CBD and depression: Current research

On the occasion of World Depression Day, we echo current research on the relationship between marijuana and CBD in this mental illness. We remind you that this is an informative article and is not intended to prevent, diagnose or treat any disease or symptom. Consult your doctor if you have any doubts and before using CBD.

Relationship between cannabis and depression

Depression has increased exponentially in recent years. In the wake of the pandemic, depression and anxiety have become very common mental illnesses.

In order to regain mental health, treatments are needed that are generally difficult to access, which has led people with depression to become interested in potential treatments such as CBD or cannabidiol. CBD or cannabidiol .

Defining depression

Before we dive into the use of CBD to alleviate depression, we need to understand a little more about what this condition is all about.

Depression is a disorder of emotions manifested by symptoms such as sadness, anxiety, irritability, lack of motivation, insomnia and suicidal thoughts (1).

Although 40% of people with depression or anxiety do not seek treatment (2), treatment may include psychiatric or psychological therapy that can be costly; or medications that usually have side effects and sometimes stop working.

Neurological origin of depression

The neurobiology of depression is related to the modulation of serotonin and noradrenaline in our brain. Generally, an imbalance in the systems of these neurotransmitters is what produces the symptoms of depression and anxiety (3).

Therapies such as cannabis for depression could be helpful, as they can stimulate the recovery of physiological balance or homeostasis in the brain (4).

Marijuana and depression: What is the relationship?

Long before science began to study the potential of cannabinoids in depression, cannabis has been used for decades to treat anxiety.

In clinical practice, one of the most commonly used treatments for depression is anxiolytics. So we might infer that, if the cannabis plant has helped anxiety for years, perhaps it can also help in the treatment of depression. However, existing scientific studies point to the contrary.

Effects of THC on depression

The tetrahydrocannabinol (THC) present in the cannabis plant, when used with CBD, has not been shown to be effective in treating depression, and may even worsen the patient’s course (5). On the other hand, CBD, used on its own, does appear to be a potential treatment for depressive disorders.

Cannabis oil rich in CBD for depression and anxiety

Although there are several ongoing clinical studies evaluating the effectiveness of CBD oil for depression, scientific evidence indicates that cannabidiol can treat symptoms of anxiety. (6, 7, 8, 9), reduce compulsive behaviors (10) and alleviate sleep disturbances (11), which can be symptoms of depression.

Although human studies on the use of cannabidiol for depression are very limited, CBD has been shown to have minor but similar effects to antidepressant drug therapy in animal studies (12).

How could CBD help depression?

Actually, it is not known exactly. Directly, the effectiveness of cannabidiol in depressive disorders is still being studied. Results from years of research suggest that CBD may help depression through its anxiolytic effect.

CBD’s ability to decrease anxiety involves various mechanisms of action, but is generally linked to the activation of serotonin 5-HT1A receptors, which could induce a minor but similar effect to commercial anxiolytics.

Treatment of depression

Diagnosis by a physician, psychiatrist or psychologist is a prerequisite for the treatment of depression.

Popularly, everyone associates depressive symptoms with an emotional state, but in some cases, the symptoms may be the manifestation of an organic disease, or the adverse effect of a medication. Hence the importance of seeing a specialist doctor for a correct assessment.

What is the dose of CBD for depression?

You may be wondering, well how do you take CBD for depression? or how much CBD should I take for depression? As there is no established dose, remember that its potential benefit is still under investigation. What we can mention is what the studies say so far.

At the moment, the consistent evidence suggesting the effectiveness of CBD for depression comes from animal models. These animal models include unconventional routes of administration, which are not practical for humans. Likewise, doses are very different when they include acute or chronic models.

How is CBD oil used for depression?

In clinical trials, the doses of CBD that have obtained anxiolytic results are also very varied. However, one of the doses that stands out most for inducing relief in depression-like behaviors was found in a study where 200 mg of CBD was used daily for 10 weeks in regular cannabis users (13).

On the other hand, for non-cannabis users, anxiolytic effects have been reported with a single dose of 400 mg of oil-based CBD; or a single dose of 600 mg (9) of oil-based CBD.

And in chronic use, the use of cannabidiol for 1 to 3 months has been tested to decrease anxiety and improve sleep disorders at doses of 25 to 75 mg/day for 1 to 3 months (11).

Note that, according to the literature, chronic doses are more effective than a single dose (15).

