A condition known as Prodromal or Clinical High Risk (CHR) for Psychosis is a serious mental disorder that may lead to prolonged periods of disturbance or a full-blown diagnosis of schizophrenia or other psychotic disorders. While the use of antipsychotic medications may or may not work, they come with unwanted and sometimes dangerous side effects. Since early detection and treatment is crucial, a safe and well-tolerated intervention, such as cannabidiol or CBD, would be highly desirable.
What is Prodromal or Clinical High Risk for Psychosis?
Prodromal refers to the period of time between the appearance of initial symptoms of a condition, in this case, psychosis, and the full development of schizophrenia. Clinical high risk indicates early symptoms a younger person may have and the risk of developing a fully diagnosable psychotic disorder, like schizophrenia. There is a high level of accuracy of prodromal symptoms predicting the onset of psychosis, making early detection and treatment possible, leading to better prognosis in the short- and long-term.
Symptoms and Behavioral Difficulties Associated with Clinical High Risk for Psychosis
Younger individuals who are at clinical high risk of psychosis generally exhibit co-existing conditions like anxiety and depression. They may also show other symptoms throughout their prodromal stages of psychosis including:
- Social withdrawal or isolation
- Bizarre behavior or appearance
- Emotional outburst or emotional flattening
- Suspiciousness or mistrust of others
- Hypervigilance
- Poor hygiene
- Poor concentration or difficulty thinking clearly
- Difficulties at school, in social settings or interpersonal relationships
CBD and Clinical High Risk for Psychosis
An article published in the journal World Psychiatry provided evidence on the effects of cannabidiol or CBD on symptoms of clinical high-risk psychosis. Thirty-three experimental subjects were divided into two groups. “Using a parallel group, double-blind, placebo-controlled design, participants were randomly allocated to either CBD (N=16) or placebo (N=17)1”. The CBD group received a CBD capsule and the experimental group received a similar looking placebo capsule for 21 days. The dose of CBD was 600mg daily and was both effective and well-tolerated among the subjects of the experiment. The subjects were administered the Comprehensive Assessment of At-Risk Mental States (CAARMS) and the Positive and Negative Syndrome Scale (PANSS) prior to and after the study. The results were positive. Those who received 600mg of CBD daily had a lower score on the CAARMS and reported less distress associated with psychiatric symptoms and had a lower PANSS total score. Although the sample size was small and it is not possible to generalize from such a small group, CBD did reduce symptoms among those with clinical high risk for psychosis. There was a noted reduction in the severity of symptoms and level of distress as well.
Final Thoughts on CBD and Clinical High-Risk Psychosis
People who are at clinical high risk for psychosis are at a critical crossroads. They may be at the beginning of a very turbulent time in their life or may develop a full psychosis, like schizophrenia. For those in treatment, antipsychotic medications may or may not work, so there is a need for a natural, safe and effective intervention. One small study showed that CBD had positive effects on disturbing symptoms associated with psychosis. Hopefully more research will be done in this area and those who are at high risk for developing psychosis will have a better alternative to antipsychotic drugs.
Reference
- Medina-Mora, Maria Elena and Rebecca Robles. Effects of Cannabidiol on Symptoms in People at Clinical High Risk for Psychosis. World Psychiatry, 23:3, 451-452, 2024.