Table 3 Studies of the use of CBD and CBD-containing compounds such as nabiximols in the treatment of other psychiatric disorders and levels of evidence (1–5)*
From: The therapeutic role of Cannabidiol in mental health: a systematic review
Author | Diagnosis | Study design | Pharmacological agent | Strength of evidence | Group (n) | Duration | Age range (years) | Dose range (mg) | Scales to measure the clinical outcome | Clinical outcome | Common side effects | Reference number |
|---|---|---|---|---|---|---|---|---|---|---|---|---|
Cooper et al., 2017 | ADHD | RCT | Nabiximols | Level 2 | Nabiximols = 15 Placebo = 15 | 6 weeks | 18–55 | Nabiximols oromucosal spray = 2.7 mg Δ9-THC and 2.5 mg CBD Mean dose = 4.7 sprays per day Maximum dose = 14 sprays/day | QbTest | - The experimental group had better scores compared to placebo group (Est = 0.17, 95%CI-0.40 to 0.07, p = 0.16, n = 15/11 active/placebo). - Nabiximols was associated with a nominally significant improvement in hyperactivity/impulsivity (p = 0.03) and a cognitive measure of inhibition (p = 0.05), and a trend towards improvement for inattention (p = 0.10) and executive learning (p = 0.11). | Muscular seizures and spasms | 34 |
Barchel et al., 2018 | ASD and related comorbidities 1. Hyperactivity 2. Sleep problems 3. Self-injury 4. Anxiety | Open-label trial | CBD and Δ9-THC | Level 3 | 53 | 30–588 days Median duration = 66 days | 4–22 Median age = 11 years | CBD oil solution with CBD and Δ9-THC at 1:20 ratio CBD 16 mg/kg (maximal daily dose 600 mg) CBD median IQR daily dose = 90 (45–143) mgΔ9-THC 0.8 mg/kg (maximal daily dose 40 mg). THC median IQR daily dose = 7 (4–11) mg | Not mentioned | - These patients were taking concomitant medications including stimulants, antipsychotics, anti-epileptics, melatonin, anti-depressants, alpha-agonists, and anti-muscarinic agents. - Out of 53 patients, 74.5% reported improvement in comorbid symptoms. - About 68.4% reported improvement in hyperactivity, 67.6% in self-injurious behaviors, 71.4% in sleep problems, and 47.1% in anxiety symptoms. | Somnolence and change in appetite | 35 |
Bergamasci et al., 2011 | Anxiety related to public speaking | RCT | CBD | Level 4 | CBD = 12 Placebo = 12 | Single dose | SAD-placebo = 22.8 SAD-CBD = 24.6 Healthy = 23.3 | 600 mg | Mini-SPIN, VAMS, SSPS, SSPS-N, BSS | - Pretreatment with a single dose of CBD significantly decreased anxiety, cognitive impairment and discomfort in speech performance. It also resulted in significantly decreased alertness in anticipatory speech. - There were significant effect of phases (F3.6,118.51/432.7; p < 0.001), group (F2,331/413.5; p < 0.001) and phases by group interaction (F7.2,118.5 1/4 6.4; p < 0.001). - There were also significant differences between placebo and healthy control group at the initial (p < 0.018), anticipatory (p < 0.001), speech (p < 0.001) and post-speech (0.018) phases. - The CBD group differs from the placebo (p < 0.012) and control (p < 0.007) groups during the speech phase | No side effects were reported. | 36 |
Shannon et al., 2019 | Anxiety and insomnia | Retrospective chart review | CBD | Level 4 | Anxiety = 47 Sleep disorder = 25 | 3 months | Sleep disorder = 18–72 Mean age = 36.5 years Anxiety = 18–70 Mean age = 34 years | 25–175 mgMost patients received 25 mg/day | HAM-A, PSQI | - Most patients received 25 mg/day CBD; a handful of patients received 50 or 75 mg/day. One patient with schizoaffective disorder and trauma was given up to 175 mg/day. - After 1 month of treatment, 79.2 and 66.7% of patients reported improvement in anxiety and sleep, respectively. - After 2 months, 78.1 and 56.1% of patients reported improvement in anxiety and sleep, respectively, which were also observed at 3-month follow-up. - Greater improvement in anxiety scores than sleep scores. | - 2 patients discontinued treatment due to fatigue and 1 patient with a development disorder had increased sexually inappropriate behaviors, resulting in discontinuation - Transient mild sedation was also reported in some patients. | 37 |
Zuard et al., 2010 | Bipolar disorder | Case report | CBD | Level 4 | 2 | 38 days | 34 and 36 | 1–5 days for both participants: Placebo Case 1: 5–19 days: CBD 600 mg and olanzapine 10–15 mg 20–33 days: CBD 900–1200 mg Case 2: 5–33 days: CBD 600–1200 mg 33–38 days: Placebo | BPRS, YMRS | - Case 1: 37 and 33% improvement on BPRS and YMRS with CBD and olanzapine, but no additional improvement with CBD monotherapy. - Case 2: CBD failed to improve symptoms of bipolar disorder at any of the prescribed doses. | No side effects were reported. | 38 |
Shannon & Opila-Lehman., 2016 | Posttraumatic stress disorder | Case report | CBD | Level 4 | 1 | 5 months of CBD | 10 | CBD oil 25 mg Liquid CBD 6–12 mg sublingual spray as needed for anxiety | SDSC, SCARED | - CBD scores improved from 34 to 18 at endpoint, indicating no anxiety. - Sleep Disturbance Scale scores improved from 59 to 38, suggesting no problem with sleep. | No side effects were reported. | 39 |
Trainor et al., 2016 | Tourette syndrome | Case report | Nabiximols | Level 4 | 1 | 4 weeks | 26 | Two oromucosal sprays of nabiximols BID Total dose = 10.8 mg Δ9-THC, 10 mg CBD per day | YGTSS, ORVRS | - Using the ORVRS to evaluate tics, motor tics were reduced by 85% and vocal tics by 90% - Number of affected body areas decreased. - mprovement of 35% on YGTSS. | No side effects were reported. | 40 |
Pichler et al., 2018 | Tourette syndrome | Case report | Cannabis tincture THC combined with CBD | Level 4 | 1 | 2 months | 47 | 34 drops cannabis tincture 3 times a day = 10 mg Δ9-THC combined with 20 mg of CBD | YGTSS | - With the combination of Δ9-THC and CBD, there was significant improvement in tic frequency and severity. - Scores decreased from 73/100 to 44/100 on YGTSS. - Patient reported improvement in quality of life and enhanced social activity. | Slight xerostomia | 41 |