The Cannabidiol, known as CBD, is one of the most frequent chemical elements in the Cannabis Sativa and, to date, the component most studied and explored by science. Due to its wide range of therapeutic properties and very low toxicity, CBD has been extensively studied by the pharmaceutical industry.
Still, many physicians find it difficult to read technical data on this substance specificities.
In this post, we have compiled the most important points on CBD you should know about, misinformation that is often disseminated, and what we have from the most consistent scientific articles so far!
To learn more about the main physiological system in which CBD and other phytocannabinoid derivatives show activity, download our complete e-book about the Endocannabinoid System!
The use of cannabidiol in the treatment of neurological and psychiatric pathologies
It is very common to hear that Cannabidiol, unlike THC, is a non-psychoactive element
Cannabidiol is a psychoactive chemical element, but it does not have potential psychotoxic effects like THC. By acting on the central nervous system,helping to modulate synaptic transmissions, o CBD has promising potential in the treatment of neurological and psychiatric diseases.
In the literary review on the medicinal scientific history of said component, the article Cannabidiol: brief compilation over a versatile molecule selected studies that present the neuroprotective, antiepileptic, anxiolytic and anticonvulsant effects of this phytocannabinoid.
>> You can read the full review here: Cannabidiol: brief compilation over a versatile molecule
In 1993, a clinical study carried out using a Public Presentation Simulator, had already verified the anxiolytic potential of CBD, in comparison with other anxiolytic drugs. Fear of public speaking was the evaluated anxiogenic trigger, so the volunteers were placed in front of a video camera, while physical and psychological symptoms such as heart rate and blood pressure were carefully monitored.
To evaluate the anxiolytic effects of CBD, a double-blind trial was conducted and the volunteers were divided into three groups, to which three drug products were administered: CBD (300 mg), diazepam (10 mg) and ipsapirone (5 mg).
As a result, the researchers concluded that Cannabidiol and Ipsapirone were able to alleviate the anxiety caused by public speaking, without causing the sedative effects often associated with diazepam use.
>> Check the article here: Effects of ipsapirone and cannabidiol on human experimental anxiety
In another study, previously carried out in 1982, 8 people were exposed to predefined amounts of CBD, THC, THC + CBD, diazepam and placebo. This research has shown that CBD, when administered concomitantly with tetrahydrocannabinol, was able to reduce anxiety as well as the psychoactive effects associated with THC.
Over the years, several studies have been carried out in animal and human models, and have obtained similar results regarding the cannabidiol anxiolytic effect.
The antipsychotic effects of Cannabis still generate debate in the scientific community. This is because THC, when consumed at high doses, by inhalation route and in genetically predisposed people, can be associated with acute psychotic symptoms and other serious negative neuropsychiatric effects.
>> To better understand the pharmacological properties and psychotoxic potential of THC, check out our contents:
Learn about the medical attributes of THC and its therapeutic properties
Myths and truths about THC toxicity
It is clear, however, that CBD has antipsychotic properties and can help in the management of psychotic disorders.
This study, carried out in rats and mice, found CBD antipsychotic effects in hyperlocomotion and psychotic symptoms caused by high doses of ketamine and amphetamine, effectively reversing the physiological effects of these drugs.
>> Read the study here: Effects of cannabidiol in animal models predictive of antipsychotic activity
This double-blind trial carried out on 42 patients, diagnosed with schizophrenia, the antipsychotic effects of the component were compared with the drug amisulpride. After 2 to 4 weeks, the two substances were found to reduce psychotic symptoms. CBD, however, showed a milder side effect profile than amisulpride, evidencing once again the low toxicity of this phytocannabinoid.
>> Read the full article here: Translational Investigation of the Therapeutic Potential of Cannabidiol (CBD): Toward a New Age
With regard to the antiepileptic properties of CBD, Brazil is a pioneer and stands out in conducting pre-clinical and clinical studies. Even in the 1980s a study randomized, double-blind trial, led by Dr. Elisaldo Carlini, was conducted on 15 patients diagnosed with difficult-to-control epilepsy.
