CBD Research - How CBD Works
HOW DOES WORK FOR OCD
There is new research coming out across the board on health issues.
OCD is no different.
This is good news for the 2.5% of the population that will experience OCD during their lives.
There are some clues however which may point to how CBD can help.
We'll look at all of it.
Some curious points:
- What's the connection with strep throat and OCD?
- Why is OCD gender neutral (very different from other mental health issues)?
- What's the relationship with stress and inflammation?
- Why is OCD more prevalent in the developed world?
- What role does the gut biome have in OCD?
We're going to look at ALL of it.
We'll then jump into the endocannabinoid system and finally, CBD.
We've often heard that a little OCD is needed to be successful.
Let's see if we can shed light on the more extreme type which hinders a quality of life.
You can check out 3rd party screened CBD brands by safety and cost here:
Otherwise, jump to any section here:
- Current research on what causes OCD
- Brain regions and OCD
- Genes tied to OCD
- Neurotransmitters and OCD
- Hormones and OCD
- Brain inflammation, Stress, and OCD
- Gut Biome and OCD
- Past Trauma and OCD
- Histamine and OCD
- Meds used for OCD
- The endocannabinoid system and OCD
- What research shows for and OCD
- How much CBD to take for OCD
- What's the best CBD for OCD
Like we said...no stone unturned.
Sufferers of OCD can appreciated that!
Current Research On What Causes OCD
Researchers are gaining a better understanding of the mechanics behind OCD.
The current theories involve:
- Specific brain area function and communication regarding primitive impulses (aggression, sexualtity, and bodily excretions)
- Specific genetic effects
- Results of bacterial/viral infection, trauma, and immune response
- Cognitive behavioral transferring of impulses (from above)
Let's look at each of these separately and then touch on some complicit causes.
Of course, we'll start with the brain!
Brain Regions And OCD
The new research on this front is fascinating!
Basically, there's an ancient (evolutionarily speaking) circuit that controls primitive impulses such as aggression, sexuality, and bodily excretions
It involves communication between the orbitofrontal cortex (just above and behind your eyes) and the thalmus (part of the old "reptilian" brain in the back...very old).
The interchange between these two very different parts of the brain is partially handled in the caudate nucleus.
Okay...we understand if you're eyes are glossing over but we'll come back around to these areas.
There's a very interesting read here:
This brain pathway is in charge of motivating you to do certain things.
The fact that OCD impulses usually involve contamination for example, points to the underlying impulse to wash hands after using the bathroom!
Read the article above...very fascinating and we'll come back around to it.
Next, to the genes please.
Genetic Factors For OCD
There's a known hereditary component to OCD.
Twin studies and family studies both bear this out.
You are 4 times more likely to develop OCD if you have a family member who has it.
This is where science is going to grow by leaps and bounds.
Throw in CRSPR technology (now being tested by the FDA as I write this) and there's hope to address this aspect and reduce suffering soon.
As expected, the genes tied to OCD govern the function of (wait for it):
- Stratium (where the caudate nucleus resides...the relay between other two areas)
- Thalamus (ancient part of the brain mentioned above)
- Cortex (that area behind our eyes)
This is the very "circuit" that appears to be malfunctioning in people with OCD.
Another critical clue (especially for the medications used) is the HTR2A gene.
This gene governs the function of serotonin which is a powerful signaling chemical in the brain.
It's also at the root target of most meds used currently for OCD.
CBD has a very interesting connection with serotonin (as does the gut biome) which we'll discuss later.
Right now, just make a note next to serotonin.
Also, demand that your legislators push to move CRSPR forward...we need a moon mission to feeling better.
Sorry for the rant...
We'll touch on the MTHFR gene later (just 40% of the population).
We brought up serotonin...are there are other neurotransmitters at play?
Neurotransmitters And OCD
Serotonin is a big one. It's a powerful worker in the "circuit" we described above between different parts of the brain.
Most people know serotonin from its effect on depression.
