In the last year, cannabidiol (CBD) has received a lot of press. Most recently, Dr. Friedman, a psychiatrist, wrote an opinion piece [1] on CBD use in The New York Times on Boxing Day (or the 2nd Day of Christmas, December 26th). The piece suggested that CBD was no better than placebo for maladies such as anxiety and pain, indicating that there wasn't enough data to say more than that (his argument was only slightly more nuanced than my summary, and he provided no references or data).
While it's true that very few randomized, controlled, double blinded, clinical studies (RCS) have been performed, there has been a large amount of research in both humans and animal models that suggest treating various neurologic, psychiatric and pain conditions is beneficial and will likely prove to be so in RCS in the future. It's actually surprising to see as much data as there is considering the governmental restrictions that have unnecessarily been in place. To review, we are talking about CBD, not THC. Both are present in cannabis, but only CBD is in hemp (or only a very minimalamount of THC is present). [2] Hemp is an incredibly useful and versatile, environmentally friendly, agricultural crop that has only since the passage of the last farm bill been legal, despite the fact that there is so little THC in it and virtually no way to obtain the psychoactive effects of marijuana from it. [3,4]
So I spent the afternoon doing a little research on the topic. As expected, there is so much research [5] that I could hardly summarize the evidence in a blog post meant to appeal to non-specialist/scientist readers, but I will give a quick stab at it with just a few highlights that I easily found on PubMed, the go-to scientific database.
CBD likely has neuroprotective effects: it has been shown to improve function in a rat model of Parkinson's disease [6,7], Huntington's disease [8], and Alzheimer's disease.
It shows promise in treating Multiple Sclerosis [9,10,11,12,13].
Treatment with CBD may improve symptoms of Post-traumatic Stress Disorder (PTSD) [14,15,16].
Rat and human studies suggest CBD has a role in treating anxiety, depression, and neurobehavioral disorders like schizophrenia [14,15,17,18].
There is a possible benefit for cancers, especially breast and prostate [7,19,20,21,22].
And then there is the well established benefit of CBD oil on some forms of epilepsy.
CBD has an excellent side effect profile and is safe at a variety of doses. The most commonly reported side effects were diarrhea, tiredness, and changes in weight and/or appetite [23,24].
There is the potential for interactions with medications that are metabolized by the liver, so consultation with a physician is recommended if you are taking any medications.
As I wrote earlier, the research on and potential for benefit of CBD oil is actually quite extensive, and I didn't even get into the possible benefits for inflammatory and autoimmune conditions.
The bottom line is that CBD oil, as long as it is from a reliable and safe source with third-party tested purity and quality inspection (like PlusCBD oil), is a reasonable option to try treating some of the conditions listed.
References
1https://www.nytimes.com/2018/12/26/opinion/cbd-cannabis-health-anxiety.html?login=email&auth=login-email.
2https://www.leafscience.com/2014/09/16/5-differences-hemp-marijuana/
3https://pluscbdoil.com/hemp/hemp-cbd-myth-vs-fact/
4https://hempsupporter.com/resources/
5Maroon, J and Bost, J. “Review of the neurological benefits of phytocanibinoids.” Surg Neurol Int. 2018; 9: 91. https://www.ncbi.nlm.nih.gov/pmc/articles/PMC5938896/
6Guo J, Ikeda SR. “Endocannabinoids modulate N-type calcium channels and G-protein-coupled inwardly rectifying potassium channels via CB1 cannabinoid receptors heterologously expressed in mammalian neurons.” Mol Pharmacol. 2004;65:665–74.
7Gwpharm.com. “GW Pharmaceuticals Achieves Positive Results in Phase 2 Proof of Concept Study in Glioma.” Available from: https://www.gwpharm.com/about-us/news/gw-pharmaceuticals-achieves-positive-results-phase-2-proof-concept-study-glioma/
8Valdeolivas S, Satta V, Pertwee RG, Fernandez-Ruiz J, Sagredo O. “Sativex-like combination of phytocannabinoids is neuroprotective in malonate-lesioned rats, an inflammatory model of Huntington's disease: Role of CB1 and CB2 receptors.” ACS Chem Neurosci. 2012;3:400–6.
