Can You Use CBD for Bipolar Disorder? What the Science Says
Using cannabis for bipolar disorder is a tricky subject. It is well established in the scientific literature that some forms of cannabis, including those that contain THC, are more likely to cause bipolar disorder than help with it.
In the scientific community, THC is known as a psychotogenic substance, meaning a substance that generates psychosis. As anyone who has used the cannabinoid knows, THC does have a profound tendency to alter your frame of mind. Those with a latent tendency toward psychosis-related mental health disorders may have them exacerbated by this mind-altering compound.
All the same, CBD has entered the spotlight in recent years as a potential mitigator of THC-induced bipolar disorder and as a potential treatment of bipolar disorder in its own right. In this review of the available evidence, we’ll discuss the most pertinent clinical and preclinical studies so-far published on the subject of CBD and bipolar disorder.
CBD for Bipolar Disorder: Overview
1. The scientific community is skeptical of using cannabis for bipolar disorder
2. THC often makes bipolar disorder worse and not better, the same as other psychosis-related disorders
3. CBD, on the other hand, does not appear to have any potential to worsen latent psychotic conditions
4. Instead, there is a growing body of evidence indicating that CBD might mitigate or improve the symptoms of bipolar disorder
5. However, more human trials must be conducted before we know exactly how CBD affects bipolar disorder
Most Recent Research on CBD for Bipolar Disorder
2023: Cannabidiol as an Adjunctive Treatment for Acute Bipolar Depression: A Pilot Study
This very recent study on the subject presents new clinical human evidence for the potential usefulness of CBD for bipolar disorder. Consisting of a cohort of 35 participants, this study noted a considerable decrease of Montgomery-Åsberg Depression Rating Scale (MADRS) after the beginning of CBD treatment. However, no reductions in “manic symptoms or any other adverse effects” were noted.
2021: Evidence for Use of Cannabinoids in Mood Disorders, Anxiety Disorders, and PTSD: A Systematic Review
This recent review of the available evidence begins by noting that “CBD pretreatment reduced anxiety in laboratory paradigms among individuals with social anxiety disorder,” a condition closely related to bipolar disorder. In the end, though, the authors found that “insufficient evidence was found for efficacy of CBD… to manage affective disorders,” calling upon future research to “investigate the safety and efficacy of managing psychiatric disorders with cannabinoids.”
2021: A Change in Blood Carbamazepine Levels Associated With Cannabis Use: Implications for Clinical Practice
This study is essential to understand for anyone considering using either CBD or THC for bipolar disorder. It consisted of only a single case study, so it wouldn’t be fair to call this piece of research a clinical trial. What it found, however, is that a single patient’s bloodstream levels of anti-bipolar medication increased when using either THC or CBD, providing another piece of evidence that CBD might interact with common medications via the CYP3A4 chemical processing pathway.
If you intend to use CBD for bipolar, understand that it may increase the effects of your bipolar medication. Consult with your doctor before beginning CBD treatment, and bring this case study along to provide the context (APA citation below).
2019: Cannabis Use and the Risk for Psychosis and Affective Disorders
This review approaches the usefulness of CBD for bipolar and other psychotic and affective disorders from another angle — admitting the psychosis-inducing effects of THC and investigating whether CBD reduces them. Based on the research available at the time, the authors found that CBD “ameliorates the psychotogenic effects of THC” and that this non-intoxicating cannabinoid “may be therapeutically useful.”
CBD for Bipolar Disorder Human Trials
2008: Cannabidiol was ineffective for manic episode of bipolar affective disorder
Aside from the 2023 clinical trial discussed above, we are only aware of one other human trial of CBD in the context of bipolar disorder. The results of this single case study are not highly positive but only pertain to the two individuals observed. Neither participant experienced any negative symptoms from using CBD, but the cannabinoid also failed to demonstrably improve their cases of bipolar disorder.
Additional CBD Bipolar Disorder Studies
2020: Cannabidiol as a Treatment for Mood Disorders: A Systematic Review
This somewhat-recent research review came to roughly the same conclusions as the others: Cannabidiol is too new to the scene for any significant evidence to accumulate regarding its usefulness for mood disorders like bipolar affective disorder. The authors also noted, however, that “cannabidiol might have a role as a treatment for mood disorders,” calling for further studies to shed light on the matter in more detail.
2005: Cannabinoids in bipolar affective disorder: a review and discussion of their therapeutic potential
As one of the first studies into CBD for bipolar disorder, this research review found that controlled trials of CBD “as [an] adjunctive medication in bipolar disorder are now indicated,” providing one of the first calls-to-action for the scientific community to pursue this line of inquiry. Even back in 2005, researchers already knew that CBD “may exert sedative, hypnotic, anxiolytic, antidepressant, antipsychotic and anticonvulsant effects,” giving this early study some degree of weight.
Discussion: Should CBD Be Used for Bipolar Disorder?
Based on the available research, there appears to be no reason not to try CBD as a potential adjunctive treatment for bipolar affective disorder. Cases of adverse reactions are very rare and almost always mild, while the potential therapeutic usefulness of CBD for bipolar disorder should not be discounted.
Human trials regarding CBD and bipolar disorder have offered mixed results. Nonetheless enough evidence exists to suggest that research on this subject should be vigorously expanded. We call upon the international research community to inquire further into the potential usefulness of CBD for bipolar affective disorder.
Sources
1. Pinto, J. V., De Souza Crippa, J. A., Ceresér, K. M. M., Vianna-Sulzbach, M., De Moura Silveira Júnior, É., Da Rosa, G. S., Da Silva, M. G. T., Hizo, G. H., Medeiros, L. S., De Oliveira, C. E. S., Bristot, G., Campos, A. C., Guimarães, F. S., Hallak, J. E. C., Zuardi, A. W., Yatham, L. N., Kapczinski, F., & Kauer-Sant’Anna, M. (2023). Cannabidiol as an adjunctive treatment for acute bipolar Depression: a pilot study. The Canadian Journal of Psychiatry. https://doi.org/10.1177/07067437231209650
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3. Ridout, K. K., Young-Wolff, K. C., & Ridout, S. J. (2021). A change in blood carbamazepine levels associated with cannabis use. The Journal of Clinical Psychiatry, 82(3). https://doi.org/10.4088/jcp.20cr13777
4. Sideli, L., Quigley, H., La Cascia, C., & Murray, R. M. (2019). Cannabis use and the risk for psychosis and affective disorders. Journal of Dual Diagnosis, 16(1), 22–42. https://doi.org/10.1080/15504263.2019.1674991
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