More than just smoke: Psychopharmacology of cannabinoids

Young, Allan H.; Nutt, David

doi:10.1177/02698811211028673

Cited by 1 publication

(2 citation statements)

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“…These findings seem to be in contrast with the therapeutic potential in treating anxiety symptoms which has been described by other authors (e.g. Crippa et al, 2018) and might be an explanation for the ‘slow dawn of the long-predicted era of cannabinoid medicines’ (Young and Nutt, 2021). Although this review showed exposure–response relationships that are poorly translational and far from conventional, it would be premature to conclude that CBD does not have anxiety-reducing properties.…”

Section: Discussioncontrasting

confidence: 76%

“…Despite the importance of integrated assessment of preclinical and clinical dose-effect relationships of a new compound before it is administered in humans (Van Gerven and Cohen, 2018), pharmacology-based dose-selection has not been performed for CBD. This omission may at least partly be responsible for the 'slow dawn of the long-predicted era of cannabinoid medicines' (Young and Nutt, 2021).…”

Section: Introductionmentioning

confidence: 99%

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Cannabidiol in clinical and preclinical anxiety research. A systematic review into concentration–effect relations using the IB-de-risk tool

et al. 2022

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Background: Preclinical research suggests that cannabidiol (CBD) may have therapeutic potential in pathological anxiety. Dosing guidelines to inform future human studies are however lacking. Aim: We aimed to predict the therapeutic window for anxiety-reducing effects of CBD in humans based on preclinical models. Methods: We conducted two systematic searches in PubMed and Embase up to August 2021, into pharmacokinetic (PK) and pharmacodynamic (PD) data of systemic CBD exposure in humans and animals, which includes anxiety-reducing and potential side effects. Risk of bias was assessed with SYRCLE’s RoB tool and Cochrane RoB 2.0. A control group was an inclusion criterion in outcome studies. In human outcome studies, randomisation was required. We excluded studies that co-administered other substances. We used the IB-de-risk tool for a translational integration of outcomes. Results: We synthesised data from 87 studies. For most observations (70.3%), CBD had no effect on anxiety outcomes. There was no identifiable relation between anxiety outcomes and drug levels across species. In all species (humans, mice, rats), anxiety-reducing effects seemed to be clustered in certain concentration ranges, which differed between species. Discussion: A straightforward dosing recommendation was not possible, given variable concentration–effect relations across species, and no consistent linear effect of CBD on anxiety reduction. Currently, these results raise questions about the broad use as a drug for anxiety. Meta-analytic studies are needed to quantitatively investigate drug efficacy, including aspects of anxiety symptomatology. Acute and (sub)chronic dosing studies with integrated PK and PD outcomes are required for substantiated dose recommendations.

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Section: Discussioncontrasting

confidence: 76%

Section: Introductionmentioning

confidence: 99%