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Cannabidiol (INN; abbreviated as: CBD) is one of at least 113 cannabinoids identified in cannabis. It is a major phytocannabinoid, accounting for up to 40% of the plant’s extract.CBD does not appear to have any psychoactive effects such as those caused by tetrahydrocannabinol (THC). It may have a downregulating impact on disordered thinking and anxiety. Potential uses are the subject of ongoing research.

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One animal study reported that co-administration with THC potentiated the effects of THC. One possible mechanism is by competing for the THC receptor sites.

USES

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Pain associated with multiple sclerosis

Nabiximols (USAN, trade name Sativex) is an aerosolized mist for oral administration containing a near 1:1 ratio of CBD and THC. The drug was approved by Canadian authorities in 2005 to alleviate pain associated with multiple sclerosis.

Research

Addiction treatment

Two systematic reviews on CBD and addiction reported beneficial effects for alleviating tobacco and cannabis dependence. The anti-addictive properties displayed might be due to CBD’s protective effect on stress and neurotoxicity. Both reviews recommended more research.

Anti-inflammatory

Two reviews address research on the theory that CBD alone or in combination with THC may have anti-oxidant and anti-inflammatory activity. Neither cited any human trials.

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Epilepsy

A 2014 Cochrane review included four randomized controlled trials. But these are all were of poor quality. A double-blinded, randomized, placebo-controlled study of CBD oil on treating Dravet syndrome, a rare form of epilepsy That begins in infancy and is difficult to treat, was conducted in 2017 and found that CBD oil significantly reduced the number of seizures with a dosing of 20mg/kg. However, it also caused increased diarrhea, vomiting, fevers, fatigue, abnormal liver function tests (LFTs), and somnolence. The LFTs showed elevated ALT and AST up to three times normal, but only in the patients also taking valproate. The study already suggests that this might be an interaction of valproate and CBD. The abnormal LFT normalized during the trial in the patients who kept taking CBD.

GW Pharmaceuticals is seeking FDA approval to market a liquid formulation of pure plant-derived CBD. It under the trade name Epidiolex (containing 99% cannabidiol and less than 0.10% Δ9-THC) as a treatment for Dravet syndrome. Epidiolex was granted fast-track status and orphan drug status in the United States for treatment of Dravet syndrome in July 2015.

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