Does CBD Work for OCD?
- A study published in 2015 stated that CBD’s anti-compulsive properties may help alleviate the symptoms of OCD(1). The study also outlined CBD’s promise in treating anxiety disorders, which are also associated with OCD.
- Another study in 2017 highlighted CBD’s ability to help reduce the compulsions caused by OCD(2). The authors of the study believe that CBD’s anxiety-reducing and antipsychotic properties provide therapeutic benefits to OCD patients.
- Although significant research has been done on CBD’s effects on OCD symptoms, more studies need to be conducted on CBD as an alternative OCD therapy.
- Before adding CBD oil to one’s medication regimen, an OCD patient must consult with a doctor first.
Why People Are Taking CBD for OCD
The main medications used in the treatment of obsessive-compulsive disorder (OCD) are selective serotonin reuptake inhibitors (SSRIs)(3).
According to the United States Food and Drug Administration (US FDA), patients are allowed to use the following SSRIs to treat OCD(4):
- Clomipramine (Anafranil)
- Fluoxetine (Prozac)
- Paroxetine (Paxil or Pexeva)
- Sertraline (Zoloft)
These SSRIs are also used to treat depression. However, OCD patients take these drugs at higher doses and for more extended periods compared with those of depression patients(5).
Despite the use of these medications, remission of the disorder is uncommon(6).
According to Harvard Health Publishing, patients with depression might take two to six weeks to respond to SSRIs. Meanwhile, OCD patients take 10 to 12 weeks to respond to these medications(7).
SSRIs also have side effects, including restlessness, gastrointestinal distress, sexual dysfunction, weight gain, and insomnia(8).
For these reasons, OCD patients might have started exploring alternative treatments, such as cannabidiol (CBD).
According to a 2019 study, there may be a link between the endocannabinoid system (ECS) and the treatment of OCD symptoms(9).
The ECS helps regulate several functions, like mood, appetite, immune responses, sleep, stress, mood, and memory(10). It has two primary receptors: the cannabinoid receptor 1 (CB1 receptor) and the cannabinoid receptor 2 (CB2 receptor).
In the 2019 study, the researchers suggested that CB1 receptors can be found in high densities in brain regions that are believed to be associated with OCD symptoms(11).
These regions in the brain include the prefrontal cortex, hippocampus, basal ganglia, and amygdala(12).
The researchers of the 2019 study also cited preclinical studies done on rodents. According to the researchers, these studies suggested that cannabinoid signaling might have positive effects on OCD-relevant functions(13).
Examples of these functions relevant to OCD include fear extinction and the balance between goal-directed strategies and the habitual actions of OCD patients.
CBD is one of the primary cannabinoids that is derived from the Cannabis sativa plant and believed to have several neurological benefits(14).
Tetrahydrocannabinol (THC) is the other phytocannabinoid that is predominantly present in the marijuana plant. It is psychoactive, unlike CBD.
CBD is not the same as medical marijuana. However, like CBD, marijuana may also have therapeutic effects on OCD.
A study in 2020 revealed that the OCD symptoms and anxiety levels of OCD patients significantly reduced when they were administered CBD and THC(15).
However, the test subjects who were given THC reported increased blood pressure, heart rate, and intoxication compared with OCD patients who received placebo and CBD concentrations.
Research published in the journal Neurochemical Research suggested that CBD’s interaction with 5-HT1A receptors could inhibit the reuptake of serotonin in the brain. This inhibition meant more serotonin would be made available to the body(16).
This inhibition is similar to the mechanism of action of SSRIs(17).
Serotonin is a neurotransmitter and a chemical in the brain responsible for several functions, like memory, sleep, depression, and anxiety management(18).
A study in 2012 that was published in the journal Translational Psychiatry stated that CBD might trigger the ECS to create more endogenous cannabinoids, including anandamide(19).
The body produces endogenous cannabinoids. Anandamide, meanwhile, is a transmitter responsible for pain, cognition, and mood functions.
The study showed that the test subjects exposed to CBD had higher anandamide levels.
A 2019 study stated that increased anandamide levels guard the body against stress and reduce signs of anxiety and fear(20).
A 2015 study published in Neurotherapeutics, the journal of the American Society for Experimental Neurotherapeutics, suggested that CBD might help treat several disorders, such as generalized anxiety disorder, social anxiety disorder, and OCD(21).
The study also outlined CBD’s anti-compulsive properties, which might help in the treatment of OCD symptoms.