It's called our "feel good" chemical.
It does so much more than that and helps different parts of the brain communicate.
It's not the only neurotransmitter at work (or not working) with OCD.
Enter glutamate.
This is a key excitatory chemical in the brain.
It's basically the gas pedal across a wide range of pathways in the brain.
If there's too much of it, many different mental health issues can occur depending on what part of the brain is affected (or susceptible due to genetics or injury):
- Autism
- PTSD
- Insomnia
- Bipolar
- ADHD
- Anxiety
You'll notice a trend there.
All share a basic attribute of something being too heightened or overactive.
Thank you, Glutamate.
In fact, a gene tied to glutamate function was implicated in OCD.
We're even starting to get results where low glutamate diets can reduce OCD symtoms:
If elevated glutamate is applied to the circuit mentioned above, you can see how the impulse intensity would spiral out of control.
Finally, if glutamate is the gas on the pedal, GABA is the brake!
There's even a connection there with OCD directly.
Compared with healthy controls, the GABA/W and NAA/W concentration in individuals with OCD are significantly decreased
So, make one more mental note on GABA and Glutamate which we'll touch on later in regards to CBD.
Next, to the second (if not first) most powerful chemicals in the body...
Hormones!
Hormones And OCD
There's a known connection between reproductive hormones and OCD (usually severity for existing sufferers).
Interestingly, OCD is one of the few mental health issues which is gender neutral.
Most of the differences across other issues are directly tied to the powerful effect of hormones.
Diagnoses are the same across gender (although younger sufferers tend to be male) but hormones can definitely drive the severity...especially in women.
Female hormones affect symptom severity in obsessive-compulsive disorder.
This pattern can be seen anytime we have fluctuation in key hormones:
In a substantial number of patients, the onset or worsening of OCD was related to reproductive cycle events, especially at menarche and postpartum
How much impact after delivery?
There's also clinical evidence that the perinatal period is a time of high risk for OCD onset, given that OCD affects 2.07 percent of pregnant women, compared to 1.08 percent of non-pregnant people.
That's almost double!
Why is this?
This goes back to serotonin which we mentioned above.
Estrogen and progesterone have powerful effects on serotonin levels and signaling.
It may not be serotonin directly but metabolites that contribute to OCD such as vasopression, oxytocin, and others.
In fact, this maybe the mechanism by which common OCD medications have their effect:
Long-term treatment with high-doses of clomipramine, fluvoxamine, and fluoxetine tend to correct these neuropeptide abnormalities.
So balance of hormones and neurotransmitters. Dog-ear that thought for later.
Next up...the root of seemingly all major ailments (body and brain).
Inflammation!
Brain Inflammation, Stress, And OCD
They have an innocuous-sounding name for it...PANDA.
pediatric autoimmune disorders associated with streptococcal infections
Basically, exposure to strep infection during adolescents can result in OCD later in life.
What is going on here?
For a subset of OCD sufferers, antibodies from infection (including strep) may cross the brain/blood barrier.
The body (and brain's) immune response targets this and unleashes its attack.
There's always collateral damage and if the location of the antibodies are in the brain regions we discussed above, OCD may be how that manifests.
This is classic auto-immune disease.
We're seeing more and more examples of this.
Such as mouth bacteria tied to dementia.
Check out CBD and autoimmune here.
Scientist are actually finding inflammation directly linked to OCD in the brain circuitry:
brain inflammation is significantly elevated – more than 30 per cent higher – in people with obsessive-compulsive disorder (OCD) than in people without the condition.
And then there's the gut!
Gut Biome And OCD
The trillions of bacteria that reside in our gut are incredibly important to our health and mental health.
Remember how we said that serotonin may be instrumental in OCD progression?
90% of our serotonin is made by our gut bacteria!
What about GABA and Glutamate (the brake and gas pedal of the brain)?
Much of those chemicals are partially synthesized in the gut.
