How CBD’s Can Effectively Treat Bipolar Disorder Symptoms and Manic Episodes

How CBD’s Can Effectively Treat Bipolar Disorder Symptoms and Manic Episodes

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As medical marijuana becomes legal in more states across the country, there’s been a spike in public interest to see whether cannabis can effectively treat mood disorders such as anxiety, depression, and psychosis that are commonly associated with bipolar disorder. Unfortunately, there are conflicts in scientific consensus for both supporting and opposing views of cannabis use for the treatment of mood disorders. Some studies have linked marijuana use with early-onset psychosis, while others suggest there are anti-psychotic benefits of cannabis in bipolar disorder patients.

It has been shown that cannabidiol has anti-psychotic properties, particularly anxiolytic benefits in humans. CBD possesses hypnotic, anti-convulsive, neuroprotective, and anti-stress benefits. Based on this evidence, research studies have begun to investigate the anxiolytic and antipsychotic benefits of CBD, which may be useful in effectively treating bipolar disorder.

The Neurochemistry of Bipolar Disorder and Cannabinoids

A dysfunctional endocannabinoid system (EC) has been implicated in mood disorders such as bipolar disorder, and modulation of the EC system by exogenous cannabinoids such as cannabidiol, tetrahydrocannabinol and anandamide can potentially treat bipolar disorder symptoms by exerting antipsychotic, anticonvulsant, and anxiolytic effects. Research studies have demonstrated the antipsychotic mechanism action of cannabidiol. Administration of cannabidiol may indirectly influence endogenous anandamide signaling by inhibiting intracellular metabolism by fatty acid amide hydrolase (FAAH). Elevated levels of anandamide can attenuate mood disturbances and treat bipolar disorder symptoms.

Research studies have pointed out the role of the dopamine (DA) system in mood disorders, including bipolar disorder. The key role of the mesoaccumbens DA system has been proven in the reward pathway (neural circuitry) and motivational behaviors. Experimental studies being conducted to investigate the efficacy of anti-psychotic drugs are based on the hypothesis of dopamine, glutamate, and other neurotransmitters. These drugs exhibit antagonism to dopamine D2 receptors which is commonly linked with hyperprolactinemia due to action of anterior-pituitary mammotrophic cells. These drugs are called typical anti-psychotics (Clozapine) which cause Parkinson-like symptoms, while atypical anti-psychotics are also effective without causing serious adverse events, which can be confirmed by a catalepsy test.

Atypical anti-psychotic drugs inhibit hyperlocomotion and the stereotype that results due to dopamine antagonists at lower doses. Effective anti-psychotic action requires the blocking of D2 receptors as well as glutamatergic N-methyl-D-aspartate (NMDA) receptors.

A comparative study assessed the anti-psychotic efficacy of haloperidol (an anti-psychotic drug) and cannabidiol (CBD) found that CBD inhibited hyperlocomotion without causing catalepsy, even at higher doses; while haloperidol caused prolactin disturbances. The pharmacological action of CBD mimics clozapine. Another neurochemical experimental study reported similar results. These results prove that CBD acts like an atypical anti-psychotic drug without causing serious and long-term side effects.

One study investigated the anti-depressive action of CBD in an experimental animal model (AKA olfactory bulbectomy mouse model) of depression (OBX). The results suggest that cannabidiol exerted rapid and sustained antidepressant action in the depressed animals by significantly augmenting cortical serotonin and glutamate levels in a dose-dependent manner. Receptor studies have shown that the action was exerted via a 5-HT1A receptor-dependent mechanism, which represents novel drug functionality. After prolonged CBD administration notable adaptive changes were documented in pre and post-synaptic 5-HT1A receptor action.

CBD can inhibit glutamate toxicity and offers anti-convulsant and mood-stabilizing benefits, which are similar to the benefits of conventional therapeutic drugs such as valproate and lithium that are indicated for bipolar disorder. In open-label human clinical trials, CBD has significantly reduced psychotic symptoms and normalized motor functions in psychiatric patients. These benefits can be useful to treat manic episodes in bipolar disorder patients.

