Background: Preclinical data implicate the endocannabinoid system in the pathology underlying obsessive-compulsive disorder (OCD), while survey data have linked OCD symptoms to increased cannabis use. Cannabis products are increasingly marketed as treatments for anxiety and other OCD-related symptoms. Yet, few studies have tested the acute effects of cannabis on psychiatric symptoms in humans.
Methods: We recruited 14 adults with OCD and prior experience using cannabis to enter a randomized, placebo-controlled, human laboratory study to compare the effects on OCD symptoms of cannabis containing varying concentrations of Δ-9-tetrahydrocannabinol (THC) and cannabidiol (CBD) on OCD symptoms to placebo. We used a within-subjects design to increase statistical power. Across three laboratory sessions, participants smoked three cannabis varietals in random order: placebo (0% THC/0% CBD); THC (7.0% THC/0.18% CBD); and CBD (0.4% THC/10.4% CBD). We analyzed acute changes in OCD symptoms, state anxiety, cardiovascular measures, and drug-related effects (e.g., euphoria) as a function of varietal.
Results: Twelve participants completed the study. THC increased heart rate, blood pressure, and intoxication compared with CBD and placebo. Self-reported OCD symptoms and anxiety decreased over time in all three conditions. Although OCD symptoms did not vary as a function of cannabis varietal, state anxiety was significantly lower immediately after placebo administration relative to both THC and CBD.
Conclusions: This is the first placebo-controlled investigation of cannabis in adults with OCD. The data suggest that smoked cannabis, whether containing primarily THC or CBD, has little acute impact on OCD symptoms and yields smaller reductions in anxiety compared to placebo.
Keywords: THC; anxiety; cannabidiol; cannabinoids; cannabis; marijuana; obsessive-compulsive disorder.
© 2020 Wiley Periodicals, Inc.
A randomised controlled trial of vaporised Δ9-tetrahydrocannabinol and cannabidiol alone and in combination in frequent and infrequent cannabis users: acute intoxication effects.Eur Arch Psychiatry Clin Neurosci. 2019 Feb;269(1):17-35. doi: 10.1007/s00406-019-00978-2. Epub 2019 Jan 19. Eur Arch Psychiatry Clin Neurosci. 2019. PMID: 30661105 Clinical Trial.
Acute effects of delta-9-tetrahydrocannabinol, cannabidiol and their combination on facial emotion recognition: a randomised, double-blind, placebo-controlled study in cannabis users.Eur Neuropsychopharmacol. 2015 Mar;25(3):325-34. doi: 10.1016/j.euroneuro.2014.11.014. Epub 2014 Dec 5. Eur Neuropsychopharmacol. 2015. PMID: 25534187 Free PMC article. Clinical Trial.
Oral Cannabidiol does not Alter the Subjective, Reinforcing or Cardiovascular Effects of Smoked Cannabis.Neuropsychopharmacology. 2016 Jul;41(8):1974-82. doi: 10.1038/npp.2015.367. Epub 2015 Dec 28. Neuropsychopharmacology. 2016. PMID: 26708108 Free PMC article. Clinical Trial.
Cannabis-based medicines--GW pharmaceuticals: high CBD, high THC, medicinal cannabis--GW pharmaceuticals, THC:CBD.Drugs R D. 2003;4(5):306-9. doi: 10.2165/00126839-200304050-00005. Drugs R D. 2003. PMID: 12952500 Review.
Acute effects of a single, oral dose of d9-tetrahydrocannabinol (THC) and cannabidiol (CBD) administration in healthy volunteers.Curr Pharm Des. 2012;18(32):4966-79. doi: 10.2174/138161212802884780. Curr Pharm Des. 2012. PMID: 22716148 Review.
- American Psychiatric Association (2014). Diagnostic and statistical manual of mental disorders: DSM-5. American Psychiatric Association. Retrieved from https://doi.org/10.1176/appi.books.9780890425596.744053
- Apergis-Schoute, A. M., Gillan, C. M., Fineberg, N. A., Fernandez-Egea, E., Sahakian, B. J., & Robbins, T. W. (2017). Neural basis of impaired safety signaling in obsessive compulsive disorder. Proceedings of the National Academy of Sciences of the United States of America, 114(12), 3216-3221. https://doi.org/10.1073/pnas.1609194114
- Bergamaschi, M. M., Queiroz, R. H. C., Chagas, M. H. N., deOliveira, D. C. G., De Martinis, B. S., Kapczinski, F., … Crippa, J. A. S. (2011). Cannabidiol reduces the anxiety induced by simulated public speaking in treatment-naïve social phobia patients. Neuropsychopharmacology, 36(6), 1219-1226. https://doi.org/10.1038/npp.2011.6
- Chait, L. D., Evans, S. M., Grant, K. A., Kamien, J. B., Johanson, C. E., & Schuster, C. R. (1988). Discriminative stimulus and subjective effects of smoked marijuana in humans. Psychopharmacology, 94(2), 206-212. https://doi.org/10.1007/bf00176846
- Cohen, K., Weizman, A., & Weinstein, A. (2019). Modulatory effects of cannabinoids on brain neurotransmission. The European Journal of Neuroscience, 50(3), 2322-2345. https://doi.org/10.1111/ejn.14407