Maybe more importantly, the gut is the seat of our immune and inflammatory response.
So what happens when the gut goes wrong?
The microbiome is cutting edge research (unfortunately).
Studies are just getting underway for specific issues such as OCD.
The initial animal studies are intriguing.
Researchers were able to affect OCD symptoms and progression by affecting the gut bacteria:
there is preclinical evidence that OCD-like behavior in rodents (frequently measured using the marble burying test, which aims to assess repetitive, compulsive behaviors, one of the core symptoms of OCD) can be modified by microbial treatments, including germ-free environments and probiotic treatments
We expect OCD to follow all the other issues where the gut biome is very influential (anxiety, depression, autism, etc).
Check out CBD and Inflammation, CBD and the Gut, or CBD and Autoimmune separately.
Let's look at past trauma.
Past Trauma And OCD
OCD may just be a very specific response to reduce anxiety with influence from the circuit in the brain mentioned above.
The relationship between PTSD and OCD is well established (as are both to anxiety):
Research shows that the likelihood of a person diagnosed with PTSD developing OCD within a year is about 30 percent.
There's a great review here:
We have an entire article on PTSD and CBD which gets into the mechanics of what causes PTSD.
You'll see very similar actors with both.
One interesting point comes into play.
Brain injury (whether direct or by infection and immune response) can result in a reduction of brain signaling and even mass (actual neurons) in important areas of the brain.
The ability to heal this loss is critical across many issues (Alzheimers, PTSD, Anxiety, Depression, etc).
It's called neurogenesis.
We have an entire article on CBD and neurogenesis but it might be one of our favorite topics with CBD.
We'll touch on that below.
One more powerful actor that has a direct impact on the type of CBD we might consider.
Histamine.
Histamine, MTHFR And OCD
Histamine is a powerful brain signaling chemical.
We know it for its allergic reaction effects but it does so much more in the brain.
It's excitatory (speeds up processes and signaling) in the brain.
In fact, it directly controls wakefulness, focus, and alertness.
That's why antihistamines make you feel drowsy and sluggish!
There are three aspects that make histamine really important to OCD.
MTHFR, Histamine and OCD
There's an entire explanation below but a quick synopsis.
A gene called MTHFR controls a key chemical transformation process in the body called methylation.
Basically, it's how our body "activates" or "de-activates" various chemicals across the body.
It's critical for the synthesis of neurotransmitters (such as serotonin and dopamine).
If we've learned anything above, these players are critical to a host of mental health issues including OCD.
People with a less than ideal functioning MTHFR gene do not break down histamine correctly.
Histamine builds up and is excitatory in the brain.
That's the first aspect and more info here:
Why does an imbalance of histamine matter (aside from horrible allergies)?
The first clue came from studies of Tourettes and tics.
recent observation of strong histaminergic control of this network of lateral feedback inhibitory connections between MSNs (Ellender et al., 2011) and observations of altered striatal histaminergic tone in Tourette's syndrome
Finally, an exciting, new front in brain research deals with microglial cells.
These are the immune cells in the brain.
They safeguard the brain from injury, attack, and infection.
A host of issues including OCD are showing that the microglial cells may be functioning incorrectly.
There's a fascinating summary of different studies where researchers knock out specific microglia genes and resulting OCD behaviors occur:
This is exciting and ground-breaking. They can literally knock a gene tied to microglial function and OCD behavior appears.
They can then cross-breed this out and the symptoms go away.
The golden age of CRSPR is coming folks!
What chemical in the brain moderates or balances microglial activity?
Histamine!
results highlight the relevance of histamine in the modulation of microglial activity that ultimately may interfere with neuronal survival in the context of Parkinson's disease (PD) and, eventually, other neurodegenerative diseases which are accompanied by microglia-induced neuroinflammation.
Finally, why histamine matters for CBD.
We'll get into that below but we definitely want CBD Isolate for OCD.
The full spectrum plant material is likely to cause a histamine release (if not storm depending on your mast cell function).