Divided into two groups, part of them were given 200 to 300 mg of CBD daily, while the others were given a placebo, for almost five months. In addition to not showing signs of toxicity or undesirable side effects (such as important sedation observed in other anticonvulsant drugs), the 8 patients who were given CBD showed improvement, and in 4 of them the seizures stopped.
>> Read the full study here: Chronic administration of cannabidiol to healthy volunteers and epileptic patients
Several other studies were carried out in order to confirm the anticonvulsant potential of cannabidiol and understand the ideal drug profile and dose needed to achieve satisfactory results. One of the most interesting findings is the demonstration that cannabidiol has a better performance profile when combined with other terpenes and cannabinoid .
This meta-analysis conducted in 2018, investigated the therapeutic effects of CBD alone compared to whole plant extracts, which are rich in CBD. It was found that patients who used CBD alone needed on average a 4-fold higher dose to achieve the same therapeutic benefits as patients who used the whole plant extract.
Furthermore, patients who used CBD alone had a significantly higher incidence of side effects when compared to patients who used the whole plant extract.
>> Access the full study here: Potential Clinical Benefits of CBD-Rich Cannabis Extracts Over Purified CBD in Treatment-Resistant Epilepsy: Observational Data Meta-analysis
The explanation for this is the entourage effecta synergistic relationship that happens between all the chemical compounds present in the Cannabis plant. A series of studies presented in this article show that the medical effects of CBD are intensified when administered concomitantly with other cannabinoids and terpenes present in the plant.
>> Learn more by reading the full article here: Cannabis-based medicines and pain: a review of potential synergistic and entourage effects
Among the most researched therapeutic effects of CBD is its anti-inflammatory activity. The CBD anti-inflammatory properties are mainly related to the activation of type-2 endocannabinoid receptors (CB2), which are involved in these activities.
According to this article, clinical studies demonstrate that CBD modulates the cytokine response in inflammatory processes. That is, it stimulates the release of anti-inflammatory cytokines and inhibits the exaggerated reaction of pro-inflammatory cytokines.
>>Read the full article here: Antioxidative and Anti-Inflammatory Properties of Cannabidiol
Exactly because of its anti-inflammatory property, CBD is a possible alternative for the adjuvant treatment of inflammatory diseases such as diabetes, cardiovascular diseases,, neurodegenerative diseases, chronic skin diseases, viral diseases, among others..
This studyconducted in 2007, investigated how cannabidiol decreases the inflammatory response of diseases such as diabetes and atherosclerosis. The final results suggest that CBD has important physiological effects against the complications of both diseases.
>> Read the whole study: Cannabidiol attenuates high glucose-induced endothelial cell inflammatory response and barrier disruption
CBD side effects
Although there is no evidence that cannabidiol causes serious side effects, it is still possible to observe undesired reactions depending on the product prescribed, the route of administration, the dosage, and individual patient characteristics. The following are among the most common symptoms: drowsiness, prostration, nausea, headache and changes in gastrointestinal transit time.
High CBD doses are more associated with side effects, as well as concomitant use with other drug products, especially anticonvulsant drugs and other psychotropic drugs. Elevated levels of hepatic transaminases have been associated, for example, with the concomitant use of CBD and sodium valproate.
>> Read more about the study here:: Serious adverse effects of cannabidiol (CBD): a review of randomized controlled trials
Cannabidiol drug-drug interactions: what do we know so far?
Both Cannabidiol and most widely prescribed allopathic drugs are metabolized by cytochrome p450.
A study carried out in the United States separated a list of 139 drugs that may have drug interactions with CBD and what are their effects, which can vary from inducers to inhibitors of a particular drug.
Read the full research Delta-9-Tetrahydrocannabinol and Cannabidiol Drug-Drug Interactions
Among the problems related to drug-drug interactions, the same article specifies that care must extend beyond the effects on the central nervous system. The cardiovascular system may show changes such as tachycardia and arterial hypotension, and liver and kidney functions may show changes in control blood tests.
However, it is advisable for the analysis of possible drug-drug interactions to be always individualized and aligned with an assertive prescriptive strategy. To avoid adverse effects and optimize results, a good doctor-patient relationship and close therapeutic follow-upare essential.
To learn more about prescriptive strategies for cannabinoid derivatives, download our Guide to Choosing Cannabis-Based Medicines!!
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