Cannabinoids in treatment of psychiatric disorders: an overview

Research into non-psychoactive cannabinoids, particularly cannabidiol (CBD), as possible therapy in psychiatric disorders is expanding. The endocannabinoid system, a complex cell-signaling part of the central and peripheral nervous systems (and the reason humans are sensitive to cannabinoids), is pivotal to the regulation of emotion and cognition, and cannabinoids act variously in antidepressant, antipsychotic, and anxiolytic ways, promising therapeutic potential of enormous range. The data fund is expanding very quickly. Post-mortem studies, for example, now report endocannabinoid abnormalities in depression, suicide, and schizophrenia. Another study, astonishingly, even correlates variants in cannabinoid receptor 1 gene with personality.  That there should be value in pharmaceutical exogenous cannabinoids in psychiatry is therefore not surprising. The field is exploding with discoveries. 

What follows is a synopsis of the current state of cannabinoid research in psychiatric disorders. Most of it is extremely encouraging, and it’s why the pace of research, at PureForm and elsewhere, continues to rise so dramatically. 

Animal experiments and clinical studies have shown that endocannabinoid pathway impairment is present indepression. Administration of CB1 agonists and anandamide degradation inhibitors repairs this, or else adjusts for it. CBD appears to attenuate motivational dysfunction, too, partly by activating the 5-HT1A receptor. Isolating mechanisms like this may identify pinpoint targets for drug development; it is just as likely that the multi-target action of molecules like CBD will itself be a valuable polypharmacology.

There is growing evidence for endocannabinoid pathways inanxiety. Cannabinoid signaling is a clear mediator in the General Adaptation Syndrome, a well understood response to acute and chronic stress. CBD seems to be a very promising drug for the treatment of anxiety, therefore, and alsopanic disorder. Studies so far are limited to acute dosing, and are not yet numerous in clinical populations. 

Long-term stress, particularly early in life, increases predisposition to subsequent psychopathologies. The endocannabinoid system, being a regulatory buffer between memories and emotional responses, is implicated in the etiology ofpost-traumatic stress disorder. This is probably why cannabis use occurs so frequently with PTSD, and why PTSD nightmares are treated sometimes with THC or synthetic analogues. Non-psychoactive cannabinoids, like CBD and WIN55,212-2 and others, appear to block long-lasting behavioral consequences of threat stress. In animal models, cannabinoids administered shortly after exposure to traumatic events have been found to prevent the development of PTSD-like symptoms. The mechanism is not completely understood, but it seems to involve mediation of memory processes and the facilitation of fear extinction. 

CBD has been shown to inhibitobsessive-compulsive behavior. Pre-clinical studies in marble-burying behavior in mice show that enhancing receptor site function not only mitigates established compulsion but prevents the shift from goal-oriented action to habit formation. These are animal studies, of course, and do not apply directly to particular disorders in humans. Inconclusive trials, of THC, have been undertaken intrichotillomania andTourette’s Syndrome, but no human trials so far have tested non-psychoactive cannabinoids in any form of OCD. 

There is a small amount of evidence that allows a hypothetical link between defects in the endocannabinoid system andeating disorders. Patients sufferinganorexia andbulimia show unusual gene polymorphisms related to cannabinoid receptor site 1, notably. It is not clear what this means, but it is known that CB1 agonists do tend to increase food intake. This supports the idea that drugs might be devised that can modulate the endocannabinoid system in eating-disorders-pathologies.

Cannabis use in patients withbipolar disorder is markedly high. Some evidence points to early cannabis use and early onset, and increased severity. Occasional reports suggest the possibility of therapeutic effects, but no evidence yet exists that cannabinoids are of clinical use in this disorder. 

Evidence is mounting that CBD, and at least two synthetic analogues, can ameliorate symptoms ofschizophrenia, acting very like atypical antipsychotic drugs. This is reasonable to expect, because both cannabinoid receptor site genes are considered to be positional and functional candidates for the development of schizophrenia, and CR1 is known to regulate dopamine signaling in the hippocampus and the cerebral cortex. CBD is showing promise in particular, and is well tolerated in patients, eliciting fewer side effects than conventional drugs. CBD even seems to reverse thepsychosis known to associate with THC. The pathways in psychosis are complex, and studies to date are limited and contradictory, but ambitious and well-warranted research is underway. 

Preliminary study suggests that CBD may have therapeutic potential for treatment ofsleep disorders, like insomnia, REM sleep behavior disorder, and excessive daytime sleepiness. Findings are mixed yet. It is of interest that CBD does affect circadian clock regulation.

There is recent speculation that cannabinoids, especially CBD, could be a treatment for symptoms and comorbidities ofautism spectrum disorder. There is, however (as of 2019), no convincing data showing any efficacy of cannabinoid treatment in this disorder. 

PureForm CBD™ is bioidentical to CBD extracted from hemp and cannabis but without residual cannabinoids like THC or any of the impurities or chemicals associated with plant-derived production processes. Our molecular assembly technique, that synthesizes CBD from aromatic terpenes instead of cannabis, assures you the food and pharmaceutical-grade quality that you need for quality-conscious customers. If you are interested in PureForm CBD™ or want to partner on any other of the 140+ known cannabinoids, please contact Damian Peters at 310-666-4869, or email  info@pureformglobal.com. 

The foregoing is a report on trends and developments in the cannabinoid industry. No product described herein is intended to diagnose, treat, cure or prevent any disease or syndrome.