Cannabidiol for the treatment of psychosis among patients with schizophrenia and other primary psychotic disorders: A systematic review with a risk of bias assessment

Maykel Farag Ghabrash; Stephanie Coronado-Montoya; John Aoun; Andrée-Anne Gagné; Flavi Mansour; Clairélaine Ouellet-Plamondon; Annie Trépanier; Didier Jutras-Aswad

doi:10.1016/j.psychres.2020.112890

Cannabidiol for the treatment of psychosis among patients with schizophrenia and other primary psychotic disorders: A systematic review with a risk of bias assessment

Psychiatry Res. 2020 Feb 21:286:112890. doi: 10.1016/j.psychres.2020.112890. Online ahead of print.

Authors

Maykel Farag Ghabrash¹, Stephanie Coronado-Montoya², John Aoun¹, Andrée-Anne Gagné¹, Flavi Mansour¹, Clairélaine Ouellet-Plamondon¹, Annie Trépanier³, Didier Jutras-Aswad⁴

Affiliations

¹ Research Center, Centre Hospitalier de l'Université de Montréal (CHUM), 900 St-Denis Street, Montréal, QC, Canada, H2X0A9; Department of Psychiatry and Addiction, Faculty of Medicine, Université de Montréal, 2900 Édouard-Montpetit Boulevard, Room S-750, Montréal, QC, Canada, H3T 1J4.
² Research Center, Centre Hospitalier de l'Université de Montréal (CHUM), 900 St-Denis Street, Montréal, QC, Canada, H2X0A9; Department of Psychiatry and Addiction, Faculty of Medicine, Université de Montréal, 2900 Édouard-Montpetit Boulevard, Room S-750, Montréal, QC, Canada, H3T 1J4. Electronic address: stephanie.coronado-montoya@umontreal.ca.
³ Research Center, Centre Hospitalier de l'Université de Montréal (CHUM), 900 St-Denis Street, Montréal, QC, Canada, H2X0A9.
⁴ Research Center, Centre Hospitalier de l'Université de Montréal (CHUM), 900 St-Denis Street, Montréal, QC, Canada, H2X0A9; Department of Psychiatry and Addiction, Faculty of Medicine, Université de Montréal, 2900 Édouard-Montpetit Boulevard, Room S-750, Montréal, QC, Canada, H3T 1J4. Electronic address: didier.jutras-aswad@umontreal.ca.

PMID: 32126328
DOI: 10.1016/j.psychres.2020.112890

Abstract

Current treatments for primary psychotic disorders include antipsychotics, some of which have significant side effects or suboptimal efficacy. Cannabidiol is a cannabinoid with potential antipsychotic properties. This systematic review examines the use of cannabidiol as an antipsychotic treatment for primary psychotic disorders. CINAHL, EBM, EMBASE, MEDLINE and PubMed databases were searched from 1970 to 2019 for experimental and observational studies evaluating the antipsychotic and cognitive modulation properties of cannabidiol in individuals with psychotic disorders. There were eight eligible studies evaluating the antipsychotic potential of cannabidiol, involving a total of 210 participants. Due to study heterogeneity, we present the extracted data on general psychopathology, positive and negative symptoms, cognition and functioning outcomes as a narrative synthesis. We found limited evidence supporting antipsychotic efficacy for cannabidiol and none supporting its benefits for cognition or functioning. Cannabidiol treatment had an advantageous side effect profile compared to other antipsychotics and was well tolerated across studies. Observational studies had a higher risk of bias than experimental studies. Factors potentially contributing to variability in outcome results included cannabidiol dosage, treatment duration, use as an adjunctive treatment and participant inclusion criteria, which warrant further investigation to determine whether cannabidiol can be effective as a treatment for psychosis.

Keywords: Cannabinoid; Cannabis; Experimental; Reviews.

Publication types

Review