The relationship between the endocannabinoid system and schizophrenia and other related mental health disorders has been the main focus of much scientific research for a few decades now. Earlier studies displayed evidence that schizophrenics had higher levels of anandamide (one of the body’s own endo-cannabinoids that works on the same receptor as tetrahydrocannabinol, THC), which created some speculation that this could be involved as a part in the illness. For more information on anandamide, read our article on the Synergy of Cannabis and Maca.
However, by the time we reached 2012, a study demonstrated that as cannabidiol (CBD) began to bring relief to the patients’ symptoms, anandamide levels rose at the same time. It was hypothesized then, by one of the main authors of the study, D. Piomelli, that the high levels seen in people with schizophrenia weren’t the cause of the issues, but the result of the brain’s attempts to solve it were. Stating, “it looks like anandamide is a signaling molecule that has evolved to help us cope with stress,” and that, “in the brain, everything it does seems to be related to ways of relieving stress. It can relieve anxiety and reduce the stress response. It is involved in stress-induced analgesia [when you stop feeling pain while fighting or fleeing]. These are all mechanisms to help us prevent [negative outcomes related to stress].” 
The state of the current evidence seems to suggest that inhibition of anandamide deactivation may contribute to the antipsychotic effects of cannabidiol, meaning, CBD helps keep levels of the “bliss” molecule, anandamide, higher in the body for longer, resulting in prolonged “feel good” states. This mechanism represents an entirely new treatment for schizophrenia. 
In a 2016 study, which looked at the specific mechanisms by which CBD produces antipsychotic effects, found a neurological foundation for its efficacy, reporting that it “triggered molecular signaling pathways associated with the effects of classic antipsychotic medications." 
The endocannabinoid system (ECS) is the most important system of physiology inside the body, responsible for maintaining the state of health, order, and balance of every other major bodily system. Like all systems, it too, can become overwhelmed and dysfunctional. If this happens, due to stress (emotional, mental, or physical), a dysfunctional ECS can lead to dysfunction in just about every other major area of the body. Emotional and mental stress can begin during gestation if the pregnant mother is stressed, where changes to the fetus can be seen in changes in the heartbeat, movement patterns, and higher levels of stress hormones in the body of the infant when born.  
Emotional and mental stress of the parents after birth also leads to the infant and child absorbing that stress, which results in higher levels of stress upon the child. If the environment is too stressful, the baby and child brain will begin to tune-out, as it has no other way of protecting itself from the stress (it can’t fight or flee). Physical stresses such as surgeries, and injuries such as a traumatic brain injury (TMJ) from being dropped, are other examples that can lead to too much stress being placed upon the ECS, which can lead to its dysfunction, and later in life, the deterioration and dysfunction of emotional, mental, and physical health leading to chronic and disabling mental and physical health conditions, which will need various forms of therapy in order to be restored back to full health. This same line of thought could be used to explain the prevalence of bipolar disorder, ADHD, ADD, and many other states of abnormal or imbalances in behavior. The ECS can be nourished and supported through the cannabinoids found in breastmilk, and from the nurturing touch of the mother, and other adults with whom the baby or child is healthily attached to (see the psychiatric work of Dr Dan Siegel, Dr Gabor Mate, and Dr Gordon Neufields work on the vital importance of healthy Attachment during the developing years). The ECS can also be assisted and restored with plant-based medicine, specifically, cannabis. The brain is "plastic" in that it can heal and change with the right environment and treatment plan leading to a healthy, well balanced human being. For more information on the endocannabinoid system, read The Endocannabinoid System Explained.
The information contained in this article is for informational purposes only and does not constitute medical advice. Prior to making changes to your lifestyle or treatment plan for a disease or condition, always consult with your doctor. It is recommended that those wishing to use cannabidiol (CBD) or medicinal cannabis utilize the help of a medical professional who has experience with cannabis products like CBD so that the dose and delivery method can be adjusted. At the same time, those who have taken the time to educate themselves can become their own highly aware health consultants. Symptoms of schizophrenia are serious, and medical treatments and guidance are necessary.
When dosing any cannabis product always start low and slow, titrating your way up from a micro dose to test for sensitivity, to higher doses within an appropriate dosing range, until symptoms subside. To ensure minimal psychoactive effects, people with schizophrenia should be cautious about titrating slowly up to a target range between a standard to macro dose. It is strictly suggested to use products that have a 20:1 ratio of CBD:THC or higher (in CBD) for this condition. Often, minimal doses of THC can make the condition worse. The cannabis strain AC/DC has often proven among users to be very effective for schizophrenia. Varieties that are high in the terpene myrcene have a more relaxing effect. For more information on the terpenes, read our Ultimate Guide to Terpenes.
Although the cannabis compound THC has been associated with increased risk of developing schizophrenia, paranoia, and anxiety, CBD seems to have the opposite effect, actually reversing and/or preventing those symptoms in some people. CBD, the non-psychoactive ingredient in cannabis, often shows anti-psychotic, anti-anxiety, and anti-depressive effects in most people. Cannabis is biphasic, meaning, the compounds can have the reverse effect in some people. For example, some people experience THC as giving them more focus, whereas others it has the opposite effect.
The Cannabis Health Index (CHI) is a scoring system based on the best available evidence in the medical literature to date for all cannabis (not just CBD) and its effectiveness on various health conditions. For the treatment of schizophrenia, based on eight studies, cannabis has a rating of likely-probable for efficacy (2.5 points out of 5).
A 2011 study discovered that utilizing cannabis with a high CBD content was associated with significantly lower degrees of psychotic symptoms, providing additional support for the antipsychotic potential of cannabidiol.  The next year, a review of thirty years of research data on CBD and psychosis concluded that the results “support the idea that CBD may be a future therapeutic option in psychosis, in general and in schizophrenia, in particular.” 
One dose of cannabidiol (CBD), a non-psychoactive cannabinoid from cannabis, was found to reduce irregular patterns or behavior associated with hallucinations, delusions, and other symptoms of psychosis, researchers discovered. The research was published in the Journal of the American Medical Association. 
A 2012 study published in Translational Psychiatry involving schizophrenic patients utilizing CBD at levels of 600 to 800mg per day over four weeks discovered that CBD was just as effective as the drug amisulpride (a common pharmaceutical used to treat schizophrenia) in treating psychotic symptoms and actually had fewer adverse effects, including less extra pyramidal symptoms and weight gain. 
In 2015, a mid-stage trial involving 88 people with schizophrenia, a cannabis-based pharmaceutical for treating schizophrenia, developed by UK-based GW Pharmaceuticals, was found to be superior to a placebo.  GW Pharmaceuticals 1:1 CBD to THC product, Sativex, has been approved for use in over 30 countries for the treatment of chronic pain, multiple sclerosis and several other conditions.
A study from 2017 evaluating the effects of CBD on psychosis were explored in two double-blind randomized placebo-controlled clinical trials,  with researchers finding that schizophrenic patients receiving 1000mg daily of CBD showed significantly more improvement than the placebo group.
For more information, see our other article on schizophrenia disorder.
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