitioner for a high-quality version you can take in a prescribed dosage,” Bongiorno says. That amount can vary. “The studies tend to use pure CBD, which requires a higher dose. I use CBD with other cannabinoids at lower doses.” He might start patients at 15 milligrams once or twice a day with food. But most studies have used a daily dose of 600 to 1,000 milligrams.
CBD is normally very safe but can have side effects in some people. The most common are dry mouth, feeling dizzy or irritable, anxiety, diarrhea, and nausea. There’s a chance of liver damage at very high doses. “I certainly wouldn’t recommend drinking 30 grams (3,000 milligrams) of CBD oil at a time,” Deans says.
CBD can affect how your body handles other medicines. This means you may have higher or lower amounts in your blood than you should. Penn State University researchers found 60 drugs that interact with CBD or cannabis. Be extra careful if you take blood thinners, heart medicine, or drugs that weaken your immune system after transplant surgery. Pierre says that even some psychiatric medicines, including antipsychotics, could interact with CBD. If you take any prescription meds, ask your doctor if CBD is safe to use.
Joseph Pierre, MD, acting chief of Community Care Systems at the VA West Los Angeles Healthcare Center and clinical professor in the Department of Psychiatry and Behavioral Sciences, UCLA.
National Center for Complementary and Integrative Health: “Cannabis (Marijuana) and Cannabinoids: What You Need to Know.”
Peter Bongiorno, ND, naturopath and acupuncturist, InnerSource Natural Health and Acupuncture, New York City and Long Island.
Journal of Clinical Medicine Research: “Dosage, Efficacy and Safety of Cannabidiol Administration in Adults: A Systematic Review of Human Trials.”
Pennsylvania State University, College of Medicine, Department of Pharmacology: “NTI Meds to be Closely Monitored when Co-administered with Cannabinoids.”
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