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Cannabidiol (CBD) as an Adjunctive Therapy in Schizophrenia: A Multicenter Randomized Controlled Trial.
Am J Psychiatry. 2018 03 01; 175(3):225-231.AJ

Abstract

OBJECTIVE

Research in both animals and humans indicates that cannabidiol (CBD) has antipsychotic properties. The authors assessed the safety and effectiveness of CBD in patients with schizophrenia.

METHOD

In an exploratory double-blind parallel-group trial, patients with schizophrenia were randomized in a 1:1 ratio to receive CBD (1000 mg/day; N=43) or placebo (N=45) alongside their existing antipsychotic medication. Participants were assessed before and after treatment using the Positive and Negative Syndrome Scale (PANSS), the Brief Assessment of Cognition in Schizophrenia (BACS), the Global Assessment of Functioning scale (GAF), and the improvement and severity scales of the Clinical Global Impressions Scale (CGI-I and CGI-S).

RESULTS

After 6 weeks of treatment, compared with the placebo group, the CBD group had lower levels of positive psychotic symptoms (PANSS: treatment difference=-1.4, 95% CI=-2.5, -0.2) and were more likely to have been rated as improved (CGI-I: treatment difference=-0.5, 95% CI=-0.8, -0.1) and as not severely unwell (CGI-S: treatment difference=-0.3, 95% CI=-0.5, 0.0) by the treating clinician. Patients who received CBD also showed greater improvements that fell short of statistical significance in cognitive performance (BACS: treatment difference=1.31, 95% CI=-0.10, 2.72) and in overall functioning (GAF: treatment difference=3.0, 95% CI=-0.4, 6.4). CBD was well tolerated, and rates of adverse events were similar between the CBD and placebo groups.

CONCLUSIONS

These findings suggest that CBD has beneficial effects in patients with schizophrenia. As CBD's effects do not appear to depend on dopamine receptor antagonism, this agent may represent a new class of treatment for the disorder.

Authors+Show Affiliations

From the Department of Psychosis Studies, Institute of Psychiatry, Psychology, and Neuroscience, King's College London; the Department of Psychiatry, Medical University of Gdansk, Gdansk, Poland; the Department of Psychiatry, "Dr. Carol Davila" Central Military Emergency University Hospital, Bucharest, Romania; GW Pharmaceuticals and the Cannabinoid Research Institute, Research and Development, GW Pharmaceuticals, Cambridge, U.K.From the Department of Psychosis Studies, Institute of Psychiatry, Psychology, and Neuroscience, King's College London; the Department of Psychiatry, Medical University of Gdansk, Gdansk, Poland; the Department of Psychiatry, "Dr. Carol Davila" Central Military Emergency University Hospital, Bucharest, Romania; GW Pharmaceuticals and the Cannabinoid Research Institute, Research and Development, GW Pharmaceuticals, Cambridge, U.K.From the Department of Psychosis Studies, Institute of Psychiatry, Psychology, and Neuroscience, King's College London; the Department of Psychiatry, Medical University of Gdansk, Gdansk, Poland; the Department of Psychiatry, "Dr. Carol Davila" Central Military Emergency University Hospital, Bucharest, Romania; GW Pharmaceuticals and the Cannabinoid Research Institute, Research and Development, GW Pharmaceuticals, Cambridge, U.K.From the Department of Psychosis Studies, Institute of Psychiatry, Psychology, and Neuroscience, King's College London; the Department of Psychiatry, Medical University of Gdansk, Gdansk, Poland; the Department of Psychiatry, "Dr. Carol Davila" Central Military Emergency University Hospital, Bucharest, Romania; GW Pharmaceuticals and the Cannabinoid Research Institute, Research and Development, GW Pharmaceuticals, Cambridge, U.K.From the Department of Psychosis Studies, Institute of Psychiatry, Psychology, and Neuroscience, King's College London; the Department of Psychiatry, Medical University of Gdansk, Gdansk, Poland; the Department of Psychiatry, "Dr. Carol Davila" Central Military Emergency University Hospital, Bucharest, Romania; GW Pharmaceuticals and the Cannabinoid Research Institute, Research and Development, GW Pharmaceuticals, Cambridge, U.K.From the Department of Psychosis Studies, Institute of Psychiatry, Psychology, and Neuroscience, King's College London; the Department of Psychiatry, Medical University of Gdansk, Gdansk, Poland; the Department of Psychiatry, "Dr. Carol Davila" Central Military Emergency University Hospital, Bucharest, Romania; GW Pharmaceuticals and the Cannabinoid Research Institute, Research and Development, GW Pharmaceuticals, Cambridge, U.K.From the Department of Psychosis Studies, Institute of Psychiatry, Psychology, and Neuroscience, King's College London; the Department of Psychiatry, Medical University of Gdansk, Gdansk, Poland; the Department of Psychiatry, "Dr. Carol Davila" Central Military Emergency University Hospital, Bucharest, Romania; GW Pharmaceuticals and the Cannabinoid Research Institute, Research and Development, GW Pharmaceuticals, Cambridge, U.K.From the Department of Psychosis Studies, Institute of Psychiatry, Psychology, and Neuroscience, King's College London; the Department of Psychiatry, Medical University of Gdansk, Gdansk, Poland; the Department of Psychiatry, "Dr. Carol Davila" Central Military Emergency University Hospital, Bucharest, Romania; GW Pharmaceuticals and the Cannabinoid Research Institute, Research and Development, GW Pharmaceuticals, Cambridge, U.K.

