University Medical Centre Utrecht, Utrecht, The Netherlands.
Brain and Mind Centre, Central Clinical School, Faculty of Medicine and Health, The University of Sydney, Sydney, Australia.
Curr Opin Psychiatry. 2020 May;33(3):185-191. doi: 10.1097/YCO.0000000000000596.
The most recent studies published or initiated in the last 18 months, investigating cannabidiol in the treatment of symptoms of schizophrenia and related conditions are summarized, including observed tolerability and reported side-effects.
Recent studies focused on patients with sub-acute psychotic syndromes of schizophrenia, clinical high-risk state for psychosis (CHR-P), or frequent cannabis users, as well as cognitive functioning in chronic schizophrenia. There is further, although not consistent evidence for cannabidiol-reducing positive symptoms, but not negative symptoms. Evidence for improvement of cognition was weaker, with one study reporting a worsening. Regarding side effects and tolerability, cannabidiol induced sedation in one study, with the other studies indicating good tolerability, even at high doses.
Recent clinical trials added further evidence for an antipsychotic potential of cannabidiol. In general, studies following trial designs as suggested by regulators in schizophrenia are needed in sufficient numbers to clarify the safety and efficacy of cannabidiol herein. In addition, such studies will further elucidate its ability to target specific aspects of the syndrome, such as negative or cognitive symptoms. Furthermore, aiming for an add-on treatment with cannabidiol will require further studies to identify potentially useful or even harmful combinations.
总结了过去 18 个月内发表或启动的最新研究,这些研究调查了大麻二酚在治疗精神分裂症症状和相关疾病方面的作用,包括观察到的耐受性和报告的副作用。
最近的研究集中在精神分裂症亚急性精神病综合征、精神病高危状态(CHR-P)或频繁使用大麻的患者,以及慢性精神分裂症的认知功能上。虽然有进一步的、但并不一致的证据表明大麻二酚可以减轻阳性症状,但不能减轻阴性症状。关于认知改善的证据较弱,一项研究报告说认知恶化。关于副作用和耐受性,一项研究表明大麻二酚引起镇静,其他研究表明耐受性良好,即使在高剂量下也是如此。
最近的临床试验为大麻二酚的抗精神病潜力提供了更多证据。总的来说,需要按照监管机构在精神分裂症中建议的试验设计进行足够数量的研究,以明确大麻二酚在此类疾病中的安全性和疗效。此外,此类研究将进一步阐明其靶向综合征特定方面(如阴性或认知症状)的能力。此外,为了添加大麻二酚作为附加治疗,需要进一步研究以确定潜在有用甚至有害的组合。