Cannabidiol: A Potential New Alternative for the Treatment of Anxiety, Depression, and Psychotic Disorders

Abstract

The potential therapeutic use of some Cannabis sativa plant compounds has been attracting great interest, especially for managing neuropsychiatric disorders due to the relative lack of efficacy of the current treatments. Numerous studies have been carried out using the main phytocannabinoids, tetrahydrocannabinol (THC) and cannabidiol (CBD). CBD displays an interesting pharmacological profile without the potential for becoming a drug of abuse, unlike THC. In this review, we focused on the anxiolytic, antidepressant, and antipsychotic effects of CBD found in animal and human studies. In rodents, results suggest that the effects of CBD depend on the dose, the strain, the administration time course (acute vs. chronic), and the route of administration. In addition, certain key targets have been related with these CBD pharmacological actions, including cannabinoid receptors (CB₁r and CB₂r), 5-HT_1A receptor and neurogenesis factors. Preliminary clinical trials also support the efficacy of CBD as an anxiolytic, antipsychotic, and antidepressant, and more importantly, a positive risk-benefit profile. These promising results support the development of large-scale studies to further evaluate CBD as a potential new drug for the treatment of these psychiatric disorders.

Keywords: PTSD; animal studies; anxiety disorders; cannabidiol; clinical trials; depressive disorders; schizophrenia.

Figure 1

Schematic representation of the main hypothesized mechanisms described for the anxiolytic, antidepressant and antipsychotic actions of CBD. AEA: anandamide; 5-HT_1A: serotonin receptor 1A; BDNF: brain delivered neurotrophic factor; CB₁r: cannabinoid CB1 receptor; CB₂r: cannabinoid CB2 receptor; ChAT: choline acetyltransferase; D2: dopamine receptor D2; DNA methyl: DNA methylation; ECS: endocannabinoid system; FAAH: fatty acid amide hydrolase; HPA axis: hypothalamus pituitary-axis; M1/M4r: muscarinic receptor 1 and 4; PPARγ: peroxisome proliferator activated receptor gamma; TRKb/mTOR: tropomyosin-receptor-kinase B/mammalian target of rapamycin; TRPV1: transient receptor potential cation channel subfamily V member 1.