Cannabidiol (CBD)
•Last Updated: April 4, 2023
Like THC, CBD is a cannabinoid (a compound in cannabis). Unlike THC, CBD won’t get you high, but it shows promise as a treatment for epilepsy, anxiety, depression, pain, inflammation, cancer, and more. Unfortunately, as of 2022, human trials are still few.
Cannabidiol (CBD) is most often used for
Last Updated:April 4, 2023
Human research on CBD has focused on two rare forms of epilepsy: Dravet syndrome and Lennox-Gastaut syndrome.[5] In humans and animals, CBD has shown promise as a treatment for a wide variety of ailments, notably anxiety,[6][7][8][9][10] depression,[8] pain,[11][12][13][14] inflammation,[15][16] and cancer.[17]
Unlike cannabis and THC, CBD doesn’t impair coordination, judgment, or memory.[18] In a Critical Review Report published in 2018, the World Health Organization concluded that there was “no evidence of recreational use of CBD or any public health-related problems associated with the use of pure CBD".
CBD’s adverse effects are usually minor, but they include lethargy, fatigue, sleepiness, fever, diarrhea, vomiting, decreased appetite, and increased levels of alanine aminotransferase (a marker of liver damage).[19][20][21]
Other drawbacks include a paucity of human evidence, the unreliability of most CBD products on the market, and the “gray area” legality of CBD products.
CBD works in myriad ways, which are still being explored. For instance, it may reduce pain and stress via the TRPV1 receptor,[22][23][24] stress and depression via the 5HTI-alpha receptor,[25][26] and inflammation via the A2A receptors.[27]
Unfortunately, CBD seems to work better in combination with THC.
Note that Cannabidiol (CBD) is also known as:
- Cannabidiol
- Epidiolex
- CBD
Cannabidiol (CBD) should not be confused with:
- THC
- Cannabis
- Sativex
The only CBD product approved in the U.S. is an epillectic drug: Epidiolex® is a solution (100 mg of CBD per milliliter) taken orally, preferably with food. The starting dosage is 2.5 mg per kilogram of body weight twice per day (so 5 mg/kg/day). The maximum dosage is 10 mg/kg twice per day (so 20 mg/kg/day). In people with hepatic impairment, the dosage is reduced.
Since (i) dosages in studies are all over the place, (ii) a CBD product’s label will very often overstate or understate this product’s CBD content,[1][2] and (iii) high-fat and high-calorie meals can greatly increase CBD absorption,[3] properly dosing CBD products is very, very difficult.
Research FeedRead all studies
- ^Freedman DA, Patel ADInadequate Regulation Contributes to Mislabeled Online Cannabidiol ProductsPediatr Neurol Briefs.(2018 Jun 18)
- ^Bonn-Miller MO, Loflin MJE, Thomas BF, Marcu JP, Hyke T, Vandrey RLabeling Accuracy of Cannabidiol Extracts Sold OnlineJAMA.(2017 Nov 7)
- ^Zgair A, Wong JC, Lee JB, Mistry J, Sivak O, Wasan KM, Hennig IM, Barrett DA, Constantinescu CS, Fischer PM, Gershkovich PDietary fats and pharmaceutical lipid excipients increase systemic exposure to orally administered cannabis and cannabis-based medicinesAm J Transl Res.(2016 Aug 15)
- ^Andre CM, Hausman JF, Guerriero GCannabis sativa: The Plant of the Thousand and One MoleculesFront Plant Sci.(2016 Feb 4)
- ^Chen JW, Borgelt LM, Blackmer ABEpidiolex (Cannabidiol): A New Hope for Patients With Dravet or Lennox-Gastaut SyndromesAnn Pharmacother.(2019 Jan 8)