You can learn all about CBD and Histamines here.
Let's look quickly at the meds. We're almost there!
Meds Used For OCD
The common medications used for OCD all center around serotonin function.
Primarily boosting it or the availability of it to neurons.
SSRI's are the goto approach which basically makes more serotonin available.
Of course, they can come with pretty severe side-effects depending on the person.
Other medications look to impact the pathways for norepiniphrine (SNRI's), Glutamate, and GABA itself.
Unfortunately, the results are less than favorable.
Roughly 25% of people do not respond to any of the regiments and a large number of the "responders" have signficant side effects or symptoms.
Let's finally get into why we're here.
What about CBD and OCD?
Enter the endocannabinoid system.
The Endocannabinoid System And OCD
Every living animal has one down to the sea urchin.
It's been "conserved" by nature for about 600 million years.
We've only known about it for a few decades now and research is showing that it's critical for balancing other key systems:
- Nervous system – including neurotransmitters like GABA, Glutamate, and Serotonin
- Endocrine system – including hormones like estrogen, progesterone, and others
- Immune system – including histamine, microglial cells, and gut biome
Any of those sound familiar?
We're talking about the dominant systems in the body and brain that govern how we feel, interpret, and interact with the world.
That's all.
Here's a quick visual:
Let's look at OCD specifically.
The first question is simple...are there even endocannabinoid receptors in the key brain areas tied to OCD?
Cannabinoid receptors are significantly expressed in most parts of the main circuitry related to OCD, the cortico-striatal-thalamic circuitry, being able to modulate the release of key neurotransmitters such as glutamate, dopamine, GABA, and serotonin
The first clue is when researchers found that the endocannabinoid system is tied to the process in the brain that governs switching between habitual and non-habitual behaviors.
This is key to OCD, addiction, and other issues.
To put a fine point on it...
An inability to shift between habitual and non-habitual behaviors has been implicated in obsessive-compulsive disorder (OCD), addiction, and other disorders characterized by impaired decision-making.
Remember way back up top...the orbitofrontal cortex as being implicated in OCD (we won't hold it against you if you don't...that was paragraphs ago!)
The authors say the new study points to a molecular mechanism through which endocannabinoids promote the formation of habits by reducing the flow of information in the OFC.
OFC is orbitofrontal cortex.
So endocannabinoid receptors are directly involved in the proper function of habitual behavior.
We spoke of the excitatory nature of Glutamate and inhibitory nature of GABA plus the need for balance between the two.
The endocannabinoid system is the great balancer:
The first conclusive evidence supporting retrograde endocannabinoid signaling came from the observation of depolarization-induced suppression of inhibition (DSI)/excitation (DSE
This just means that the ECS (endocannabinoid system) is able to both increase or decrease activity across almost all these pathways.
Almost all the current medications rely on boosting serotonin levels available to neurons.
The problem is that this carries pretty significant side effects and eventually loses its effect.
A new study points to focusing on the CB (endocannabinoid receptors) instead:
Not only did WIN 55,212-2 have an anti-compulsive effect, but the effect was overwhelmingly apparent with a 50% reduction in measured compulsive behavior
https://impulse.appstate.edu/sites/impulse.appstate.edu/files/Kirschner and Stavnezer final.pdf
There was also an anti-anxiety effect but we have an entire article on CBD and anxiety here.
More importantly...
In addition to WIN 55,212-2 success as an anti-compulsive drug, its efficacy persisted in this longer-term treatment.
We're finally starting to get studies on people with OCD and other compulsive behavior illnesses.
The initial results are encouraging.
It showed significant improvement in Tourette syndrome tics measured by the total score on the Yale Global Tic Severity Scale after 4 and 8 hours.
There, the key was boosting 2-AG, the most prominent cannabinoid in the brain.
We've spoken quite a bit about the brake/gas pedals in the brain...GABA and Glutamate specifically.
