Cannabidiol (CBD)

Last Updated: September 28 2022

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

What is CBD?

CBD (cannabidiol) is the second most abundant cannabinoid in cannabis, after THC (tetrahydrocannabinol).[1] Unlike THC, CBD won’t get you high; it’s typically used medicinally, not recreationally, with the four most commonly targeted conditions being pain, anxiety, depression, and sleep disorders.

What are CBD’s main benefits?

Human research on CBD has focused on two rare forms of epilepsy: Dravet syndrome and Lennox-Gastaut syndrome.[3] In humans and animals, CBD has shown promise as a treatment for a wide variety of ailments, notably anxiety,[4][5][6][7][8] depression,[6] pain,[9][10][11][12] inflammation,[13][14] and cancer.[15]

Unlike cannabis and THC, CBD doesn’t impair coordination, judgment, or memory.[16] 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

What are CBD’s main drawbacks?

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).[17][18][19]

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.

How does CBD work?

CBD works in myriad ways, which are still being explored. For instance, it may reduce pain and stress via the TRPV1 receptor,[21][22][23] stress and depression via the 5HTI-alpha receptor,[24][25] and inflammation via the A2A receptors.[26]

Unfortunately, CBD seems to work better in combination with THC.

What else is Cannabidiol (CBD) known as?
Note that Cannabidiol (CBD) is also known as:
  • Cannabidiol
  • Epidiolex
  • CBD
Cannabidiol (CBD) should not be confused with:
  • THC
  • Cannabis
  • Sativex
Dosage information

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,[93][94] and (iii) high-fat and high-calorie meals can greatly increase CBD absorption,[49] properly dosing CBD products is very, very difficult.