Pub Type(s)

Journal Article
Multicenter Study
Randomized Controlled Trial
Research Support, Non-U.S. Gov't

Language

eng

PubMed ID

29241357

Citation

McGuire, Philip, et al. "Cannabidiol (CBD) as an Adjunctive Therapy in Schizophrenia: a Multicenter Randomized Controlled Trial." The American Journal of Psychiatry, vol. 175, no. 3, 2018, pp. 225-231.
McGuire P, Robson P, Cubala WJ, et al. Cannabidiol (CBD) as an Adjunctive Therapy in Schizophrenia: A Multicenter Randomized Controlled Trial. Am J Psychiatry. 2018;175(3):225-231.
McGuire, P., Robson, P., Cubala, W. J., Vasile, D., Morrison, P. D., Barron, R., Taylor, A., & Wright, S. (2018). Cannabidiol (CBD) as an Adjunctive Therapy in Schizophrenia: A Multicenter Randomized Controlled Trial. The American Journal of Psychiatry, 175(3), 225-231. https://doi.org/10.1176/appi.ajp.2017.17030325
McGuire P, et al. Cannabidiol (CBD) as an Adjunctive Therapy in Schizophrenia: a Multicenter Randomized Controlled Trial. Am J Psychiatry. 2018 03 1;175(3):225-231. PubMed PMID: 29241357.
* Article titles in AMA citation format should be in sentence-case
TY - JOUR T1 - Cannabidiol (CBD) as an Adjunctive Therapy in Schizophrenia: A Multicenter Randomized Controlled Trial. AU - McGuire,Philip, AU - Robson,Philip, AU - Cubala,Wieslaw Jerzy, AU - Vasile,Daniel, AU - Morrison,Paul Dugald, AU - Barron,Rachel, AU - Taylor,Adam, AU - Wright,Stephen, Y1 - 2017/12/15/ PY - 2017/12/16/pubmed PY - 2018/12/28/medline PY - 2017/12/16/entrez KW - Cannabidiol KW - Clinical Trial KW - Psychosis KW - Schizophrenia KW - Treatment SP - 225 EP - 231 JF - The American journal of psychiatry JO - Am J Psychiatry VL - 175 IS - 3 N2 - OBJECTIVE: Research in both animals and humans indicates that cannabidiol (CBD) has antipsychotic properties. The authors assessed the safety and effectiveness of CBD in patients with schizophrenia. METHOD: In an exploratory double-blind parallel-group trial, patients with schizophrenia were randomized in a 1:1 ratio to receive CBD (1000 mg/day; N=43) or placebo (N=45) alongside their existing antipsychotic medication. Participants were assessed before and after treatment using the Positive and Negative Syndrome Scale (PANSS), the Brief Assessment of Cognition in Schizophrenia (BACS), the Global Assessment of Functioning scale (GAF), and the improvement and severity scales of the Clinical Global Impressions Scale (CGI-I and CGI-S). RESULTS: After 6 weeks of treatment, compared with the placebo group, the CBD group had lower levels of positive psychotic symptoms (PANSS: treatment difference=-1.4, 95% CI=-2.5, -0.2) and were more likely to have been rated as improved (CGI-I: treatment difference=-0.5, 95% CI=-0.8, -0.1) and as not severely unwell (CGI-S: treatment difference=-0.3, 95% CI=-0.5, 0.0) by the treating clinician. Patients who received CBD also showed greater improvements that fell short of statistical significance in cognitive performance (BACS: treatment difference=1.31, 95% CI=-0.10, 2.72) and in overall functioning (GAF: treatment difference=3.0, 95% CI=-0.4, 6.4). CBD was well tolerated, and rates of adverse events were similar between the CBD and placebo groups. CONCLUSIONS: These findings suggest that CBD has beneficial effects in patients with schizophrenia. As CBD's effects do not appear to depend on dopamine receptor antagonism, this agent may represent a new class of treatment for the disorder. SN - 1535-7228 UR - https://www.unboundmedicine.com/medline/citation/29241357/Cannabidiol__CBD__as_an_Adjunctive_Therapy_in_Schizophrenia:_A_Multicenter_Randomized_Controlled_Trial_ L2 - https://ajp.psychiatryonline.org/doi/10.1176/appi.ajp.2017.17030325?url_ver=Z39.88-2003&rfr_id=ori:rid:crossref.org&rfr_dat=cr_pub=pubmed DB - PRIME DP - Unbound Medicine ER -