Treatment of social anxiety disorder and attenuated psychotic symptoms with cannabidiol

• Published in: BMJ case reports Vol. 13; no. 10; p. e235307
• Main Authors: Berger, Maximus, Li, Emily, Amminger, Günter Paul
• Format: Journal Article
• Language: English
• Published: England BMJ Publishing Group LTD 07.10.2020; BMJ Publishing Group
• Series: Case report
• Subjects: Adult; Anxiety disorders; Blood; Cannabidiol; Cannabidiol - administration & dosage; Case reports; Clinical trials; Cognitive Behavioral Therapy - methods; Comorbidity; Depressive Disorder, Major - diagnosis; Depressive Disorder, Major - psychology; Depressive Disorder, Major - therapy; Depressive Disorder, Treatment-Resistant - therapy; Dose-Response Relationship, Drug; Drug Monitoring - methods; Hallucinations; Humans; Innovations in Treatment; Insomnia; Male; Mental disorders; Mirtazapine - administration & dosage; Phobia, Social - diagnosis; Phobia, Social - psychology; Phobia, Social - therapy; Post traumatic stress disorder; Psychiatric Status Rating Scales; Psychologists; Psychosis; Psychotic Disorders - diagnosis; Psychotic Disorders - therapy; Psychotropic drugs; Psychotropic Drugs - administration & dosage; Sleep; Sleep Initiation and Maintenance Disorders - diagnosis; Sleep Initiation and Maintenance Disorders - therapy; Social anxiety; Suicides & suicide attempts; Treatment Outcome; psychotic disorders (including schizophrenia); psychiatry (drugs and medicines); anxiety disorders (including OCD and PTSD)
• ISSN: 1757-790X; 1757-790X
• DOI: 10.1136/bcr-2020-235307

Anxiety disorders in young people are frequently comorbid with other mental disorders and respond unsatisfactorily to first-line treatment in many cases. Here, we report the case of a 20-year-old man with severe social anxiety disorder, major depressive disorder, insomnia and attenuated psychotic symptoms despite ongoing treatment with cognitive behavioural therapy and mirtazapine who was treated with adjunctive cannabidiol (CBD) in doses between 200 and 800 mg/day for 6 months. During treatment with CBD, he experienced subjective benefits to his anxiety, depression and positive symptoms during treatment that were confirmed by clinicians and by standardised research instruments. Findings from this case study add to existing evidence in support of the safety of CBD and suggest that it may be useful for young people with treatment refractory anxiety and for attenuated psychotic symptoms.