Examine Database
References
1.^Andre CM, Hausman JF, Guerriero GCannabis sativa: The Plant of the Thousand and One MoleculesFront Plant Sci.(2016 Feb 4)
2.^Corroon J, Phillips JAA Cross-Sectional Study of Cannabidiol UsersCannabis Cannabinoid Res.(2018 Jul 1)
3.^Chen JW, Borgelt LM, Blackmer ABEpidiolex (Cannabidiol): A New Hope for Patients With Dravet or Lennox-Gastaut SyndromesAnn Pharmacother.(2019 Jan 8)
4.^Shannon S, Lewis N, Lee H, Hughes SCannabidiol in Anxiety and Sleep: A Large Case SeriesPerm J.(2019)
5.^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)
6.^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)
7.^Zuardi AW, Cosme RA, Graeff FG, Guimarães FSEffects of ipsapirone and cannabidiol on human experimental anxietyJ Psychopharmacol.(1993 Jan)
8.^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)
9.^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)
11.^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)
14.^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)
15.^Massi P, Solinas M, Cinquina V, Parolaro DCannabidiol as potential anticancer drugBr J Clin Pharmacol.(2013 Feb)
17.^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)
18.^Devinsky O, Cross JH, Wright STrial of Cannabidiol for Drug-Resistant Seizures in the Dravet SyndromeN Engl J Med.(2017 Aug 17)
19.^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)
21.^Ho KW, Ward NJ, Calkins DJTRPV1: a stress response protein in the central nervous systemAm J Neurodegener Dis.(2012)
22.^Jara-Oseguera A, Simon SA, Rosenbaum TTRPV1: on the road to pain reliefCurr Mol Pharmacol.(2008 Nov)
24.^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)
29.^Howlett AC, Barth F, Bonner TI, Cabral G, Casellas P, Devane WA, Felder CC, Herkenham M, Mackie K, Martin BR, Mechoulam R, Pertwee RGInternational Union of Pharmacology. XXVII. Classification of cannabinoid receptorsPharmacol Rev.(2002 Jun)
30.^Devane WA, Hanus L, Breuer A, Pertwee RG, Stevenson LA, Griffin G, Gibson D, Mandelbaum A, Etinger A, Mechoulam RIsolation and structure of a brain constituent that binds to the cannabinoid receptorScience.(1992 Dec 18)
33.^Hilderbrand RLHemp & Cannabidiol: What is a Medicine?Mo Med.(2018 Jul-Aug)
34.^Borrelli F, Fasolino I, Romano B, Capasso R, Maiello F, Coppola D, Orlando P, Battista G, Pagano E, Di Marzo V, Izzo AABeneficial effect of the non-psychotropic plant cannabinoid cannabigerol on experimental inflammatory bowel diseaseBiochem Pharmacol.(2013 May 1)
35.^Battista N, Di Tommaso M, Bari M, Maccarrone MThe endocannabinoid system: an overviewFront Behav Neurosci.(2012 Mar 14)
36.^Laprairie RB, Bagher AM, Kelly ME, Denovan-Wright EMCannabidiol is a negative allosteric modulator of the cannabinoid CB1 receptorBr J Pharmacol.(2015 Oct)
37.^Hampson AJ, Grimaldi M, Axelrod J, Wink DCannabidiol and (-)Delta9-tetrahydrocannabinol are neuroprotective antioxidantsProc Natl Acad Sci U S A.(1998 Jul 7)
39.^Manini AF, Yiannoulos G, Bergamaschi MM, Hernandez S, Olmedo R, Barnes AJ, Winkel G, Sinha R, Jutras-Aswad D, Huestis MA, Hurd YLSafety and pharmacokinetics of oral cannabidiol when administered concomitantly with intravenous fentanyl in humansJ Addict Med.(2015 May-Jun)
40.^Arndt DL, de Wit HCannabidiol Does Not Dampen Responses to Emotional Stimuli in Healthy AdultsCannabis Cannabinoid Res.(2017 Jun 1)
41.^Bergamaschi MM, Queiroz RH, Zuardi AW, Crippa JASafety and side effects of cannabidiol, a Cannabis sativa constituentCurr Drug Saf.(2011 Sep 1)
42.^Schuel H, Chang MC, Berkery D, Schuel R, Zimmerman AM, Zimmerman SCannabinoids inhibit fertilization in sea urchins by reducing the fertilizing capacity of spermPharmacol Biochem Behav.(1991 Nov)
44.^Leweke FM, Piomelli D, Pahlisch F, Muhl D, Gerth CW, Hoyer C, Klosterkötter J, Hellmich M, Koethe DCannabidiol enhances anandamide signaling and alleviates psychotic symptoms of schizophreniaTransl Psychiatry.(2012 Mar 20)
46.^Busse FP, Fiedler GM, Leichtle A, Hentschel H, Stumvoll MLead poisoning due to adulterated marijuana in leipzigDtsch Arztebl Int.(2008 Oct)
47.^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)
49.^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)
50.^Winter H, Ginsberg A, Egizi E, Erondu N, Whitney K, Pauli E, Everitt DEffect of a high-calorie, high-fat meal on the bioavailability and pharmacokinetics of PA-824 in healthy adult subjectsAntimicrob Agents Chemother.(2013 Nov)
51.^Huestis MAHuman cannabinoid pharmacokineticsChem Biodivers.(2007 Aug)
52.^Eagleston LRM, Kalani NK, Patel RR, Flaten HK, Dunnick CA, Dellavalle RPCannabinoids in dermatology: a scoping reviewDermatol Online J.(2018 Jun 15)
54.^Pretzsch CM, Freyberg J, Voinescu B, Lythgoe D, Horder J, Mendez MA, Wichers R, Ajram L, Ivin G, Heasman M, Edden RAE, Williams S, Murphy DGM, Daly E, McAlonan GMEffects of cannabidiol on brain excitation and inhibition systems; a randomised placebo-controlled single dose trial during magnetic resonance spectroscopy in adults with and without autism spectrum disorderNeuropsychopharmacology.(2019 Feb 6)
56.^Chagas MH, Zuardi AW, Tumas V, Pena-Pereira MA, Sobreira ET, Bergamaschi MM, dos Santos AC, Teixeira AL, Hallak JE, Crippa JAEffects of cannabidiol in the treatment of patients with Parkinson's disease: an exploratory double-blind trialJ Psychopharmacol.(2014 Nov)
57.^Peres FF, Lima AC, Hallak JEC, Crippa JA, Silva RH, Abílio VCCannabidiol as a Promising Strategy to Treat and Prevent Movement Disorders?Front Pharmacol.(2018 May 11)