Another study conducted in 2017 revealed that CBD had several therapeutic actions, including anxiety-reducing and antipsychotic activities(22). The study also highlighted CBD’s ability to lessen the compulsions caused by OCD and other psychiatric conditions.
How CBD Oil Works to Alleviate Symptoms of OCD
The National Institute of Mental Health (NIMH) describes OCD as a chronic condition. Patients who are diagnosed with the disorder have uncontrollable, recurring thoughts (obsessions) and behaviors (compulsions) that they are urged to repeat frequently(23).
NIMH defines obsessions as repeated urges or unwanted thoughts that may cause anxiety. Obsessive symptoms include(24):
- Fear of contamination or germs
- Forbidden thoughts that involve sex, religion, or harm
- Aggressive thoughts towards oneself or others
- Urge to have things in perfect order (e.g., symmetrical)
Meanwhile, compulsions are the repetitive behaviors that OCD patients feel the urge to do in response to their obsessive thoughts. These compulsive behaviors include(25):
- Excessive cleaning or handwashing
- Arranging things in a particular way
- Repeatedly checking on things (e.g., repeatedly checking if the door has been locked or the oven has been turned off)
- Compulsive counting
NIMH also says that OCD patients may develop other mental disorders. These conditions include depression, anxiety, and body dysmorphic disorder (the mistaken belief that a part of one’s body is abnormal)(26).
According to NIMH, OCD patients can also develop a tic disorder. This condition is characterized by sudden, brief, and repetitive movements, like eye blinking, facial grimacing, head or shoulder jerking, and shoulder shrugging.
Tics can also be vocal. Examples of vocal tics are repetitive throat-clearing, grunting, or sniffing sounds.
NIMH says that symptoms may ease over time, or they may worsen. NIMH also reports that OCD patients are likely to use substances, like alcohol or drugs, to calm themselves down.
NIMH recommends that people with OCD avoid the triggers of their obsessions.
According to Mayo Clinic, the causes of OCD have not been entirely determined. However, there have been theories as to why people develop OCD. These theories include(27):
- Biology – OCD may be caused by changes in the natural chemistry or brain function of an individual.
- Genetics – Developing OCD may be genetic, but the specific genes that are affected have yet to be identified.
- Learned obsessions and behaviors – Obsessions and compulsions may have been learned from family members or gradually learned over time.
Several factors may also contribute to an individual’s likelihood of developing OCD. These include(28):
- Family history – Chances of developing OCD are higher when one has relatives with the disorder.
- Stressful life events – Traumatic experiences may trigger intrusive thoughts, rituals, and emotional distress, which are all characteristic of OCD.
- Other mental health disorders – These include anxiety disorders, depression, and substance abuse among others.
CBD’s suggested therapeutic benefits might be helpful in the alleviation of symptoms of OCD.
CBD for Anxiety
According to a study published in the World Journal of Psychiatry, adults and children with OCD reveal that their obsessions cause them severe distress and anxiety(29).
Researchers of a 2014 study have found that CBD might demonstrate anti-anxiety and antidepressant effects in animal models(30).
The authors revealed that these therapeutic benefits might be associated with CBD’s interaction with the 5-HT1A receptors.
Another study conducted in 2019 has found that CBD might help in the treatment of neuropsychiatric disorders, such as anxiety, epilepsy, and schizophrenia(31).
The researchers have also discovered CBD’s calming effects on the central nervous system.
CBD for Psychosis
A study in 2017 that was published in the journal BMC Psychiatry stated that symptoms of OCD have a strong correlation with symptoms of psychosis(32). The study also said that patients with psychotic disorders often have OCD, as well.
A 2020 study has found that CBD and compounds that contain CBD, such as nabiximols, were helpful in relieving the psychotic symptoms and cognitive impairment of patients who had a variety of mental conditions(33).
The disorders included in the study were schizophrenia, social anxiety, autism spectrum disorder, attention deficit hyperactivity disorder (ADHD), insomnia, anxiety, bipolar disorder, post-traumatic stress disorder (PTSD), and Tourette syndrome.
CBD for Depression
A study in 2019 published in the journal Brain Sciences reported that OCD and depression are frequently associated with one another(34). They cause severe emotional distress and have detrimental effects on the quality of life of patients.
As mentioned previously, the National Institute of Mental Health says that OCD patients are more likely to develop depression.