- ^Shannon S, Lewis N, Lee H, Hughes SCannabidiol in Anxiety and Sleep: A Large Case SeriesPerm J.(2019)
- ^Zuardi AW, Rodrigues NP, Silva AL, Bernardo SA, Hallak JEC, Guimarães FS, Crippa JASInverted U-Shaped Dose-Response Curve of the Anxiolytic Effect of Cannabidiol during Public Speaking in Real LifeFront Pharmacol.(2017 May 11)
- ^de Mello Schier AR, de Oliveira Ribeiro NP, Coutinho DS, Machado S, Arias-Carrión O, Crippa JA, Zuardi AW, Nardi AE, Silva ACAntidepressant-like and anxiolytic-like effects of cannabidiol: a chemical compound of Cannabis sativaCNS Neurol Disord Drug Targets.(2014)
- ^Zuardi AW, Cosme RA, Graeff FG, Guimarães FSEffects of ipsapirone and cannabidiol on human experimental anxietyJ Psychopharmacol.(1993 Jan)
- ^Bergamaschi MM, Queiroz RH, Chagas MH, de Oliveira DC, De Martinis BS, Kapczinski F, Quevedo J, Roesler R, Schröder N, Nardi AE, Martín-Santos R, Hallak JE, Zuardi AW, Crippa JACannabidiol reduces the anxiety induced by simulated public speaking in treatment-naïve social phobia patientsNeuropsychopharmacology.(2011 May)
- ^Cuñetti L, Manzo L, Peyraube R, Arnaiz J, Curi L, Orihuela SChronic Pain Treatment With Cannabidiol in Kidney Transplant Patients in UruguayTransplant Proc.(2018 Mar)
- ^Palmieri B, Laurino C, Vadalà MShort-Term Efficacy of CBD-Enriched Hemp Oil in Girls with Dysautonomic Syndrome after Human Papillomavirus VaccinationIsr Med Assoc J.(2017 Feb)
- ^Hammell DC, Zhang LP, Ma F, Abshire SM, McIlwrath SL, Stinchcomb AL, Westlund KNTransdermal cannabidiol reduces inflammation and pain-related behaviours in a rat model of arthritisEur J Pain.(2016 Jul)
- ^Wade DT, Robson P, House H, Makela P, Aram JA preliminary controlled study to determine whether whole-plant cannabis extracts can improve intractable neurogenic symptomsClin Rehabil.(2003 Feb)
- ^Philpott HT, OʼBrien M, McDougall JJAttenuation of early phase inflammation by cannabidiol prevents pain and nerve damage in rat osteoarthritisPain.(2017 Dec)
- ^Oláh A, Tóth BI, Borbíró I, Sugawara K, Szöllõsi AG, Czifra G, Pál B, Ambrus L, Kloepper J, Camera E, Ludovici M, Picardo M, Voets T, Zouboulis CC, Paus R, Bíró TCannabidiol exerts sebostatic and antiinflammatory effects on human sebocytesJ Clin Invest.(2014 Sep)
- ^Massi P, Solinas M, Cinquina V, Parolaro DCannabidiol as potential anticancer drugBr J Clin Pharmacol.(2013 Feb)
- ^Iffland K, Grotenhermen FAn Update on Safety and Side Effects of Cannabidiol: A Review of Clinical Data and Relevant Animal StudiesCannabis Cannabinoid Res.(2017 Jun 1)
- ^Devinsky O, Patel AD, Cross JH, Villanueva V, Wirrell EC, Privitera M, Greenwood SM, Roberts C, Checketts D, VanLandingham KE, Zuberi SM, GWPCARE3 Study GroupEffect of Cannabidiol on Drop Seizures in the Lennox-Gastaut SyndromeN Engl J Med.(2018 May 17)
- ^Devinsky O, Cross JH, Wright STrial of Cannabidiol for Drug-Resistant Seizures in the Dravet SyndromeN Engl J Med.(2017 Aug 17)
- ^Fischer B, Russell C, Sabioni P, van den Brink W, Le Foll B, Hall W, Rehm J, Room RLower-Risk Cannabis Use Guidelines: A Comprehensive Update of Evidence and RecommendationsAm J Public Health.(2017 Aug)
- ^Ho KW, Ward NJ, Calkins DJTRPV1: a stress response protein in the central nervous systemAm J Neurodegener Dis.(2012)
- ^Jara-Oseguera A, Simon SA, Rosenbaum TTRPV1: on the road to pain reliefCurr Mol Pharmacol.(2008 Nov)