9Wade, DT, et al.“Do cannabis-based medicinal extracts have general or specific effects on symptoms in multiple sclerosis? A double-blind, randomized, placebo-controlled study on 160 patients.”Mult Scler. 2004 Aug;10(4): 434–41
10Gowran A, Noonan J, Campbell.VACNS Neurosci Ther. 2011 Dec; 17(6):637–44.
11Huntley A. “A review of the evidence for efficacy of complementary and alternative medicines in MS.” Int MS J.2006 Jan; 13(1):5–12, 4.
12Consroe P, Musty R, Rein J, Tillery W, Pertwee R. “The perceived effects of smoked cannabis on patients with multiple sclerosis.” Eur Neurol.1997; 38(1):44–8.
13Iskedjian M, Bereza B, Gordon A, Piwko C, Einarson TR. “Meta-analysis of cannabis based treatments for neuropathic and multiple sclerosis-related pain.” Curr Med Res Opin. 2007 Jan; 23(1):17–24.
14Campos AC, Moreira FA, Gomes FV, Del Bel EA, Guimarães FS.“Multiple mechanisms involved in the large-spectrum therapeutic potential of cannabidiol in psychiatric disorders.” PhilosTrans R Soc Lond B Biol Sci.2012 Dec 5; 367(1607):3364–78.
15Bergamaschi 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 JA. “Cannabidiol reduces the anxiety induced by simulated public speaking in treatment-naïve social phobia patients.” Neuropsychopharmacology.2011 May; 36(6):1219–26.
16Stern CA, Gazarini L, Takahashi RN, Guimarães FS, Bertoglio LJ. “On disruption of fear memory by reconsolidation blockade: evidence from cannabidiol treatment.” Neuropsychopharmacology.2012 Aug; 37(9):2132–42.
17Grinspoon L, Bakalar JB. “The use of cannabis as a mood stabilizer in bipolar disorder: anecdotal evidence and the need for clinical research.” J Psychoactive Drugs. 1998 Apr-Jun; 30(2):171–7.
18Leweke FM, Piomelli D, Pahlisch F, Muhl D, Gerth CW, Hoyer C, Klosterkötter J, Hellmich M, Koethe D. “Cannabidiol enhances anandamide signaling and alleviates psychotic symptoms of schizophrenia.” Transl Psychiatry. 2012 Mar 20; 2:e94.
19De Petrocellis L, Ligresti A, Schiano Moriello A, Iappelli M, Verde R, Stott CG, Cristino L, Orlando P, Di Marzo V. “Non-THC cannabinoids inhibit prostate carcinoma growth in vitro and in vivo: pro-apoptotic effects and underlying mechanisms.” Br J Pharmacol.2013 Jan; 168(1):79–102.
20Ligresti A, Moriello AS, Starowicz K, Matias I, Pisanti S, De Petrocellis L, Laezza C, Portella G, Bifulco M, Di Marzo V. “Antitumor activity of plant cannabinoids with emphasis on the effect of cannabidiol on human breast carcinoma.” J Pharmacol Exp Ther.2006 Sep; 318(3):1375–87.
21McAllister SD, Murase R, Christian RT, Lau D, Zielinski AJ, Allison J, Almanza C, Pakdel A, Lee J, Limbad C, Liu Y, Debs RJ, Moore DH, Desprez PY. “Pathways mediating the effects of cannabidiol on the reduction of breast cancer cell proliferation, invasion, and metastasis.” Breast Cancer Res Treat.2011 Aug; 129(1):37–47.
22Solinas M, Massi P, Cantelmo AR, Cattaneo MG, Cammarota R, Bartolini D, Cinquina V, Valenti M, Vicentini LM, Noonan DM, Albini A, Parolaro D. “Cannabidiol inhibits angiogenesis by multiple mechanisms.” Br J Pharmacol. 2012 Nov; 167(6):1218–31.
23Iffland K, Grotenhermen F. “An Update on Safety and Side Effects of Cannabidiol: A Review of Clinical Data and Relevant Animal Studies.” Cannabis Cannabinoid Res.2017; 2(1):139–154.
24Ramirez BG, Blazquez C, Gomez del Pulgar T, Guzman M, de Ceballos ML. “Prevention of Alzheimer's disease pathology by cannabinoids: Neuroprotection mediated by blockade of microglial activation.” J Neurosci. 2005;25:1904–13.
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