Authors of a study published in Frontiers in Immunology stated that CBD might have anxiolytic (anxiety-reducing), antipsychotic, and neuroprotective properties that might be helpful in the treatment of depression, social phobia, epilepsy, sleep disorders, and Parkinson’s disease(35).
Another study in 2016 revealed that CBD might exhibit fast antidepressant effects because it enhances glutamate and serotonin levels(36).
Glutamate is a neurotransmitter that has an essential role in an individual’s learning and memory(37).
The Pros and Cons of CBD Oil for OCD
- Animal studies, human studies, and clinical trials have suggested CBD’s promise in treating OCD symptoms.
- A study published in the journal Cannabis and Cannabinoid Research states that CBD has an excellent safety profile(38). Hence, it may be safely used in the treatment of OCD.
- The World Health Organization reveals that there has been no reported case of CBD addiction in humans(39). Hence, it is not a substance that is highly likely to be abused.
- If federal and state laws allow CBD use in an area, a prescription is not required when purchasing CBD products.
- Further research and clinical studies are needed to determine if CBD is an effective treatment for OCD.
- CBD has minimal side effects, such as weight or appetite changes, tiredness, and diarrhea(40).
- The US FDA has approved the use of CBD only in the treatment of epilepsy(41). For this reason, a standard CBD dosage for treating OCD has yet to be developed.
- There might be drug interactions between CBD and SSRIs. Liver enzymes, called cytochrome P450, metabolize SSRIs. CBD might inhibit CYP450 enzymes and reduce the efficacy of SSRIs in the treatment of OCD(42).
How CBD Oil Compares to Alternative Treatments for OCD
According to a study, some OCD patients cannot tolerate the side effects of traditional medications for OCD(43). The authors of the study also believe that these drugs eventually lose their effectiveness in some patients.
Meanwhile, some OCD patients are starting to take an interest in natural remedies and alternative therapies for OCD.
One alternative remedy is the use of Silybum marianum, commonly known as milk thistle.
A study published in the journal Progress in Neuro-psychopharmacology and Biological Psychiatry was done using fluoxetine (an SSRI) and milk thistle capsules as a treatment for OCD(44).
The authors of the study observed that there was no significant difference between the efficacy of fluoxetine and the milk thistle capsules.
Another medicinal herb that is being used to treat OCD is curcumin, turmeric’s active ingredient. A study has found that curcumin had protective effects on the disorder(45).
Alternative therapies are also available to OCD patients. According to Mayo Clinic, deep brain stimulation (DBS) is one of these alternative procedures(46). This FDA-approved treatment involves implanting electrodes in some regions of the brain.
The electrodes implanted during DBS produce electrical impulses that are believed to help regulate abnormal impulses. This treatment is only available to adults who are 18 years and older.
Adults who are 22 to 68 years old may also seek transcranial magnetic stimulation (TMS)(47). The procedure uses magnetic fields to stimulate the brain’s nerve cells to alleviate OCD’s symptoms.
An electromagnetic coil is placed against the scalp and near the forehead of patients.
Compared to herbal medications, CBD might have neuroprotective properties that can benefit OCD patients(48). The studies previously mentioned also highlighted CBD’s anxiety-reducing, antidepressant, and antipsychotic effects.
Like DBS and TMS, CBD may also be used as an adjunct therapy.
How to Choose the Right CBD for OCD
OCD patients who want to explore CBD as a treatment for their disorder may choose from three types. These include full-spectrum CBD oil, broad-spectrum, and CBD isolates.
Among the three, full-spectrum CBD oil is believed to be more effective because of the entourage effect. This mechanism involves the synergy of all the active ingredients of the cannabis plant to give maximum therapeutic effect to users.
The ingredients of a full-spectrum CBD oil include less than 0.30% THC, flavonoids, terpenes, fatty acids, and essential oils.
OCD patients should note that THC may have mild psychoactive effects on some individuals. Some drug tests can also detect THC.
For patients who want to avoid these risks, a broad-spectrum CBD oil is more recommended. It has all the components of a full-spectrum oil, except for THC.
Some patients may be allergic to the ingredients of full-spectrum and broad-spectrum CBD oils. There is an option that makes use of pure cannabidiol. This oil is known as a CBD isolate.
Some CBD oil products are sometimes labeled as ‘CBD hemp oil’ or ‘CBD hemp extract.’
