When we wrote our Risks of CBD post, we mentioned CBD and psychosis as something we would talk more about later. Since it’s a common discussion to see pop up within the CBD community, we thought we’d take the chance to circle back around and clear up some misconceptions or confusion around the topic. Part of this will be by defining the differences between how THC and CBD may potentially impact issues of psychosis, take a look at the research, and evaluate what we currently know. So today we wanted to clear the air, cut through some of the confusion, and discuss the state of science as we know it.

Defining Psychosis

Psychosis, simply put, is when someone loses their grasp on reality. Symptoms of psychosis can range from things like hallucinations, disorganized speech, delusions, mood changes, decreased socialization, and more. According to The Canadian Association for Mental Health, psychosis episodes happen to about 3 out of every 100 people, so it’s not as uncommon a thing to experience as one might think. There’s a range of larger disorders that can include psychosis as a symptom, such as schizophrenia, bipolar, depression, or drug-induced psychosis. For this article, while we mostly discuss cannabis and psychosis, we’ll also be examining some research around cannabis and schizophrenia.

Traditional medication includes antipsychotics, which target heightened levels of a chemical called dopamine and help regulate the release of other neurotransmitters within our brains and bodies. However, these medications are sometimes ineffective and often have challenging side-effects.

A Note About THC

Many conversations about CBD and psychosis don’t revolve around CBD at all, but actually what we know about THC. It’s not uncommon to see questions asked within the community whether or not they should stay away from CBD entirely if schizophrenia runs in their family or if they’ve had issues with psychosis before. However, CBD and THC, while both a type of cannabinoid, are very different compounds and affect us very differently. While this post is specifically discussing CBD and psychosis, we’d be amiss if we didn’t cover what we know about THC, if only to differentiate their effects from each other.

Particularly in reference to youth and cannabis use, there’s been a strong, well-researched association made between the developing of disorders (including schizophrenia) and THC. Essentially, the research we have so far suggests that the rate of schizophrenia is higher in heavy cannabis users. This is the reason why certain people will avoid THC altogether, or why there are often questions raised about CBD and its potential to exasperate issues of psychosis.

However, the link between THC and psychosis is more complicated than one causes the other. While heavy cannabis use is associated with increased risk of developing particular disorders (such as schizophrenia, depression, or anxiety), the extent in which it causes these disorders is heavily debated. This research analysis does find connections between THC use and developed schizophrenia, however, these connections appear to be more highlighted in individuals who already have particular genetic deviances, or are already more at risk of developing mental health challenges. Other variables, such as the aforementioned genetics, age of first use, and how much cannabis is being consumed also seem to have an impact. Ultimately, associations don’t always mean causation, so how much THC use causes disorders is still unconfirmed.

It’s also important to keep in mind that when it comes to mental health conditions, there’s a lot we don’t know yet. How someone develops a condition like schizophrenia is complicated. There are many variables that need to be considered. While there is a strong link between THC and schizophrenia, like we mentioned above, there are a lot of other factors at play as well.

When it comes to psychosis and not necessarily schizophrenia, however, we do know that some of the more adverse side-effects of THC can include psychotic symptoms, such as paranoia, anxiety, and mild delusions. Ultimately, while THC use can perhaps lead to instances of psychosis, whether it causes psychosis related disorders, exasperates the issue in individuals who are already predisposed, or acts with other variables to increase risk, we don’t know enough to say for sure yet.

State of the Science

When it comes to CBD, however, it’s a completely different story. Instead of being investigated as a potential cause of disorders, it’s being explored as a treatment.

One research review and analysis found that CBD may have potential to help treat psychosis, especially early stages of the disorder. In particular, it contrasts with antipsychotic medications in the sense that it may have antipsychotic properties without directly acting on dopamine receptors. This potentially opens up a possibility for a new kind of psychosis management medication. However, the study also cautions against using over-the-counter CBD products for medicinal reasons, and reiterates that more research is needed before we can say anything for certain.

An article published by the Psychiatric Times goes on to describe what little research we have into CBD’s potential to treat schizophrenia and describes inconclusive results: larger doses (1000mgs) were found to be more effective, while smaller doses (600mgs) did no better than the placebo group did. As we’ve spoken about before, CBD dosage is a complicated topic. Without more research, it’s hard to say anything definitively yet. As we know, the type of CBD being used and the unique profile of a product (cannabinoids, terpenes, and flavonoids) may also play a role in how it affects our bodies. With all these variables, it can be hard to pinpoint anything more specific.

This research analysis found that there’s not enough research to make any claims about how CBD impacts schizophrenia. It calls for more studies, particularly around how CBD may have the potential to mitigate some of the effects THC has on exasperating symptoms of schizophrenia.

The Question of Full Spectrum

Although the research is still new and we don’t know enough to say anything for certain yet, CBD may have the potential to influence how THC impacts our bodies. This is particularly important in the case of Full Spectrum CBD, specifically in how THC possibly exasperates issues of psychosis while CBD may improve them. There’s some information to suggest that CBD may have the potential to minimize THC’s psychosis triggering effects. However, the interaction between CBD and THC still needs a lot more research before we can say anything definitively.

On a less positive note, this case study calls for more caution around CBD products, particularly Full Spectrum ones. Within the article is outlined the story of a 17-year old male, who, after smoking a decent amount of Full Spectrum CBD, developed psychosis related symptoms due to the high amounts of THC. However, it’s worth noting that the individual described had been taking other medications at the time (so interaction is possible), and had a history of psychosis related symptoms. Regardless, the caution still remains: consuming large quantities of Full Spectrum will inevitably increase the amount of THC consumed. Sources like WebMD also caution against using Full Spectrum CBD if schizophrenia is a concern due to the THC content.

Medication Interactions or other health warnings

On the note of mental health disorders and medication, including antipsychotics, it’s important to keep in mind that CBD can interact with certain medications and substances. Put simply, CBD can change the way certain medications are metabolized by our system. Essentially, CBD has been found to either increase the amount of medication remaining in your body, or diminish it. Either this means that medication isn’t there when you need it to be, or you’re possibly risking an overdose. While being on the lookout for grapefruit warnings is a good start, it’s always best to check in with your doctor and local health authorities in order to ensure you’re being as safe as possible.

Since CBD and medication interaction is a much larger topic, we’ve spoken about it in more detail here.

TL;DR

When it comes to cannabis and psychosis, it’s a bit of a complex topic. While there are clear links between THC and developing psychosis and schizophrenia, the nature of those links still aren’t clear. In contrast, CBD is currently being investigated as a treatment for both psychosis and schizophrenia, with particular notes about how it might be used to counteract THC’s exasperating qualities. Ultimately, we’re just looking forward to knowing a lot more in the future.