- ^Terzian AL, Aguiar DC, Guimarães FS, Moreira FAModulation of anxiety-like behaviour by Transient Receptor Potential Vanilloid Type 1 (TRPV1) channels located in the dorsolateral periaqueductal grayEur Neuropsychopharmacol.(2009 Mar)
- ^Linge R, Jiménez-Sánchez L, Campa L, Pilar-Cuéllar F, Vidal R, Pazos A, Adell A, Díaz ÁCannabidiol induces rapid-acting antidepressant-like effects and enhances cortical 5-HT/glutamate neurotransmission: role of 5-HT1A receptorsNeuropharmacology.(2016 Apr)
- ^Resstel LB, Tavares RF, Lisboa SF, Joca SR, Corrêa FM, Guimarães FS5-HT1A receptors are involved in the cannabidiol-induced attenuation of behavioural and cardiovascular responses to acute restraint stress in ratsBr J Pharmacol.(2009 Jan)
- ^Mecha M, Feliú A, Iñigo PM, Mestre L, Carrillo-Salinas FJ, Guaza CCannabidiol provides long-lasting protection against the deleterious effects of inflammation in a viral model of multiple sclerosis: a role for A2A receptorsNeurobiol Dis.(2013 Nov)
- ^O'Connor SM, Lietzan EThe Surprising Reach of FDA Regulation of Cannabis, Even After DeschedulingAm Univ Law Rev.(2019)
- ^Russo EBCurrent Therapeutic Cannabis Controversies and Clinical Trial Design IssuesFront Pharmacol.(2016 Sep 14)
- ^Busse FP, Fiedler GM, Leichtle A, Hentschel H, Stumvoll MLead poisoning due to adulterated marijuana in leipzigDtsch Arztebl Int.(2008 Oct)
- ^Pavlovic R, Nenna G, Calvi L, Panseri S, Borgonovo G, Giupponi L, Cannazza G, Giorgi AQuality Traits of "Cannabidiol Oils": Cannabinoids Content, Terpene Fingerprint and Oxidation Stability of European Commercially Available PreparationsMolecules.(2018 May 20)
- ^White CMA Review of Human Studies Assessing Cannabidiol's (CBD) Therapeutic Actions and Potential.J Clin Pharmacol.(2019-07)
- ^Bracken MBWhy animal studies are often poor predictors of human reactions to exposureJ R Soc Med.(2009 Mar)
- ^Deiana S, Watanabe A, Yamasaki Y, Amada N, Arthur M, Fleming S, Woodcock H, Dorward P, Pigliacampo B, Close S, Platt B, Riedel GPlasma and brain pharmacokinetic profile of cannabidiol (CBD), cannabidivarine (CBDV), Δ⁹-tetrahydrocannabivarin (THCV) and cannabigerol (CBG) in rats and mice following oral and intraperitoneal administration and CBD action on obsessive-compulsive behaviourPsychopharmacology (Berl).(2012 Feb)
- ^Wong SS, Wilens TEMedical Cannabinoids in Children and Adolescents: A Systematic ReviewPediatrics.(2017 Nov)
- ^Śledziński P, Zeyland J, Słomski R, Nowak AThe current state and future perspectives of cannabinoids in cancer biologyCancer Med.(2018 Mar)
- ^Martínez-Martínez E, Martín-Ruiz A, Martín P, Calvo V, Provencio M, García JMCB2 cannabinoid receptor activation promotes colon cancer progression via AKT/GSK3β signaling pathwayOncotarget.(2016 Oct 18)
- Depression Symptoms - Timo Woelfl, Cathrin Rohleder, Juliane K Mueller, Bettina Lange, Anne Reuter, Anna Maria Schmidt, Dagmar Koethe, Martin Hellmich, F Markus LewekeEffects of Cannabidiol and Delta-9-Tetrahydrocannabinol on Emotion, Cognition, and Attention: A Double-Blind, Placebo-Controlled, Randomized Experimental Trial in Healthy VolunteersFront Psychiatry.(2020 Nov 13)
- Anxiety Symptoms - Linares IM, Zuardi AW, Pereira LC, Queiroz RH, Mechoulam R, Guimarães FS, Crippa JACannabidiol presents an inverted U-shaped dose-response curve in a simulated public speaking testBraz J Psychiatry.(2019 Jan-Feb)
