by Vjatśelsav Śuvalov, PĒLL’s Head Chemist
Introduction
The cannabis plant has more than 140 cannabinoid compounds, with Δ9-tetrahydrocannabinol (Δ9-THC) and cannabidiol (CBD) attracting significant interest. Δ9-THC is the primary psychoactive ingredient, and CBD is a non-intoxicating ingredient. Evidence from preclinical studies suggested that CBD had potential therapeutic benefits ranging from anti-inflammatory to neuroprotective, antipsychotic, analgesic, anticonvulsant, antiemetic, antioxidant, antiarthritic, and antineoplastic properties.
CBD Pharmacokinetics
Different methods are used for the administration of CBD products.
Safety
Toxicology
CBD has been found to have relatively low toxicity, although not all potential effects have been explored.
Adverse Reactions in Humans
CBD does not produce the effects that are typically seen with cannabinoid THC. 4 No serious adverse effects (SAE) were observed in the studies with healthy volunteers, which corroborates previous studies and reviews. No such effects were observed in patients with Huntington’s disease, Parkinson’s disease, type 2 diabetes, Crohn’s disease, and social anxiety disorder, even considering that in some of these studies patients were taking other medications.
Abuse Potential
A study of abuse liability profile of oral cannabidiol in comparison to oral placebo and active smoked cannabis demonstrated that CBD was placebo-like on all measures.
The therapeutic potential of Cannabidiol
Much research and many clinical trials are still required to understand the full therapeutic potential of CBD products. The quality of final products is the most challenging aspect in determining the application of different CBD formulations. The quality of clinical trials is also very important factor in the identification of the effect and correct usage amount. Following conclusions can be made after the review of currently available information.
Pain and Inflammation Treatment
The mechanism of CBD action in pain and inflammation management is well studied. Pain and inflammation treatment potential of CBD is supported by multiple preclinical trials using the mouse model.
Reduction in body pain was observed by multiple small-size clinical studies using various amounts of administrated CBD. (50-150 mg, twice daily)
Our products with 10% and 30% CBD isolate contain 1000 and 3000 mg of pure CBD, respectively.
In one study transdermal CBD gel was effective in the treatment of knee pain related to osteoarthritis in CBD amounts of 250 mg/day.
Anxiety
Multiple studies explored the effect of CBD in reducing anxiety. It was confirmed that using CBD a few hours before speaking to the public significantly reduces the stress. A larger amount of about 300 mg was more effective than smaller amounts. Interestingly, larger amounts than 300 mg produced a much smaller effect. Patient-specific amount of CBD is recommended to reduce anxiety.
Sleep
Mixed results are reported from studies that investigated CBD use for sleep quality improvement. Only one study reported an increased duration of sleep after using 160 mg of CBD. The report also included decreased remembrance of dreams after using 40-160 mg of CBD. 10 Mixtures of cannabinoids in plant extracts have shown more promising results in inducing sleep.
Substance use disorders and withdrawal
The application of CBD in the treatment of substance use disorders is in very early stages at the moment. Using 800 mg of CBD did not reduce nicotine craving and withdrawal of tobacco smokers. Few studies of cannabis use induced withdrawal and craving treatment with CBD (200-1200mg of CBD daily) reported no reduction in cannabis use frequency.
Schizophrenia and Psychosis
Multiple clinical studies investigated the effectiveness of CBD in reducing the symptoms of schizophrenia and psychosis. 800-1000 mg per day showed significant improvement in symptoms when compared to placebo in multiple study groups.
Seizure/Epilepsy
Clinical trials of CBD solution used at a maximum dose of 25-50 mg/kg/day proved effective in the reduction of motor seizures by 43%.
Sport performance
CBD has been reported to exert a number of physiological, biochemical, and psychological effects, that have the potential to benefit athletes. For instance, there is preliminary supportive evidence for anti-inflammatory, neuroprotective, analgesic, and anxiolytic actions of CBD and the possibility it may protect against GI damage associated with inflammation and promote the healing of traumatic skeletal injuries. The central observation is that studies directly investigating CBD and sports performance are lacking, and until these are conducted, we can only speculate in regard to its effects.
References
- R. Khan, The therapeutic role of Cannabidiol in mental health: a systematic review, (2020), https://doi.org/10.1186/s42238-019-0012-y
- A. Millar, A Systematic Review on the Pharmacokinetics of Cannabidiol in Humans, (2018), https://doi.org/10.3389/fphar.2018.01365
- A.Stout, Exogenous cannabinoids as substrates, inhibitors, and inducers of human drug-metabolizing enzymes: a systematic review., (2014), https://doi.org/10.3109/03602532.2013.849268
- WHO Expert Committee on Drug Dependence, CANNABIDIOL (CBD) Critical Review Report, (2018), https://www.who.int/medicines/access/controlled-substances/WHOCBDReportMay2018-2.pdf
- R.G. dos Santos, Serious adverse effects of cannabidiol (CBD): a review of randomized controlled trials, (2020), https://doi.org/10.1080/17425255.2020.1754793
- S. Babalonis, Oral cannabidiol does not produce a signal for abuse liability in frequent marijuana smokers, (2017). https://doi.org/10.1016/j.drugalcdep.2016.11.030
- C.M. White, A Review of Human Studies Assessing Cannabidiol’s (CBD) Therapeutic Actions and Potential, (2019), https://doi.org/10.1002/jcph.1387
- T. Lowin, Joints for joints: Cannabinoids in the treatment of rheumatoid arthritis, (2019), https://doi.org/10.1097/BOR.0000000000000590
- C.A. Gusho, Cannabidiol: A Brief Review of Its Therapeutic and Pharmacologic Efficacy in the Management of Joint Disease, (2020), https://doi.org/10.7759/cureus.7375
- D.J. Sholler, Therapeutic Efficacy of Cannabidiol (CBD): a Review of the Evidence From Clinical Trials and Human Laboratory Studiesm (2020), https://doi.org/10.1007/s40429-020-00326-8
- D. McCartney, Cannabidiol and Sports Performance: a Narrative Review of Relevant Evidence and Recommendations for Future Research, (2020), https://doi.org/10.1186/s40798-020-00251-0
