A Review of Human Studies Assessing Cannabidiol's (CBD) Therapeutic Actions and Potential

Abstract

Cannabidiol (CBD) is a highly touted product for many different disorders among the lay press. Numerous CBD products are available, ranging from a US Food and Drug Administration (FDA)-approved product called Epidiolex to products created for medical marijuana dispensaries and products sold in smoke shops, convenience stores, and over the Internet. The legal status of the non-FDA-approved products differs depending on the source of the CBD and the state, while the consistency and quality of the non-FDA-approved products vary markedly. Without independent laboratory verification, it is impossible to know whether the labeled CBD dosage in non-FDA-approved CBD products is correct, that the delta-9-tetrahydrocannabinol content is <0.3%, and that it is free of adulteration and contamination. On the Internet, CBD has been touted for many ailments for which it has not been studied, and in those diseases with evaluable human data, it generally has weak or very weak evidence. The control of refractory seizures is a clear exception, with strong evidence of CBD's benefit. Acute CBD dosing before anxiety-provoking events like public speaking and the chronic use of CBD in schizophrenia are promising but not proven. CBD is not risk free, with adverse events (primarily somnolence and gastrointestinal in nature) and drug interactions. CBD has been shown to increase liver function tests and needs further study to assess its impact on suicidal ideation.

Trends in use, pharmacology, and clinical applications of emerging herbal nutraceuticals

“…In addition to the FDA‐approved medicine, CBD products are sold in “smoke” shops, convenience stores and over the Internet (White, ). CBD was the 12th highest selling herbal supplement in the U.S. natural channel with total sales of $7,583,438 in 2017, displaying an extraordinary increase of 303% from the previous year (Table ).…”

“…Due to the very poor methodology and sample size, conclusions from these trials cannot be drawn. A third study, a double‐blind crossover randomized trial in patients with multiple sclerosis, spinal cord injury, brachial plexus damage and limb amputation ( n = 24), found a significant improvement of pain control in the CBD group (White, ).…”

“…The possibility that non‐FDA‐approved CBD products freely available in the market may cause adverse events due the variable quality (e.g. contamination, adulteration and THC content in CBD extracts higher than 0.3%) cannot be excluded (White, ).…”

“…Synthetically produced AX consists only of the trans isomer and has been reported to contain trace amounts of residual solvents and chemical reagents (Edwards et al 2016 (Crippa, Guimarães, Campos, & Zuardi, 2018;Izzo, Borrelli, Capasso, di Marzo, & Mechoulam, 2009). In contrast to Δ 9 -tetrahydrocannabinol (THC), which has euphoric properties due to activation of brain cannabinoid CB 1 receptors, CBD has very low affinity for both CB 1 and CB 2 receptors, has no known abuse potential and exerts multiple pharmacological actions (e. In addition to the FDA-approved medicine, CBD products are sold in "smoke" shops, convenience stores and over the Internet (White, 2019). CBD was the 12th highest selling herbal supplement in the U.S. natural channel with total sales of $7,583,438 in 2017, displaying an extraordinary increase of 303% from the previous year (Table 2).…”

A Review of Cannabis and Interactions With Anticoagulant and Antiplatelet Agents

“…THC elicits psychoactive effects but also has shown medical benefits, particularly for neurologic disorders . In contrast, CBD can help to moderate and subdue the psychosis‐inducing effects of THC . Although research is ongoing, combinations of THC and CBD have shown benefit for neurodegenerative diseases such as multiple sclerosis, glaucoma, pain management, food intake disorders, involuntary motor disorders, schizophrenia, and sleep conditions.…”