^ Jump up to: a b c d Boggs, Douglas L; Nguyen, Jacques D; Morgenson, Daralyn; Taffe, Michael A; Ranganathan, Mohini (6 September 2017). "Clinical and preclinical evidence for functional interactions of cannabidiol and Δ9-tetrahydrocannabinol". Neuropsychopharmacology. 43 (1): 142–154. doi:10.1038/npp.2017.209. ISSN 0893-133X. PMC 5719112. PMID 28875990.
In a small study published in the journal JCI Insight in 2017, researchers observed that CBD may help prevent stress-related changes in blood pressure. For the study, nine healthy male volunteers took a single dose of either CBD or placebo. Compared to those given the placebo, those treated with CBD had lower blood pressure both before and after experiencing a stressful event.
Preliminary research indicates that cannabidiol may reduce adverse effects of THC, particularly those causing intoxication and sedation, but only at high doses. Safety studies of cannabidiol showed it is well-tolerated, but may cause tiredness, diarrhea, or changes in appetite as common adverse effects. Epidiolex documentation lists sleepiness, insomnia and poor quality sleep, decreased appetite, diarrhea, and fatigue.
In fact, the U.S. Food and Drug Administration (FDA) approved Epidiolex (a drug made with a purified form of CBD oil) in June 2018 for the treatment of seizures associated with two rare and severe forms of epilepsy in patients 2 years of age and older. These two epilepsy forms are known as Lennox-Gastaut syndrome and Dravet syndrome. Epidiolex is the first FDA-approved drug that contains a purified drug substance derived from marijuana.
For example, 100mg of isolated CBD may be substantially less effective at alleviating symptoms than 100mg of a whole-plant, cannabis extract that contains CBD. While it may be cheaper and more cost-effective to extract CBD from industrial hemp, users may ultimately experience less benefit due to the absence of clinically significant levels of terpenes and other compounds which are plentiful in cannabis. While high-CBD cultivars of cannabis do contain much higher levels of various cannabinoids and terpenes, there are risks and side effects associated with its use.
Cannabidiol can be taken into the body in multiple ways, including by inhalation of cannabis smoke or vapor, as an aerosol spray into the cheek, and by mouth. It may be supplied as CBD oil containing only CBD as the active ingredient (no added tetrahydrocannabinol [THC] or terpenes), a full-plant CBD-dominant hemp extract oil, capsules, dried cannabis, or as a prescription liquid solution. CBD does not have the same psychoactivity as THC, and may affect the actions of THC. Although in vitro studies indicate CBD may interact with different biological targets, including cannabinoid receptors and other neurotransmitter receptors,as of 2018 the mechanism of action for its biological effects has not been determined.
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CBD shows promise in the treatment of anxiety disorders, according to a report published in the journal Neurotherapeutics in 2015. Looking at results from experimental research, clinical trials, and epidemiological studies, the report’s authors found evidence that CBD may help treat generalized anxiety disorder, panic disorder, social anxiety disorder, obsessive-compulsive disorder, and post-traumatic stress disorder. However, the authors caution that human-based research on CBD and anxiety is fairly limited at this point.
Selective breeding of cannabis plants has expanded and diversified as commercial and therapeutic markets develop. Some growers in the U.S. succeeded in lowering the proportion of CBD-to-THC to accommodate customers who preferred varietals that were more mind-altering due to the higher THC and lower CBD content. Hemp is classified as any part of the cannabis plant containing (depending on the jurisdiction) no more than 0.2% to 1.0% THC in dry weight form (not liquid or extracted form).[unreliable source?]
Research suggests that CBD may exert some of its pharmacological action through its inhibition of fatty acid amide hydrolase (FAAH), which may in turn increase the levels of endocannabinoids, such as anandamide, produced by the body. It has also been speculated that some of the metabolites of CBD have pharmacological effects that contribute to the biological activity of CBD.
There has been little high-quality research into the use of cannabidiol for epilepsy, and what there is is limited to refractory epilepsy in children. While the results of using medical-grade cannabidiol in combination with conventional medication shows some promise, they did not lead to seizures being eliminated, and were associated with some minor adverse effects.
Laboratory evidence indicated that cannabidiol may reduce THC clearance, increasing plasma concentrations which may raise THC availability to receptors and enhance its effect in a dose-dependent manner. In vitro, cannabidiol inhibited receptors affecting the activity of voltage-dependent sodium and potassium channels, which may affect neural activity. A small clinical trial reported that CBD partially inhibited the CYP2C-catalyzed hydroxylation of THC to 11-OH-THC.