Vaping CBD in depression?

It has also been reported that CBD vaporizations can aid emotional processing (16).

Use of CBD and medications for depression

Can I use CBD if I am taking medication for depression?

Some medications for the treatment of depression (such as fluoxetine or Prozac) focus on inhibiting the reuptake of serotonin, in other words, they help make more serotonin available to our neurons.

On the other hand, cannabidiol, although it does not help to make more serotonin available, can stimulate serotonin receptors and induce an effect similar to that of this neurotransmitter.

Interaction between CBD and serotonin reuptake inhibitors (SSRIs).

It has been seen that small doses that do not produce a therapeutic effect of treatments such as fluoxetine, if administered with low doses that do not produce a therapeutic effect of CBD, can have a synergistic effect when administered simultaneously.

This suggests that very low doses of cannabidiol and fluoxetine, when administered together, may potentiate an antidepressant effect (17).

Since fluoxetine is a selective serotonin reuptake inhibitor (SSRI), perhaps the effect could be seen with other drugs in this category such as citalopram (Celexa), escitalopram (Lexapro), paroxetine (Paxil, Pexeva) and sertraline (Zoloft).

Recall that the above combinations have not been explored in detail clinically and that the combination with fluoxetine was evaluated in a study conducted under laboratory conditions. Visit our post on CBD and drug interactions to learn what happens when CBD is taken with another medication.

Important Note on the Use of CBD for Depression

Depression is a mental health disorder whose treatment should be discussed with a medical specialist. Probably, the approach should contemplate different treatments, including psychotherapy. Consult with your physician before using cannabidiol for depression and other mental health disorders.

All medications that have an effect on the central nervous system, such as anxiolytics or antidepressants, should be monitored with caution by a health professional.

While studies suggest that CBD has potential to treat some symptoms of depression, its use in the treatment of depression is still under investigation.

We remind you that this is an informative article that is not intended to prevent, diagnose or treat any disease. Consult your doctor before using CBD. Its content can complement, but never replace, the diagnosis or treatment of any disease or symptom. Cannactiva products are not medicines. We recommend that you consult your doctor if you are already being treated for depression and that you do not use CBD without his or her advice and supervision.