These results suggest a possible synergistic action on glutamatergic inhibition (by increase in AEA) and GABAergic enhancement (by the activation of GABAA receptors).
AEA is Anandamide, our 2nd most prevalent endocannabinoid in the brain behind 2-AG.
That's a great place to jump to CBD.
You're going to love the connection between AEA and CBD.
What Research Shows For CBD And OCD
First, CBD is short for cannabidiol.
It's a cannabinoid found naturally in the cannabis plan.
CBD is able to interact with the endocannabinoid system we have in our body.
Here's a great article on exactly what is CBD.
Let's zoom in for CBD and OCD.
There are dozens of studies (finally) on the effects of CBD on OCD and a host of other related issues (anxiety, PTSD, etc).
Let's see what NIH has to show.
First, they studied a proxy for OCD in animal models (called marble burying):
CBD inhibited obsessive-compulsive behaviour in a time-dependent manner matching its pharmacokinetic profile.
Research details here.
Interestingly, they studied multiple cannabinoids and only CBD had the effect.
Furthermore...
Acute systemic CBD reduced marble-burying behavior for up to 7 days, with no attenuation in effect up to high (120 mg/kg) doses, and effect shown to depend on CB1Rs but not 5-HT1ARs
This means that CBD is causing this effect by directly affecting CB1 receptors in the brain.
5HT receptors are where serotonin does most of its work.
It's good that CBD doesn't directly hammer the 5HT pathway like other meds.
The serious side effects are missing as a result.
This is where most sites end in terms of OCD.
We're just getting started.
CBD has a fascinating effect of promoting fear extinction.
This is a technical term for "forgetting bad things" and yes, the brain has specific circuitry to "remember trauma and fear".
It's helpful (don't touch a hot stove) but if too heightened, you can see the implications in a range of issues with PTSD and OCD being first and foremost.
Remember that past trauma can be a determining factor with OCD.
CBD, a non-psychoactive phytocannabinoid could be an interesting pharmacological approach to reduce the anxiogenic effects of stress and promote the extinction of fear memories.
Anxiety is intimately tied to OCD.
In fact, it's estimated that 11% of people with OCD have social anxiety disorder which share certain attributes (exaggerated fears and anxiety response).
There's a pretty comprehensive overview of CBD's benefits for anxiety here for additional reading.
Anxiety may offer the single greatest potential for CBD and that definitely affects OCD.
Let's look at the neurotransmitter angle.
Glutamate, GABA, and Serotonin to start.
A current theory is that an imbalance of these neurotransmitters are at the root of OCD.
We showed the studies above on their effects.
CBD has a direct effect on balancing all three (and others).
Let's look at a specific example that pops up with studies on convulsions and schizophrenia.
Look...Glutamate is important within limits.
It's needed for learning, memory formation, and reacting to outside stimulus.
The key is within limits.
The endocannabinoid system that CBD boosts is the balancer there.
We can't put it better than researchers did here:
endocannabinoids are released to retain NMDAR activity within physiological limits.
NMDAR is the pathway glutamate operates in.
The key word there is "within physiological limits"
Too much glutamate (not enough endocannabinoid reigning it in) and we have issues.
Remember the marble burying test above (animal equivalent to OCD behavior)?
It was Anandamide (our naturally occuring cannabinoid) that brought down excessive glutamate:
Cannabinoids inhibit glutamate release in the central nervous system
What's the connection with CBD and Anandamide (so called the "bliss" molecule)...
Cannabidiol enhances anandamide signaling and alleviates psychotic symptoms of schizophrenia
Thanks were staying with us there. It is brain science after all!
That's the gas pedal.
What about the brake? GABA
There's a beautiful explanation of CBD ability to affect GABA levels in the brain here:
One of the most fascinating aspects is that it doesn't directly pump neurotransmitters like the common medications (hence their side effects) but supports when activity is slow and backs off when high.
This goes back to the balancing act that the endocannabinoid system is tasked with.
