Cannabidiol

Updated | 2019-04-26


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Cannabidiol


Overview

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Extracts of Cannabis sativa and Cannabis indica contain cannabidiol (CBD), a cannabinoid, at concentrations of 40% or more [Bergamaschi et al. 2011]. CBD is commonly marketed as cannabidiol oil or CBD oil. Unlike tetrahydrocannabinol (THC), CBD does not have psychoactive properties. CBD and THC have similar molecular weights but different structures (see compounds). In 2018, the US Food and Drug Administration (FDA) approved a highly-pure cannabidiol extract from Cannabis for treating epilepsy. An extract containing equal amounts of CBD and THC is also approved for use in a number of European countries for treating symptoms of multiple sclerosis (MS). Most research has studied the efficacy of CBD/THC combinations in treating various health conditions. Therefore, more research is necessary to study the medicinal qualities of CBD alone. CBD is currently being marketed as a panacea (or cure-all); however, most of the claims have little to no supportive evidence, such as pain management. For the nutritional value of hemp, see hemp seeds.



Evidence

Strong:

CBD alone:
  • Epilepsy in Children [2-11]
    • Includes: Dravet Syndrome and Lennox-Gastaut Syndrome

Good:

CBD alone:
  • Counteracts the Effects of Cannabis and Tetrahydrocannabinol (THC) Intoxication and Psychosis [12-28]
CBD/THC combinations:
  • Cannabis Dependence and Withdrawal [29-34]
  • Multiple Sclerosis (MS) Patients [35-77]

Promising:

CBD alone: CBD/THC combinations:

Conflicting (Unclear):

CBD alone:

Limited Evidence:

CBD alone:
  • Cannabis Dependence and Withdrawal [91]
  • Chronic Pain in Kidney Transplant Patients [92]
  • Dysautonomic Syndrome after Human Papillomavirus (HPV) Vaccination [93]
  • Epidermolysis Bullosa in Children, a topical cannabidiol (CBD) oil [94]
  • Febrile Infection-Related Epilepsy Syndrome (FIRES) [95]
  • Graft-Versus-Host Disease (GVHD) [96]
  • Malignant Migrating Partial Seizures [97]
  • Parkinson’s Disease [98]
  • Posttraumatic Stress Disorder (PTSD) in Children [99]
  • Quite Smoking (Smoking Cessation) [100]
  • REM Sleep Behavior Disorder (RBD) in Patients with Parkinson’s Disease [101]
  • Social Anxiety Disorder (SAD) [102-103]
  • Tumors, synthetic cannabidiol [104]
  • Type 2 Diabetes, tetrahydrocannabivarin (THCV) may be more effective [105]
CBD/THC combinations:
  • ADHD [106]
  • Arthritis [107]
  • Cancer-Related Anorexia-Cachexia Syndrome [108]
  • Central Neuropathic Pain from Brachial Plexus Avulsion [109]
  • Chemotherapy-Induced Nausea and Vomiting [110]
  • Chemotherapy-Induced Neuropathic Pain [111]
  • Chronic Pain [112]
  • Epilepsy in Children [113]
  • Painful Diabetic Peripheral Neuropathy [114-115]
  • Stiff-Person Syndrome (SPS) [116]
  • Tourette Syndrome (TS) [117]

No Evidence:

CBD alone: CBD/THC combinations:
  • Huntington’s Disease [123]

No Clinical Research:

  • HIV
  • And all other conditions.


Side Effects
Side effects may include:
  • Decreased Appetite
  • Diarrhea
  • Disturbance in Attention
  • Dizziness
  • Drowsiness
  • Dry Mouth
  • Headache
  • Intermittent Episodes of Feeling Hot
  • Nausea
Precautions and Adverse Events:
  • Avoid or contact a licensed healthcare practitioner, if you have or had a history of depression, psychotic disorders, and schizophrenia. Cannabidiol (CBD) may weaken the immune system and should not be taken if you have an HIV infection.
  • In general, researchers have found that CBD is safer than tetrahydrocannabinol (THC) because CBD has antipsychotic-like properties and may counteract the effects of THC.
  • Even though Cannabis has been associated with causing amotivational syndrome (i.e., detachment, lack of drive and emotions), taking CBD did not improve motivation.
  • Since there are not enough studies on CBD and patients with schizophrenia, CBD may cause more harm than good or nothing at all.
  • Schizophrenia onset may be caused by THC, but not by CBD.
  • CBD has been shown to not cause chromosome damage.
  • CBD does not appear to impact performance.
[124-138]


Pregnant or Nursing

There is not enough research on the use of supplements containing cannabidiol and CBD oil during pregnancy and breast-feeding, so consult a licensed healthcare practitioner before use or avoid use. Nonetheless, it is not recommended to take CBD during pregnancy and breast-feeding.



Interactions

Major

  • Drugs changed by Cytochrome P450s (CYPs) in the liver
  • Alcohol
  • Ketamine
  • Tetrahydrocannabinol (THC)
  • Vitamin A
[139-147]

Moderate

  • Anticancer Drugs
[139-147]

Potential

  • Cannabidiol may NOT interact with Secobarbital and the opioid, Fentanyl
[139-147]


Dosage

Cannabidiol and CBD oil supplements are not "drugs", the best doses have not been thoroughly established. Make sure to follow the specific product instructions and take as directed on the label or consult a licensed healthcare practitioner before use.



Compounds
Cannabidiol compounds


References

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