Cannabinoids influence mood perceptions and exert anti-depressant action by acting as an agonist in central CB1 receptors. 5-HT is believed to be responsible for mood control and implicated in antidepressant-like actions. Research evidences have pointed out the action of CBD in the serotonin (5-HT) system and related neurons. Administration of CB1R agonists such as phytocannabinoids into the ventromedial prefrontal cortex of the brain has resulted in enhanced 5-HT neuronal activity and CB1R-dependent antidepressant-like effects in the experimental animals. This study clearly shows the dose-dependent antidepressant benefit of CBD, which can be particularly useful for the treatment of mood disorders, including bipolar disorder.

The Neuroprotective, Anti-psychotic, and Anxiolytic Benefits of CBD

Recent studies have found that CBD can provide neuro-protection in acute and chronic neurodegenerative disorders. Published studies have shown that oxidative stress and free radical generation may play an important role in the pathogenesis of bipolar disorder. In vitro studies and in vivo studies have confirmed that CBD possess neuroprotective properties.

CBD can exert anti-oxidative (scavenging free radicals) and neuroprotective benefits in humans. In this study, CBD was found to be an inhibitor of oxidative damage (free radicals) and increased BDNF (brain-derived neurotrophic factor) levels in the brain regions. BDNF is vital for synaptic plasticity and hence for neuro-protection. Similar results were reported by another study. By mitigating the oxidative stress in the brain, cannabidiol can treat and prevent the symptoms of bipolar disorder.

Not only research studies, but even anecdotal, subjective reports and case studies have shown anti-psychotic benefits of cannabis. Most of the bipolar disorder patients studied use cannabis either to treat the symptoms or to reduce the side effects of conventional therapeutic drugs, such as lithium. Although this evidence looks promising, stringent laws and anti-drug campaigns have made it impossible to conduct large-scale, controlled studies to fully explore the anti-psychotic benefits of marijuana to treat bipolar disorder.  

One prospective study that collected mood data of bipolar disorder patients over two years has reported marijuana use was associated with complete abstinence of substance abuse in bipolar disorder patients. Although cannabis did not reduce total number of days of abnormal mood, marijuana increased the number of hypomanic days and decreased the number of depressed days in bipolar disorder patients.

Bipolar disorder patients often report subjective mood improvement after marijuana use. A small research study that enrolled 43 bipolar disorder patients reported remarkable reduction in total mood disturbance in marijuana smokers, while a slight worsening of symptoms was observed in pure marijuana users. Most of the patients who reported mood improvements were diagnosed with worse mood ratings before marijuana use. This empirical evidence can support the anecdotal claims that cannabis can treat mood-related symptoms.

One open-label clinical trial study that enrolled a 19-year old schizophrenic woman who suffered serious adverse events after standard anti-psychotic therapeutic drugs use has compared the use of CBD oil followed by interruption of treatment and placebo administration. Finally, the patient was treated with increasing doses of haloperidol. The treatment benefits were assessed by the Brief Psychiatric Rating Scale (BPRS). Significant improvement in mood symptoms was observed during the CBD oil treatment period, and found to be worsening during treatment the interruption period and placebo treatment. These reported improvements were not further improved by haloperidol treatment. This evidence clearly shows that bipolar disorder symptoms are poorly controlled by conventional therapies, while marijuana is a reliable option to treat mood disorders, including bipolar disorder. By employing the Ugvalg for Kliniske Undersgelser (UKU) scale, the study observed no serious side effects after marijuana use.

In a double-blind, placebo-controlled study, CBD was equally effective in treating anxiety, compared with diazepam and ipsapirone, in humans. The study results were concordant with another clinical trial study as evidenced by cerebral activity pattern.

This evidence is further strengthened by other independent academic studies that indicated cannabidiol as an effective and safer anti-psychotic treatment option for bipolar disorder. One study has reported that CBD has a similar pharmacological profile as like mood stabilizing drugs, albeit without serious side effects.

Bipolar disorder is characterized by impaired learning abilities and verbal fluency. One study reported that cannabis treatment can significantly improve learning abilities and verbal fluency in bipolar disorder patients. However, comparatively slighter improvements were observed in patients who were treated with conventional therapies such as antidepressants and lithium. Cannabis therapy generally causes fewer but temporary side effects, whereas conventional therapy can cause prolonged and serious adverse events.  