Give when needed but take when too much.
It's quite a beautifully responsive system.
Sorry...we geek out sometimes.
Back to OCD.
Most of the most meds for OCD deal with serotonin.
Does this same "support system" apply to serotonin?
The danger with the meds (SSRI, etc) it that they work in one direction.
They pump up serotonin available to the brain.
If you get too much, it can actually have psychotic effects!
Again...balance.
Serotonin is such a powerful workhorse in the brain.
It's not just about feeling good.
It's a communicator across different brain areas!
There's lots of research on CBD and serotonin due its effects on depression.
Learn all about that pathway at CBD and depression here.
Some key takeaways..
Our results suggest that the antidepressant-like effect induced by CBD in the FST is dependent on serotonin levels in the central nervous system (CNS).
Maybe more importantly, let's go back to some key determinants of OCD we described in the beginning.
The sections on strep infection, inflammation, and brain mass loss become important.
A study showed that CBD's effect on the serotonin system may be caused by a very interesting reaction to infection and inflammation.
We'll start with the easier-to-chew bullet point:
(FAAH) inhibitors share mechanisms with other antidepressants: the ability to enhance central serotonergic and noradrenergic transmission and promote neurogenesis in the hippocampus.
CBD is an FAAH inhibitor.
It therefore enhances serotonin signaling and creates new brain tissue in the hippocampus (which can lose tissue as a result of inflammation, infection, and autoimmune).
Here's where things get downright silly for OCD and just generally, health.
Brain inflammation is a known cause of many serious mental health issues (we mentioned ties with OCD above).
Here's the connection...and we're going to summarize because it's very complicated (study link below for the brave).
Stay with us...it's very cool!
Bacteria, viruses, etc can use an amino acid, tryptophan, to make new invaders
The body responds to infection by reducing the levels of trytophan as a counter measure
Tryptophan is an important building block for serotonin (and other pathways) and NAD (the source of all our energy).
Therefore...infection leads to poor serotonin signaling.
CBD's effect on serotonin signaling appears to operate (at least partially) by rebalancing this tryptophan pathway!
Without the side effects of SSRI's and other "hammers" on serotonin levels.
This can explain the autoimmune angle. The strep and infection angle. The inflammation angle.
We need more research but its effect could be widespread and matches other research which shows that our immune response to antibodies that get out into the body are the key to most modern diseases.
Remember that roughtly 75% of OCD sufferers get some relief from compulsive symptoms from serotonin meds but unfortunately, replace them with other equally severe symptoms.
CBD's side effects and safety profile is significantly stronger (see CBD safety here).
More information on corresponding topics here:
Whew...thanks for staying with us but there is so much suffering caused by OCD.
We wanted to give it our full effort.
People deserve to feel better!
On to more practical questions.
How Much CBD To Take For OCD
We have an entire section on CBD dosage here.
Basically, the general starting dosage to test how your body responds is 20-30mg.
Research was based on 300-600 mg dosages for more serious issues.
There are definitely tips on how to take CBD to get the most out of it at this Quick Start Guide on CBD.
- 2 hours away from medication
- After a meal
- Hold under the tongue
Lots of ways to get the most out of CBD.
Remember the issue on histamines?
Let's talk about why that's important.
What's The Best CBD For OCD
All the research we mentioned above is on CBD by itself.
Not CBD Full spectrum. Not Hemp oil.
Not only do those introduce other chemicals which we don't have research on (some is actually negative such as THC for anxiety), but there's the histamine issue.
Roughly 40-60% of people have histamine (think allergies) issues.
Introducing all that plant material is going the wrong direction (more excitatory...more immune response in the brain).
For this reason, CBD isolate is the safest option for people with OCD.
We also don't want any THC in the product.
Based on this and cost per mg of CBD, the two from our safety screen list are :
Let us know what works for you.
If we're able to help, pass on the word. There are so many people out there suffering from OCD.
Let's help each other!
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