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Cannabidiol as a potencial treatment for psychosis : a systematic review
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Resumo(s)
Introdução: Δ9 -Tetrahydrocannabinol (Δ9 -THC), é um dos aproximadamente 60 fitocannabinoides presentes na planta Cannabis Sativa, sendo o principal constituinte psicotrópico. O Cannabidiol (CBD), por outro lado, é o segundo fitocanabinóide mais presente, mas sem características psicoactivas. O CBD tem sido alvo de interesse nos últimos 30 anos por uma variada de razões. Primeiro, estudos mostram que esta molécula tem efeitos contrários aos do Δ9 –THC, podendo potencialmente servir como um antipsicótico. Depois, apresenta um perfil de segurança claro e não aparenta causar depêndencia ao utilizador. Por fim, também poderá servir como um potencial tratamento para outras doenças psiquiátricas e neurodegenerativas, por apresentar um grande leque de efeitos: ansiolítico, antidepressivo, neuroprotector, imuno-modulador e anti-inflamatório.
O objectivo desta revisão sistemática é agrupar toda a informação do potencial antipsicótico do CBD.
Métodos: Foi feita uma revisão sistemática da literatura com o intuito de encontrar relatos de caso e ensaios clínicos que estudem a eficácia do CBD, em monoterapia e como tratamento adjuvante, a tratar sintomatologia psicótica.
Resultados: Foram incluídos oito estudos nesta revisão sistemática. Sendo que a maioria mostrou que o CBD é eficaz a reduzir sintomas positivos, negativos e cognitivos de pacientes tanto com psicose recente como com psicose crónica. Também mostraram que o CBD é bem tolerado, e apresenta mínimos efeitos adversos.
Conclusão: Os estudos de pequena escala incluídos para além de mostrarem uma melhoria clinica significativa na maioria dos pacientes que foram tratados com o CBD, demonstraram também o perfil seguro e bem-tolerado do fármaco. Estes resultados, adicionados aos provenientes de estudos observacionais e pré-clínicos, mostram o promissor papel do CBD no tratamento de Distúrbios psicóticos no futuro.
São necessários estudos de larga escala, para percebermos a sua utilidade clínica em monoterapia ou como um adjuvante, e para conseguirmos estabelecer as doses terapêuticas.
Introduction: Δ9 -Tetrahydrocannabinol (Δ9 -THC), is one of the approximately 60 phytocannabinoids and 400 chemicals present in the plant Cannabis Sativa. Δ9 -THC is the principal psychoactive constituent. Cannabidiol (CBD), on the other hand, is the major non-psychotropic phytocannabinoid. CBD has been receiving a lot of attention in the last 30 years. First, because it appears to inhibit the neuroactive effects of Δ9 -THC, potentially having antipsychotic action. Second, CBD exhibits reduced toxicity and dependency profile. Finally it appears to be useful in a variety of neurodegenerative and other psychiatric illnesses, because it potentially has anxiolytic, antidepressant, neuroprotective, anti-inflammatory and immunomodulating properties. This systematic review aims to bring together evidence of CBD antipsychotic effects. Methods: Systematic review of the literature searching for all clinical trials and case reports that study CBD efficacy as an antipsychotic potential, either in monotherapy or as an adjunctive treatment Results: Eight studies were included in this systematic review, with most of them showing CBD as an effective compound in combating positive, negative and cognitive symptoms in both early and chronic schizophrenia. CBD was well tolerated and showed minimal side effects in the studied patients. Conclusion: Small-scale studies have shown clinical improvement in the majority of patients that undergo treatment with CBD, and proved its safe and well-tolerated profile. These results adding to preclinical and observational research, show that CBD is a promising candidate for future implementation in Psychotic disorders. Large-scale trials are needed to establish CBD´s clinical utility on its own or as an adjunctive medication, and figure out its therapeutic dosages.
Introduction: Δ9 -Tetrahydrocannabinol (Δ9 -THC), is one of the approximately 60 phytocannabinoids and 400 chemicals present in the plant Cannabis Sativa. Δ9 -THC is the principal psychoactive constituent. Cannabidiol (CBD), on the other hand, is the major non-psychotropic phytocannabinoid. CBD has been receiving a lot of attention in the last 30 years. First, because it appears to inhibit the neuroactive effects of Δ9 -THC, potentially having antipsychotic action. Second, CBD exhibits reduced toxicity and dependency profile. Finally it appears to be useful in a variety of neurodegenerative and other psychiatric illnesses, because it potentially has anxiolytic, antidepressant, neuroprotective, anti-inflammatory and immunomodulating properties. This systematic review aims to bring together evidence of CBD antipsychotic effects. Methods: Systematic review of the literature searching for all clinical trials and case reports that study CBD efficacy as an antipsychotic potential, either in monotherapy or as an adjunctive treatment Results: Eight studies were included in this systematic review, with most of them showing CBD as an effective compound in combating positive, negative and cognitive symptoms in both early and chronic schizophrenia. CBD was well tolerated and showed minimal side effects in the studied patients. Conclusion: Small-scale studies have shown clinical improvement in the majority of patients that undergo treatment with CBD, and proved its safe and well-tolerated profile. These results adding to preclinical and observational research, show that CBD is a promising candidate for future implementation in Psychotic disorders. Large-scale trials are needed to establish CBD´s clinical utility on its own or as an adjunctive medication, and figure out its therapeutic dosages.
Descrição
Trabalho Final do Curso de Mestrado Integrado em Medicina, Faculdade de Medicina, Universidade de Lisboa, 2021
Palavras-chave
Canabidiol Antipsicótico Psicose Distúrbio psicótico Esquizofrenia Psiquiatria