THE USE OF CANNABIDIOL FOR THE TREATMENT OF INDIVIDUALS AT ULTRA HIGH RISK FOR THE DEVELOPMENT OF PSYCHOSES: A SYSTEMATIC REVIEW OF THE LITERATURE

• Grant number: 22/02530-6
• Support Opportunities: Scholarships in Brazil - Scientific Initiation
• Start date: July 01, 2022
• End date: December 31, 2023
• Field of knowledge: Health Sciences - Medicine - Psychiatry
• Principal Investigator: Mario Rodrigues Louzã Neto
• Grantee: Pietro Homsi Figueira de Aguiar
• Host Institution: Instituto de Psiquiatria Doutor Antonio Carlos Pacheco e Silva (IPq). Hospital das Clínicas da Faculdade de Medicina da USP (HCFMUSP). Secretaria da Saúde (São Paulo - Estado). São Paulo , SP, Brazil

Abstract

Individuals with an ultra high risk for the development of psychosis (ultra high risk - UHR psychosis) means that they have a high risk of transition to a psychotic disorder, but that still do not have sufficient criteria to receive such diagnosis. Thus, its early identification and clinical control is an important prevention and intervention strategy for psychotic syndromes. Based on standardized diagnostic assessments, they present identification criteria (UHR criteria), which are genetic vulnerability (genetic risk associated with loss of functionality), attenuated psychotic symptoms (APS) and/or brief intermittent psychotic symptoms (BLIPS). These interested parties seem to present alterations in the endocannabinoid system in limbic and paralimbic regions (hippocampus, parahippocampal gyrus and amygdala), striatum and frontal cortex; areas that contribute to the development of psychotic symptoms, in addition to also presenting important changes in inflammation and oxidative stress, which seem to interact, above all, as a positive feedback manner. The cannabidiol compound (CBD) comes from the Cannabis Sativa plant and appears as a possible anxiolytic and antipsychotic, in addition to having a neuroprotective effect and being a potent anti-inflammatory. Its mechanism of action occurs through the signaling of the endocannabinoid systems and its antipsychotic property benefits from the increased availability of anandamide in the central nervous system, one of the neurotransmitters of the endocannabinoid system. Thus, evidence obtained that CBD can act on important neurofunctional changes and no inflammatory process related to psychotic symptoms in relation to UHR. That said, this systematic review seeks to gather information about the effectiveness of cannabidiol as an additional medicinal treatment for those at ultra high risk for developing psychosis, so acting as a form of intervention in the evolution of psychotic disorders.