In addition to human clinical trial evidence, let’s have a look at the pre-clinical studies that demonstrate the benefits of cannabis on symptoms of bipolar disorder. CBD’s anti-psychotic effect has been demonstrated in several experimental studies based on encouraging results in conditioned emotional response, the Vogel conflict test, and the elevated plus-maze studies.

Considering this evidence, we can clearly see the anti-psychotic benefits of marijuana for treatment of bipolar disorders. Based on all of this irrefutable scientific proof, large-scale, prospective, controlled clinical studies should be conducted by renowned academic institutions to provide sound evidence to support the use of CDB to treat bipolar disorder, and therefore benefit mankind.

24 COMMENTS

  1. I had the most untreatable bipolar for the past fourteen years where the unconventional therapy caused more side effects than benefits. I tried CBD and from the first trial my symptoms were stabilized. IT has been five months now.

    • Hello Susan, interested in how you went about using the cbd, dosage etc. In the same boat as you and embarking on cbd oil. If I could find out any info from you that would be great, cheers, Katy

    • Hi susan my name is Angela and i just ordered my first bottle of CBD oil its expensive!39.99 plus 8.99 shipping..What cbd oil do you use? Where do you get it and is it expensive?

  2. Thank you sharing your experience with CBD. Really sounds great!

    I think you’ve meant to say conventional therapy. Yes, these drugs do more harm than benefits.

    Your story is not an anecdotal evidence but really stands as a subjective case study to prove CBD’s efficacy in BPD.

  3. Hi Prakash and others who may know. I am currently taking lamotragine 250mg and brintellex antidepressant for bipolar 2. I want to explore using cbd oil and wondered if you any info re safety of taking both at once. Or if you had any studies I could point my psychiatrist to.

  4. Hi Lisa,

    I’m sorry to say, I can’t find any safety data related to drug-drug interactions of CBD and lamotragine plus brintellex, as no studies were conducted on this topic. I believe CBD has no pharmacological influence such as synergistic, antagonist activities, on these medications.

  5. Thank you for this very indepth article on such an unexplored subject. It also means so much to hear stories from others that share a similiar struggle. I too am almost at the end of the prescription drug line: the next and final stop (for me) will be Lithium.

    Living with BPD is a constant battle to adjust, adapt, and function. Often times it feels a poor quality of life, not only for me but my loved ones as well.

    Is anyone willing to share their dosage information for CBD usage? Also, does anyone know of medical professionals or other resources that focus on treating BPD with CBD? Peace and blessings to all.

    • I am taking 12.5 mg at bedtime, CBD oil derived from marijuana with a small amount of THC. During the day I take one dose, about 20 mg, of CBD oil derived from organic hemp. The antidepressant effects have been amazing. No side effects. I’m sleeping better than I have in years. I am considering going off the mood stabilizer I am on now and relying on CBD alone.

  6. Diagnosed withbipolar ii, ptsd, and intermittent explosive disorder within the last year. Dr first started me on Serouel (terrible slept for 3 days) upped my wellbutrin to a high dose and caused manic symptoms like seeing cats out of the corner of myeye. Never could do Lithium cause I have thryoid disease. Finally did Trileptal (300mg) and Wellbutrin (150mg) was stable on that but was still rollercoasting and having major manic sometimes hypomanic episodes and those episodes include obsessive/nitpicking cleaning, due to nervousness and restlessness everything must be clean and in order in my house or I can think clearly and have rage like symptoms. She upped the trileptal to 600mg and added 20-40mg of Geodon before bed that was supposed to knock out my manic insomniac, up til 2am obsessed over unsolved murder cases and conspiracy theories, and would get into moods where I didnt shower for 2 days and never wanted to leave the house or answer my phone, the Geodon gave me nightmares, muscle cramping while sleeping and made me sleep like shit. I then found my boyfriend dead in a bathroom after months of struggling with his heroin addiction and several attempts to get him to get clean. It traumatized me that I got home 15 minutes too late and wasnt able to save his life, beat his ass, kick him out, and go to rehab. Went through and still am going thru the stages of grieving on top of bipolar disorder. I have crying outbreaks where I think of him, the situation, cry and cant breath. She upped my trileptal to 900mg, geodon to 80mg and wanted me to start dosing the meds during the day instead of before bed. I became a zombie and was falling asleep sitting up and my family would talk to me and Id talk nonsense. I asked her to decrease my meds back down to what i was comfortable on, as i always told her none of these pills are magic and I was comfortable dealing with the ups and downs, although the lower doses did take the edge, and I asked her to add a PRN anti anxiety panic attack med like Ativan or Xanax for my grieving and panic attacks. She dropped me as patient because I take suboxone for my back after I was ejected from a car, was on pain meds, was cut from them when I was still in pain (sacroiliac fracture, completely broken tail bone, MCL tear, post concussion synrome. No doctors in my area would help me with pain meds so I turned to heroin. That was 3 years ago and I am three years sober but take Suboxone for back pain, and naltrexone/naloxone in low dose also helps my fibromyalgia, another thing that started 7 years ago after having my daughter, they could find no explanation for my pain, so was diagnosed with that. A GREAT friend, introduced me to CBD oil and I am in the first few days of trying it out. I am praying it helps with my bipolar, anxiety and panic attacks, because we all know how dangerous benzodiazepams can be let alone these toxic anti pyschotics. This article made my day I hope they continue to conduct studies for the mental health aspect and benefits of CBD. GOOD LUCK TO ALL!!!!