- Anxiety Symptoms - Hundal H, Lister R, Evans N, Antley A, Englund A, Murray RM, Freeman D, Morrison PDThe effects of cannabidiol on persecutory ideation and anxiety in a high trait paranoid groupJ Psychopharmacol.(2018 Mar)
- Schizophrenia symptoms - McGuire P, Robson P, Cubala WJ, Vasile D, Morrison PD, Barron R, Taylor A, Wright SCannabidiol (CBD) as an Adjunctive Therapy in Schizophrenia: A Multicenter Randomized Controlled TrialAm J Psychiatry.(2018 Mar 1)
- Schizophrenia symptoms - Boggs DL, Surti T, Gupta A, Gupta S, Niciu M, Pittman B, Schnakenberg Martin AM, Thurnauer H, Davies A, D'Souza DC, Ranganathan MThe effects of cannabidiol (CBD) on cognition and symptoms in outpatients with chronic schizophrenia a randomized placebo controlled trialPsychopharmacology (Berl).(2018 Jul)
- Crohn's Disease Symptoms - Naftali T, Mechulam R, Marii A, Gabay G, Stein A, Bronshtain M, Laish I, Benjaminov F, Konikoff FMLow-Dose Cannabidiol Is Safe but Not Effective in the Treatment for Crohn's Disease, a Randomized Controlled TrialDig Dis Sci.(2017 Jun)
- Anxiety Symptoms - Zuardi AW, Rodrigues NP, Silva AL, Bernardo SA, Hallak JEC, Guimarães FS, Crippa JASInverted U-Shaped Dose-Response Curve of the Anxiolytic Effect of Cannabidiol during Public Speaking in Real LifeFront Pharmacol.(2017 May 11)
- Anxiety Symptoms - Zuardi AW, Shirakawa I, Finkelfarb E, Karniol IGAction of cannabidiol on the anxiety and other effects produced by delta 9-THC in normal subjectsPsychopharmacology (Berl).(1982)
- Anxiety Symptoms - Zuardi AW, Cosme RA, Graeff FG, Guimarães FSEffects of ipsapirone and cannabidiol on human experimental anxietyJ Psychopharmacol.(1993 Jan)
- Ulcerative Colitis Symptoms - Irving PM, Iqbal T, Nwokolo C, Subramanian S, Bloom S, Prasad N, Hart A, Murray C, Lindsay JO, Taylor A, Barron R, Wright SA Randomized, Double-blind, Placebo-controlled, Parallel-group, Pilot Study of Cannabidiol-rich Botanical Extract in the Symptomatic Treatment of Ulcerative ColitisInflamm Bowel Dis.(2018 Mar 19)
- Seizure Frequency - Devinsky O, Patel AD, Cross JH, Villanueva V, Wirrell EC, Privitera M, Greenwood SM, Roberts C, Checketts D, VanLandingham KE, Zuberi SM, GWPCARE3 Study GroupEffect of Cannabidiol on Drop Seizures in the Lennox-Gastaut SyndromeN Engl J Med.(2018 May 17)
- Seizure Frequency - Devinsky O, Marsh E, Friedman D, Thiele E, Laux L, Sullivan J, Miller I, Flamini R, Wilfong A, Filloux F, Wong M, Tilton N, Bruno P, Bluvstein J, Hedlund J, Kamens R, Maclean J, Nangia S, Singhal NS, Wilson CA, Patel A, Cilio MRCannabidiol in patients with treatment-resistant epilepsy: an open-label interventional trialLancet Neurol.(2016 Mar)
- Seizure Frequency - Hess EJ, Moody KA, Geffrey AL, Pollack SF, Skirvin LA, Bruno PL, Paolini JL, Thiele EACannabidiol as a new treatment for drug-resistant epilepsy in tuberous sclerosis complexEpilepsia.(2016 Oct)
- Pain - Cuñetti L, Manzo L, Peyraube R, Arnaiz J, Curi L, Orihuela SChronic Pain Treatment With Cannabidiol in Kidney Transplant Patients in UruguayTransplant Proc.(2018 Mar)
- Pain - Palmieri B, Laurino C, Vadalà MShort-Term Efficacy of CBD-Enriched Hemp Oil in Girls with Dysautonomic Syndrome after Human Papillomavirus VaccinationIsr Med Assoc J.(2017 Feb)
- Pain - Wade DT, Robson P, House H, Makela P, Aram JA preliminary controlled study to determine whether whole-plant cannabis extracts can improve intractable neurogenic symptomsClin Rehabil.(2003 Feb)