Referencias
  1. Rantala, M. J., Luoto, S., Krams, I., & Karlsson, H. (2018). Depression subtyping based on evolutionary psychiatry: Proximate mechanisms and ultimate functions. Brain, behavior, and immunity, 69, 603-617. https://doi.org/10.1016/j.bbi.2017.10.012
  2. Tiller J. W. (2013). Depression and anxiety. The Medical journal of Australia, 199(S6), S28-S31. https://doi.org/10.5694/mja12.10628
  3. Ressler, K. J., & Nemeroff, C. B. (2000). Role of serotonergic and noradrenergic systems in the pathophysiology of depression and anxiety disorders. Depression and anxiety, 12 Suppl 1, 2-19. PMID: 11098410
  4. Kesner, A. J., & Lovinger, D. M. (2020). Cannabinoids, Endocannabinoids and Sleep. Frontiers in molecular neuroscience, 13, 125. https://doi.org/10.3389/fnmol.2020.00125
  5. Feingold, D., & Weinstein, A. (2021). Cannabis and Depression. Advances in experimental medicine and biology, 1264, 67-80. https://doi.org/10.1007/978-3-030-57369-0_5
  6. de Mello Schier, A. R., de Oliveira Ribeiro, N. P., Coutinho, D. S., Machado, S., Arias-Carrion, O., Crippa, J. A., Zuardi, A. W., Nardi, A. E., & Silva, A. C. (2014). Antidepressant-like and anxiolytic-like effects of cannabidiol: a chemical compound of Cannabis sativa. CNS & neurological disorders drug targets, 13(6), 953-960. https://doi.org/10.2174/1871527313666140612114838
  7. Zuardi, A. W., Shirakawa, I., Finkelfarb, E., & Karniol, I. G. (1982). Action of cannabidiol on the anxiety and other effects produced by delta 9-THC in normal subjects. Psychopharmacology, 76(3), 245-250. https://doi.org/10.1007/BF00432554
  8. Crippa, J. A., Derenusson, G. N., Ferrari, T. B., Wichert-Ana, L., Duran, F. L., Martin-Santos, R., Simões, M. V., Bhattacharyya, S., Fusar-Poli, P., Atakan, Z., Santos Filho, A., Freitas-Ferrari, M. C., McGuire, P. K., Zuardi, A. W., Busatto, G. F., & Hallak, J. E. (2011). Neural basis of anxiolytic effects of cannabidiol (CBD) in generalized social anxiety disorder: a preliminary report. Journal of psychopharmacology (Oxford, England), 25(1), 121-130. https://doi.org/10.1177/0269881110379283
  9. Bergamaschi, M. M. M., Queiroz, R. H., Chagas, M. H., de Oliveira, D. C., De Martinis, B. S., Kapczinski, F., Quevedo, J., Roesler, R., Schröder, N., Nardi, A. E., Martín-Santos, R., Hallak, J. E., Zuardi, A. W., & Crippa, J. A. (2011). Cannabidiol reduces the anxiety induced by simulated public speaking in treatment-naïve social phobia patients. Neuropsychopharmacology : official publication of the American College of Neuropsychopharmacology, 36(6), 1219-1226. https://doi.org/10.1038/npp.2011.6
  10. Nardo, M., Casarotto, P. C., Gomes, F. V., & Guimarães, F. S. (2014). Cannabidiol reverses the mCPP-induced increase in marble-burying behavior. Fundamental & clinical pharmacology, 28(5), 544-550. https://doi.org/10.1111/fcp.12051
  11. Shannon, S., Lewis, N., Lee, H., & Hughes, S. (2019). Cannabidiol in Anxiety and Sleep: A Large Case Series. The Permanente journal, 23, 18-041. https://doi.org/10.7812/TPP/18-041
  12. Zanelati, T. V., Biojone, C., Moreira, F. A., Guimarães, F. S., & Joca, S. R. (2010). Antidepressant-like effects of cannabidiol in mice: possible involvement of 5-HT1A receptors. British journal of pharmacology, 159(1), 122-128. https://doi.org/10.1111/j.1476-5381.2009.00521.x
  13. Solowij, N., Broyd, S. J., Beale, C., Prick, J. A., Greenwood, L. M., van Hell, H., Suo, C., Galettis, P., Pai, N., Fu, S., Croft, R. J., Martin, J. H., & Yücel, M. (2018). Therapeutic Effects of Prolonged Cannabidiol Treatment on Psychological Symptoms and Cognitive Function in Regular Cannabis Users: A Pragmatic Open-Label Clinical Trial. Cannabis and cannabinoid research, 3(1), 21-34. https://doi.org/10.1089/can.2017.0043
  14. Crippa, J. A., Zuardi, A. W., Garrido, G. E., Wichert-Ana, L., Guarnieri, R., Ferrari, L., Azevedo-Marques, P. M., Hallak, J. E., McGuire, P. K., & Filho Busatto, G. (2004). Effects of cannabidiol (CBD) on regional cerebral blood flow. Neuropsychopharmacology : official publication of the American College of Neuropsychopharmacology, 29(2), 417-426. https://doi.org/10.1038/sj.npp.1300340
  15. Long, L. E., Chesworth, R., Huang, X. F., McGregor, I. S., Arnold, J. C., & Karl, T. (2010). A behavioral comparison of acute and chronic Delta9-tetrahydrocannabinol and cannabidiol in C57BL/6JArc mice. The international journal of neuropsychopharmacology, 13(7), 861-876. https://doi.org/10.1017/S1461145709990605
  16. Hindocha, C., Freeman, T. P., Schafer, G., Gardener, C., Das, R. K., Morgan, C. J., & Curran, H. V. (2015). Acute effects of delta-9-tetrahydrocannabinol, cannabidiol and their combination on facial emotion recognition: a randomised, double-blind, placebo-controlled study in cannabis users. European neuropsychopharmacology : the journal of the European College of Neuropsychopharmacology, 25(3), 325-334. https://doi. org/10.1016/j.euroneuro.2014.11.014 17. Sales, A. J., Crestani, C. C., Guimarães, F. S., & Joca, S. R. L. (2018). Antidepressant-like effect induced by Cannabidiol is dependent on brain serotonin levels. Progress in neuro-psychopharmacology & biological psychiatry, 86, 255-261. https://doi.org/10.1016/j.pnpbp.2018.06.002

Masha Burelo
Investigadora en cannabinoides | Doctoranda en Neurociencia

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