  7. I am 49 and was diagnosed with BPD II when I was 26. I am currently on 1200mg Lithium, 200mg Lamictal, 40mg Cipralex and 5mg Abillify. I am battling with side effects and have felt flat for months. I too wish to change over to CBD oil. Would I be able to wean my meds AND start the oil at the same time? Any response at all would be appreciated. Thanks!

  8. I too was eventually Diagnosed with BPD….I’m said to have the worst stage, 3…..I am mostly ok but I always end up spiralling into hypomania. …mania and short period of pychosis…maybe I can do a year or couple months of being / seeming normal. ..without medication but if there are any major stressor…like child birth ( to a very heartless father of my child) (my baby girl is 3 yes and taken against my will to the USA….I deliberately avoided my meds after about a month of pregnancy because I wanted a next to perfect….nearly normal pregnancy and i wanted to bteast feed for as long as i could manage after having the baby….I did it (breast feed for a little over 3 weeks..then switched to enfamil when i had to go baxk on my meds due to family of the father bullshit, my own dysfunctional family bullshit, my own continous bullshit struggles with bipolar and some amount of post child birth depression….and an absence of good support system, love and genuine care for me…..I struggled to feed myself, clothed my self , and just survive despite the man who impregnated me being a very successful doctor..I had to endure abuse and cold hearted messages and texts from the women in his family who found out about my medical history and who thought it was a good idea to let me know if should send my only Child away so she could get a better life…..I held on to my baby girl Kenya for as long as I could….I taught her to read …I taught her to recall basis life info…like the days of the werk, monthso of the year and most of the opposites…like easy visit difficult. …above and below. ..reading time…simple maths. …she is next to genius….but at 3 yes old she now has to wonder why her mommy never comes to her…..this is very difficult for me….as before I allowed her to visit her father in the states I endured the huge embarrassed of finding out that her father was getting married to another woman (who was pregnant with his second child ) and they got married Aug 9 2015 in NYC while Kenya and I were in Jamaica. ……that mornings coincidentally. …my father passed away………
    The struggles of a Bipolar labled persons are real….and we get abused mostly by the people who should love us or at least protect us……I’ve had countless jobs, I’ve either been asked to resign, resigned or simply walked off countless jobs because of my hidden reality…..I comply with medicine as far as it allows me a close to normal life…. (sleeping off a high doses for the greater part of the day…waking up to eat again then medication that puts me right back to sleep …is not a life) so I prayed for death and being Creator- fearing. ..I was a a point in my depressed slump where I was bargaining with my Creator for death. ..it was during that period in my life I was introduced by my Mom to the father of my only baby …..so now despite not having her with me currently. ..and not knowing when I’ll ever see her in person again. …I can’t enter the USA being a non citizen, I am preparing myself to be able to get rightful parental custody in a near future. ….I am being punished for my honest remarks and of course for being a human being ….diagnosed with Bipolar……
    I am curious about CBD…..my friend a 3 Yr Media student is encouraging me to try it….but what I want to say is that my Bipolar originated shortly after being secretly fed cannabis. ..ganja. .as we say in Jamaica over a period of time…it was hidden in food I consumed whilst I went through a stressful time of parental physical abuse …..left my home to seek refuge at relatives….went to another relative home on invite ( not admitting) that I did so really because I wad being sexuality entreated. …touching etc by a male cousin who lived in the home I went initially to seek refuge…..life is tough as this happened during my end of high school exam preparations……I made it to one of the best…if not the best University in my country but had no idea that Bipolar was in store….first generation university attendant…the first in my nuclear unit to endure reading for a degree. ..the only one with the paper to prove it endured…
    But the costs were high. …..I’m now very motivated to thrive and be the best mom, employee, future business owner, best righteous obeyed of my Creator and best human being. ..that is can be…despite all that…I will have a life that will make me happy as I am about to exhail my last exhail…many many many years from now…
    All my fellow BPD diagnosees around the globe…I encourage you to know you are special…you are worth being alive, you are very important to this world….you need to know it…own it and get out of bed (when u can) you have to live…overcome and pull up by encouraging another of us….we will beat this. ..we must