58.^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)
59.^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)
60.^Zuardi AW, Hallak JE, Dursun SM, Morais SL, Sanches RF, Musty RE, Crippa JACannabidiol monotherapy for treatment-resistant schizophreniaJ Psychopharmacol.(2006 Sep)
61.^Stockings E, Zagic D, Campbell G, Weier M, Hall WD, Nielsen S, Herkes GK, Farrell M, Degenhardt LEvidence for cannabis and cannabinoids for epilepsy: a systematic review of controlled and observational evidenceJ Neurol Neurosurg Psychiatry.(2018 Jul)
62.^Devinsky O, Verducci C, Thiele EA, Laux LC, Patel AD, Filloux F, Szaflarski JP, Wilfong A, Clark GD, Park YD, Seltzer LE, Bebin EM, Flamini R, Wechsler RT, Friedman DOpen-label use of highly purified CBD (Epidiolex®) in patients with CDKL5 deficiency disorder and Aicardi, Dup15q, and Doose syndromesEpilepsy Behav.(2018 Sep)
63.^Warren PP, Bebin EM, Nabors LB, Szaflarski JPThe use of cannabidiol for seizure management in patients with brain tumor-related epilepsyNeurocase.(2017 Oct - Dec)
64.^Thiele E, Marsh E, Mazurkiewicz-Beldzinska M, Halford JJ, Gunning B, Devinsky O, Checketts D, Roberts CCannabidiol in patients with Lennox-Gastaut syndrome: Interim analysis of an open-label extension studyEpilepsia.(2019 Mar)
65.^Szaflarski JP, Bebin EM, Cutter G, DeWolfe J, Dure LS, Gaston TE, Kankirawatana P, Liu Y, Singh R, Standaert DG, Thomas AE, Ver Hoef LW, UAB CBD ProgramCannabidiol improves frequency and severity of seizures and reduces adverse events in an open-label add-on prospective studyEpilepsy Behav.(2018 Oct)
66.^Szaflarski JP, Bebin EM, Comi AM, Patel AD, Joshi C, Checketts D, Beal JC, Laux LC, De Boer LM, Wong MH, Lopez M, Devinsky O, Lyons PD, Zentil PP, Wechsler R, CBD EAP study groupLong-term safety and treatment effects of cannabidiol in children and adults with treatment-resistant epilepsies: Expanded access program resultsEpilepsia.(2018 Aug)
68.^Ali S, Scheffer IE, Sadleir LGEfficacy of cannabinoids in paediatric epilepsyDev Med Child Neurol.(2019 Jan)
69.^Chen KA, Farrar M, Cardamone M, Gill D, Smith R, Cowell CT, Truong L, Lawson JACannabidiol for treating drug-resistant epilepsy in children: the New South Wales experienceMed J Aust.(2018 Aug 3)
70.^Reddy DS, Golub VMThe Pharmacological Basis of Cannabis Therapy for EpilepsyJ Pharmacol Exp Ther.(2016 Apr)
72.^Bisogno T, Hanus L, De Petrocellis L, Tchilibon S, Ponde DE, Brandi I, Moriello AS, Davis JB, Mechoulam R, Di Marzo VMolecular targets for cannabidiol and its synthetic analogues: effect on vanilloid VR1 receptors and on the cellular uptake and enzymatic hydrolysis of anandamideBr J Pharmacol.(2001 Oct)
74.^Martin-Santos R, Crippa JA, Batalla A, Bhattacharyya S, Atakan Z, Borgwardt S, Allen P, Seal M, Langohr K, Farré M, Zuardi AW, McGuire PKAcute effects of a single, oral dose of d9-tetrahydrocannabinol (THC) and cannabidiol (CBD) administration in healthy volunteersCurr Pharm Des.(2012)
75.^Crippa JA, Hallak JE, Machado-de-Sousa JP, Queiroz RH, Bergamaschi M, Chagas MH, Zuardi AWCannabidiol for the treatment of cannabis withdrawal syndrome: a case reportJ Clin Pharm Ther.(2013 Apr)
76.^Morgan CJ, Das RK, Joye A, Curran HV, Kamboj SKCannabidiol reduces cigarette consumption in tobacco smokers: preliminary findingsAddict Behav.(2013 Sep)
77.^Hindocha C, Freeman TP, Grabski M, Stroud JB, Crudgington H, Davies AC, Das RK, Lawn W, Morgan CJA, Curran HVCannabidiol reverses attentional bias to cigarette cues in a human experimental model of tobacco withdrawalAddiction.(2018 May 1)
78.^Hindocha C, Freeman TP, Grabski M, Crudgington H, Davies AC, Stroud JB, Das RK, Lawn W, Morgan CJA, Curran HVThe effects of cannabidiol on impulsivity and memory during abstinence in cigarette dependent smokersSci Rep.(2018 May 15)
80.^Hurd YL, Yoon M, Manini AF, Hernandez S, Olmedo R, Ostman M, Jutras-Aswad DEarly Phase in the Development of Cannabidiol as a Treatment for Addiction: Opioid Relapse Takes Initial Center StageNeurotherapeutics.(2015 Oct)
81.^Elms L, Shannon S, Hughes S, Lewis NCannabidiol in the Treatment of Post-Traumatic Stress Disorder: A Case SeriesJ Altern Complement Med.(2019 Apr)
82.^Linares IMP, Guimaraes FS, Eckeli A, Crippa ACS, Zuardi AW, Souza JDS, Hallak JE, Crippa JASNo Acute Effects of Cannabidiol on the Sleep-Wake Cycle of Healthy Subjects: A Randomized, Double-Blind, Placebo-Controlled, Crossover StudyFront Pharmacol.(2018 Apr 5)
83.^Sulé-Suso J, Watson NA, van Pittius DG, Jegannathen AStriking lung cancer response to self-administration of cannabidiol: A case report and literature reviewSAGE Open Med Case Rep.(2019 Feb 21)
86.^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)
87.^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)
88.^Gaston TE, Bebin EM, Cutter GR, Liu Y, Szaflarski JP, UAB CBD ProgramInteractions between cannabidiol and commonly used antiepileptic drugsEpilepsia.(2017 Sep)
90.^Welty TE, Luebke A, Gidal BECannabidiol: promise and pitfallsEpilepsy Curr.(2014 Sep)
91.^Brzozowska N, Li KM, Wang XS, Booth J, Stuart J, McGregor IS, Arnold JCABC transporters P-gp and Bcrp do not limit the brain uptake of the novel antipsychotic and anticonvulsant drug cannabidiol in micePeerJ.(2016 May 26)
93.^Freedman DA, Patel ADInadequate Regulation Contributes to Mislabeled Online Cannabidiol ProductsPediatr Neurol Briefs.(2018 Jun 18)
94.^Bonn-Miller MO, Loflin MJE, Thomas BF, Marcu JP, Hyke T, Vandrey RLabeling Accuracy of Cannabidiol Extracts Sold OnlineJAMA.(2017 Nov 7)