schizophrenia

Does Cannabis Affect Schizophrenia?

Schizophrenia is a hugely misunderstood mental health condition that has been wrongly stigmatised by the media for many years, leading many to believe that those suffering from the condition have a ‘split-personality’ or are a threat to society due to the delusions they experience. In actuality, although the condition is often severe, very few people affected are violent or a threat to others.

According to the World Health Organisation, schizophrenia affects approximately 21 million people worldwide, while the Royal College of Psychiatrists estimates that schizophrenia ‘affects around 1 in every 100 people over the course of their life’. This prevalence increases for members of some ethnic minority groups and for those who have a parent affected by the condition, in which case the likelihood of experiencing the condition jumps to 1 in 10. For those who have a brother or sister with the condition, the chance of also contracting the condition is around 1 in 8.

What are the symptoms of schizophrenia?

The most easily recognisable symptoms of schizophrenia are hallucinations and delusions. Aside from these symptoms, there are many other characteristics of the condition. These include:

  • Losing the motivation to carry out regular, everyday activities.
  • Finding it hard to care about your personal hygiene as you normally would.
  • Feeling like you want to avoid people and friends, perhaps because it’s common for schizophrenics to feel suspicious of acquaintances or strangers as part of their disorder.
  • Confusion of thoughts.

Often, the symptoms of schizophrenia will be classified within two different categories: ‘positive’ and ‘negative’.

Positive symptoms refer to the behaviours that start to occur as a result of the condition, for instance hearing voices, experiencing delusions and seeing things.

Negative symptoms refer to the behaviours that you begin to lack as a result of the condition, for instance losing the motivation to engage in activities you once enjoyed, feeling a disconnect from your emotions and generally feeling more lethargic.

Can schizophrenia be treated?

Yes, schizophrenia can be treated, although treatment simply lessens the effects of the symptoms upon your life as opposed to curing the condition completely. The NHS highlights that while many people recover from the illness, relapses where symptoms return are common.

Conventionally, schizophrenia is treated through using a combination of medicines and therapies like CBT (cognitive behavioural therapy). When used together, these therapies should help the affected person to understand their thoughts more clearly, lessen the strength of their hallucinations and make them feel more motivated overall.

However, with the wrong kind of medication, or too high a dosage, motivation may be decreased, often leaving the sufferer feeling deflated and depressed.

Can cannabis help?

The endocannabinoid appears to play a vital role in the symptom management and aetiology of schizophrenia and is one of the main areas, in regard to mental health study, where translational neuroscience studies have been carried out.

Generally, a person’s unique genetic endocannabinoid biology and expression of certain receptors in the system will affect their individual response to cannabis-based medicines. It seems logical then that in the future, personalised medicine in this area may become more common, with companies even starting to test patients’ individual genetics to see whether this will predict their response to CBMPs (cannabis-based medicinal products).

What the studies say:

In a case study involving a severe case of schizophrenia carried out by Makiol et. al. (2019) adjunctive cannabidiol was added to the patient’s treatment using a dosing regimen that started with 500mg two times a day and then increased up to 750mg two times a day. In the previously treatment-resistant patient, the CBD treatment helped to combat negative symptoms by enabling the patient to restore her motivation as measured by PANSS scale. This treatment also helped with the patient’s positive symptoms by helping to rid her of her auditory hallucinations.

A study by Leweke et. al (2012) found that cannabidiol (CBD) exhibited a reduction in symptoms of schizophrenia similar to that exhibited by other antipsychotics. It was also linked with higher levels of circulating Anandamide in the participants’ blood. This study therefore suggests further research should be carried out on the endocannabinoid system and how cannabinoids can aid in symptom relief.

In a case series by Zuardi et. al. (2006), schizophrenia patients took part in a trial using CBD as a monotherapy to assess its anti-psychotic properties. While one patient showed mild improvement here, two other patients showed no response to oral CBD (cannabidiol) treatment.

When analysing the hair samples of cannabis users, Morgan et. al. (2008) correlated the content of CBD (cannabidiol) alone, THC (tetrahydrocannabinol) alone or a combination of both of theses cannabinoids to the intensity of positive and negative schizophrenia-like symptoms in the different groups. The researchers’ results showed that people with more positive schizophrenia-like symptoms were more likely to have a higher THC content and lower CBD content habit.

When investigating a group of cannabis-using schizophrenic patients, Van Amsterdam (2018) found that cannabinoid therapies involving high THC should be suggested as a serious risk factor and complication. The researchers therefore suggested non-cannabis or low THC-cannabis and high-CBD based therapies for people with high risk schizophrenia should be explored and investigated further by researchers.

Looking forward

As you can tell from the studies above, there is conflicting evidence in this area currently, with many more studies needed if we’re going to garner conclusions that are definitive and cohesive.

As things currently stand, the effects of cannabis-based treatment on the symptoms of schizophrenia are unclear, highlighting the need for larger patient studies to be carried out so the results of such studies can be deemed appropriate and accurate for the wider public rather than just a select group of individuals.

For more information on these studies and the treatment of schizophrenia using medical cannabis, take a look at our evidence base, a ground-breaking systematic review of the history of research in this area and a global first-of-its-kind searchable database for clinical referencing.

As always, like with any other patients, those with schizophrenia should only proactively seek to use medical cannabis products after a close consultation with and careful assessment from an experienced medical practitioner.

Further investigation and research into cannabis use (both recreational and medical) is thoroughly encouraged by The Academy, particularly through the use of our own online coursesevidence base and whitepapers.

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