    • I am sorry for you Eskay ihope and pray the best for you..Cbd oil does not have thc its not the same as marijuana..it wont hurt to try it..

  9. My family and I have seen the differences in myself with my schizoaffective disorder, and getting off many medications with your product. It has also created more quality time with my daughter. Thank you BioCBD water soluble products. – John

  10. Thank you everyone for putting your lives out here. I have been seeking any and all information I can on CBD oil for BPD. It has been eye opening and both up and down with feeling I am on the right track. My sister has been suffering from BPD for the past 25 yrs and both our mother and I discouraged with the current treatments that have proven to not work nor be a healthy way of life. I have recently started my sister on CBD oil with a low percent of THC (24:1). She has been taking .5 ml three times a day for a week now but have not seen any changes yet. I have read to start out on a low dose and keep with it for a week. I am wondering if doubling the dose for the next week would be a good idea or would that be too much?

  11. I’m very interested in this idea, and I think it would definitely be worth trying CBD to see what effect it had, since it is true that CBD does show both anti-anxiety and anti-psychotic effects both of which are active in bipolar. But, that said, THIS ARTICLE IS INACCURATE AND MISLEADING. (I was worried when I started reading and a lot of it sounded like the person writing it was enthusiastically stringing words together that they didn’t really understand.) then I came to this sentence:

    “A comparative study assessed the anti-psychotic efficacy of haloperidol (an anti-psychotic drug) and cannabidiol (CBD) found that CBD inhibited hyperlocomotion without causing catalepsy, even at higher doses; while haloperidol caused prolactin disturbances. The pharmacological action of CBD mimics clozapine.”
    This sentence has a link to a study that compared haloperidol and CLOZAPINE, not haloperidol and CBD. oops. that’s a pretty huge mis-statement! The next study they link to actually did study CBD and it did have encouraging results, but the results were in rats, not people.

    Several other links that SEEM to be about CBD are not (when you click the link you see that it’s about the effectiveness of drugs that have some of the same general effects of CBD, but are not, in fact, CBD.

    This statement is also only half true: “CBD has significantly reduced psychotic symptoms and normalized motor functions in psychiatric patients.” This link was to a study of psychosis in people with parkinson’s disease. It’s true that CBD helped with their psychosis (yay, this is the important part!) but the CBD did not “normalize” their motor functioning. It just didn’t WORSEN their motor functioning (also an important finding, but not what the quote in this sloppy article claims.)

    This quote “This evidence clearly shows that bipolar disorder symptoms are poorly controlled by conventional therapies, while marijuana is a reliable option to treat mood disorders, including bipolar disorder. “ is in response to a study of a case study of using CBD to treat SCHIZOPHRENIA, not bipolar. So the article is clearly sensationalist and wildly inaccurate and sloppy.

    Still, given that many of the known effects of CBD are related to the problems in bipolar, and given the extremely favourable side-effect profile of CBD (virtually nil), if I had bipolar I would likely give (pure) CBD oil (with no THC) a try.

  12. How to sensibly buy LEGAL cbd oil? Because I got a letter saying customs has confiscated my package two times already and I’m pissed.

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