Is CBD the Future of Antipsychotic Drugs? 

The medicinal properties of cannabidiol – often referred to as CBD – have long captured the imagination of researchers. And it's not surprising.

Recent studies have revealed that CBD may help to alleviate symptoms of many conditions. The aim is to see if it can unlock a new means for treating psychotic disorders.

Psychotic conditions like schizophrenia affect millions of people globally. The symptoms of psychosis are diverse and usually debilitating. They can include hallucinations, delusions and confused or troubled thoughts.

Typical antipsychotics like quetiapine and olanzapine are frequently used to treat psychosis and work by blocking dopamine receptors in the brain. They were initially conceived in the 1950s and helped to revolutionise the treatment of psychotic disorders.

However, they don't work for everyone and can induce severe side effects. Most people with psychosis have no choice but to take them regardless, as there are no alternatives.

This is why it is essential to explore avenues for new therapies. Particularly those that do not rely on an agent that unbalances the dopamine system. CBD, therefore, presents one such avenue for investigation.

A growing body of evidence has found that CBD may reduce the symptoms of psychosis. Instead of affecting the dopamine system like existing antipsychotics, CBD works partially by modulating the body's endocannabinoid system, which modulates neurotransmitters, metabolism and inflammation.

Led by Oxford University and supported by King's College London, the STEP (Stratification and Treatment in Early Psychosis) programme is the first of its kind.

The team will use a CBD drug product already licensed and used in clinical practice to treat severe epilepsy. The study is enormous in scale and ambition, spanning 38 sites in 11 countries and three clinical trials.
The team will assess 1,000 participants before and after treatment using a range of neuroimaging techniques to clarify how CBD acts to produce its effects. 

Alongside this, researchers will use a range of clinical, cognitive, neuroimaging and blood measures to identify biological signposts indicating if a patient might respond well to the treatment. 
The data will then be used to investigate whether CBD is viable not only for treating those with established psychosis but also as a preventative measure in those at high risk of developing it.

Existing therapies for psychosis are restricted; they can have substantial side effects, which may encourage patients to stop taking them altogether. This is alongside the fact that they don't work for everyone from the start. Studies such as this offer optimism in finding new treatments that could be effective at numerous stages of psychotic disorders. Medicines may also be supplied with considerably more personalisation to the individual patient.

If successful, this study could aid transformational change by finding new and improved ways to intervene in anxiety, depression and psychosis as early as possible.