大麻使用者首发精神病患者采用大麻二酚治疗的潜力。
The Potential of Cannabidiol Treatment for Cannabis Users With Recent-Onset Psychosis.
机构信息
Maryland Psychiatric Research Center, University of Maryland School of Medicine, Baltimore, MD.
出版信息
Schizophr Bull. 2018 Jan 13;44(1):46-53. doi: 10.1093/schbul/sbx105.
Abstract
A major factor associated with poor prognostic outcome after a first psychotic break is cannabis misuse, which is prevalent in schizophrenia and particularly common in individuals with recent-onset psychosis. Behavioral interventions aimed at reducing cannabis use have been unsuccessful in this population. Cannabidiol (CBD) is a phytocannabinoid found in cannabis, although at low concentrations in modern-day strains. CBD has a broad pharmacological profile, but contrary to ∆9-tetrahydrocannabinol (THC), CBD does not activate CB1 or CB2 receptors and has at most subtle subjective effects. Growing evidence indicates that CBD acts as an antipsychotic and anxiolytic, and several reports suggest neuroprotective effects. Moreover, CBD attenuates THC's detrimental effects, both acutely and chronically, including psychotogenic, anxiogenic, and deleterious cognitive effects. This suggests that CBD may improve the disease trajectory of individuals with early psychosis and comorbid cannabis misuse in particular-a population with currently poor prognostic outcome and no specialized effective intervention.
摘要
首次精神病发作后预后不良的一个主要因素是大麻滥用，这在精神分裂症中很常见，在近期发病的精神病患者中尤其常见。针对减少大麻使用的行为干预在该人群中并未取得成功。大麻二酚 (CBD) 是一种存在于大麻中的植物大麻素，尽管在现代大麻品种中的浓度较低。CBD 具有广泛的药理学特性，但与 ∆9-四氢大麻酚 (THC) 不同，CBD 不会激活 CB1 或 CB2 受体，并且只有最轻微的主观作用。越来越多的证据表明 CBD 具有抗精神病和抗焦虑作用，并且有几项报告表明其具有神经保护作用。此外，CBD 可减轻 THC 的有害作用，无论是急性还是慢性的，包括致精神病、焦虑和认知损害作用。这表明 CBD 可能改善早期精神病患者和共病大麻滥用者（尤其是预后不良且没有专门有效干预措施的人群）的疾病进程。
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