CBD comes from the flowers, leaves, and stalks of a hemp plant. Meanwhile, hemp seed oil, which is extracted from hemp seeds, does not contain CBD.
Before patients use CBD oil, they should make sure their CBD product is of high quality. Here are some guidelines before making a purchase, especially online:
- Check if the state where the CBD products are going to be bought allows the use of CBD and other medical cannabis-related products.
- Research on the CBD manufacturer’s legitimacy. Make sure the products to be purchased are non-GMO and derived from certified organic hemp.
- Look up the CBD brand and its products online. Check the reviews and see if the store is authorized by the government to sell CBD. More credible brands have money-back guarantee policies to assure customer satisfaction.
- Determine the extraction process used in a CBD oil product. CO2 extraction is a safe process(49). Natural carrier oils that are used in the extraction methods of CBD include MCT oil (medium-chain triglycerides from coconut oil), hemp seed oil, and extra-virgin olive oil.
- Request access to a product’s batch testing reports. To certify the quality and potency of the ingredients of their CBD products, manufacturers allow third-party laboratories to analyze these. There has been a prevalence of mislabeled CBD products being sold online. In 2018, researchers found that a significant number of CBD products contained less CBD than what was declared in the label(50). The authors also found that 43% of the product samples tested had more CBD than what was on the label, while 21% had THC amounts that were enough to get children high.
- Before buying a CBD product for OCD treatment, patients should consult with a doctor first.
CBD Dosage for OCD
Due to the US FDA’s lack of approval, a standard CBD dosage chart for OCD patients has not yet been developed. When taking CBD oil for OCD, patients should go low and slow.
OCD patients are advised to start with a low dosage of CBD. If there are no side effects, the dosage may be increased gradually until therapeutic effects are observed.
Patients are also advised to keep a journal to record their reactions to the CBD treatment. They may use this journal as a reference upon consultation with their physician.
Before adding CBD to their OCD therapy, patients should always inform their doctor first.
How to Take CBD for OCD
CBD is available in different formats. OCD patients may take CBD orally, through CBD oil, CBD sprays, CBD oil tinctures (drops), CBD gel caps, CBD capsules, or gummies.
These formats allow patients to consume CBD directly or to mix these CBD products with food or beverages.
CBD capsules, gel caps, and pills are a convenient way to bring CBD wherever the patient goes. Their format also guarantees that patients take a consistent dosage of CBD.
Meanwhile, CBD oil and CBD tinctures allow patients to adjust the CBD dosage as needed.
Tinctures may be taken sublingually by using the dropper to apply the oil under the tongue for 60 to 90 seconds before swallowing.
CBD may also be used during massages. These massages may be therapeutic and stress-relieving to OCD patients who are undergoing bouts of depression.
OCD patients may also opt to inhale CBD via vape or vape pens. This method gives quick results because users ingest the active ingredients in an instant. A study suggests that CBD’s bioavailability is higher when inhaled compared with CBD that’s orally taken(51).
Bioavailability is defined as the extent and rate at which the active ingredient from the product is absorbed by the body and made available at the site of the drug action(52).
The effects may be instantly perceived as CBD enters the bloodstream through the lungs, not the digestive system. However, findings from the Centers for Disease Control and Prevention (CDC) state that lung problems have been associated with the use of vape products(53).
One disadvantage of using CBD vape products is that the amount of CBD in each draw cannot be accurately determined. The results last for half an hour to two hours at most.
Elderly OCD patients and those with lung problems are discouraged from using CBD in this format.
Topical CBD formats are also available, such as creams, balms, lotions, and salves.
OCD is a chronic condition that affects children and adults alike. To date, its causes are unknown.
Traditional medications that are used in the treatment of OCD include SSRIs. However, they have side effects that may be harmful to some patients.
Studies have also shown that the efficacy of these SSRIs may decrease throughout the OCD patient’s treatment.
Alternative medicine, such as milk thistle and curcumin, are being used to treat OCD. Therapies, such as deep brain stimulation (DBS) and transcranial magnetic stimulation (TMS), are also being employed to help manage OCD symptoms.
Significant studies in animal and human models have shown that CBD might be promising in the treatment of psychiatric disorders. One such condition is obsessive-compulsive disorder.
There is significant research on CBD’s effects on anxiety symptoms and other conditions associated with OCD. However, further research is needed on CBD’s therapeutic benefits on OCD.
Before using CBD in the treatment of OCD, it is advised that patients first consult with a medical professional.
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