Cannabidiol (CBD) may provide a small but statistically significant benefit for certain schizophrenia symptoms when used alongside standard antipsychotic treatment, according to a new systematic review and meta-analysis.
The study, published in European Archives of Psychiatry and Clinical Neuroscience, was conducted by researchers from the University of Thessaly, the Technical University of Munich and the University of Catania.
Researchers analyzed randomized controlled trials examining CBD as an adjunctive treatment for adults with schizophrenia spectrum disorders. Rather than replacing existing antipsychotic medications, the studies looked at CBD used in addition to standard treatment, a design researchers said avoids the risks of discontinuing established medication while evaluating whether CBD can help address remaining symptoms.
The review included five randomized controlled trials comparing CBD augmentation to placebo. Researchers focused on changes in Positive and Negative Syndrome Scale scores, a commonly used measure for schizophrenia symptoms.
The analysis found CBD was associated with a statistically significant improvement in total PANSS scores, as well as positive symptoms and general symptoms. Positive symptoms can include hallucinations and delusions, while general symptoms may include broader issues such as anxiety, depression or difficulties with functioning.
However, researchers found no significant improvement in negative symptoms, which can include reduced emotional expression, lack of motivation and social withdrawal. Dropout rates were also not significantly different between the CBD and placebo groups, and heterogeneity was low across outcomes.
The researchers concluded that adjunctive CBD showed a small but consistent advantage over placebo for specific symptom clusters, while noting that larger trials are needed to determine its clinical impact.
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