Can CBD Cause Hallucinations?

CBD is a non-cbd hallucinations  compound that does not contain enough of the psychoactive component tetrahydrocannabinol (THC) to cause hallucinations. However, in combination with other drugs that promote dopamine production and increase levels of catecholamines in the brain such as atypical antipsychotics, the onset of vivid hallucinations may occur. Hallucinations can be visual, auditory, tactile, or olfactory. They can be spontaneous or induced by a variety of hallucinogenic substances including LSD and psilocybin. In this case, the patient’s use of cannabis in combination with dopamine-promoting medication triggered intense hallucinations that were similar to those caused by the atypical antipsychotic.

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The patient was referred for a PGx test to determine whether there might be a genetic component to his response to these medications. The PGx results confirmed that he was homozygous for the COMT variant rs4680 AA, which is associated with decreased activity of this enzyme and increased levels of catecholamines in the brain. This result supports the need to consider herb-drug interactions and PGx data when performing a medication safety review.

CBD has been shown to be effective in the treatment of psychosis by several neuroimaging studies of first-episode psychosis patients. In one study, CBD normalized alterations in prefrontal and medial temporal activation that are characteristic of psychosis. Another study found that in regular cannabis users who were experiencing psychosis, CBD significantly improved both their ratings of psychotic symptoms and their functioning and was associated with a reduction in urinary THC metabolites over 4 weeks (Freeman et al. 2020).

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