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Cannabidiol as an antipsychotic agent

Published online by Cambridge University Press:  16 April 2020

F.M. Leweke
Affiliation:
Department of Psychiatry and Psychotherapy, University of Cologne, Cologne, Germany
D. Koethe
Affiliation:
Department of Psychiatry and Psychotherapy, University of Cologne, Cologne, Germany
C.W. Gerth
Affiliation:
Department of Psychiatry and Psychotherapy, University of Cologne, Cologne, Germany
B.M. Nolden
Affiliation:
Department of Psychiatry and Psychotherapy, University of Cologne, Cologne, Germany
D. Schreiber
Affiliation:
Department of Psychiatry and Psychotherapy, University of Cologne, Cologne, Germany
S. Gross
Affiliation:
Department of Psychiatry and Psychotherapy, University of Cologne, Cologne, Germany
F. Schultze-Lutter
Affiliation:
Department of Psychiatry and Psychotherapy, University of Cologne, Cologne, Germany
M. Hellmich
Affiliation:
Institute for Medical Statistics, Informatics and Epidemiology, University of Cologne, Cologne, Germany
J. Klosterkotter
Affiliation:
Department of Psychiatry and Psychotherapy, University of Cologne, Cologne, Germany

Abstract

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Background

The human endocannabinoid system interacts with various neurotransmitter systems and the endocannabinoid anandamide was found significantly elevated in CSF and inversely correlated to psychopathology (Giuffrida et al. 2004) providing a link to the neurobiology of schizophrenia. While delta-9-tetrahydrocannabinol, the psychoactive compound of Cannabis sativa, shows psychedelic properties, the major herbal cannabinoid compound cannabidiol was suggested recently a re-uptake inhibitor of anandamide. In addition potential antipsychotic properties have been hypothezised.

Methods

We performed an explorative, 4-week, double-blind, controlled clinical trial on the effects of purified cannabidiol in acute schizophrenia compared to the antipsychotic amisulpride. The antipsychotic properties of both drugs were the primary target of the study. Furthermore, side-effects and anxiolytic capabilities of both treatments were investigated.

Results

42 patients fulfilling DSM-IV criteria of acute paranoid schizophrenia or schizophreniform psychosis participated in the study. Both treatments were associated with a significant decrease of psychotic symptoms after 2 and 4 weeks as assessed by BPRS and PANSS. However, there was no statistical difference between both treatment groups. In contrast, cannabidiol induced significantly less side effects (EPS, increase in prolactin, weight gain) when compared to amisulpride.

Conclusions

Cannabidiol proved substantial antipsychotic properties in acute schizophrenia. This is in line with our suggestion of an adaptive role of the endocannabinoid system in paranoid schizophrenia, and raises further evidence that this adaptive mechanism may represent a valuable target for antipsychotic treatment strategies.

The Stanley Medical Research Institute (00-093 to FML) and the Koeln Fortune Program (107/2000 + 101/2001 to FML) funded this study.

Type
S14. Symposium: Neurocognitive and Clinical Effects of Cannabinoids
Copyright
Copyright © European Psychiatric Association 2007
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