The Impact of Cannabidiol on Psychiatric and Medical Conditions PMC

Multiple studies evaluated the potential therapeutic effect of CBD on anxiety, psychotic symptoms, and depression in humans since the 1980s, mostly showing mild AEs [28-35]. CBD effectively treated anxiety by activating limbic and paralimbic regions of the brain [30]. THC crosses the placenta and can accumulate in significantly elevated concentrations in breast milk.

Dysphoric reactions to cannabis are not uncommon, especially in naive users. Reactions can include severe anxiety or panic, unpleasant somatic sensations, delirium, mania, or paranoia. Anxiety and/or panic are the most common reactions; they are of sudden onset during or shortly after smoking, or they can appear more gradually 1-2 hours after an oral dose. These effects often occur in those who unwittingly consume marijuana (eg. those ingesting baked goods that they did not know contained marijuana). These anxiety/panic reactions usually resolve without intervention.

Reviewer response for version 3

Given the recent approval of CBD by the FDA and EMA for childhood epilepsy syndromes, and the wide range of other indications for which it is being marketed, a quantitative assessment of its safety and tolerability is timely. The aim of the present study was to address this issue by conducting a systematic review and meta-analysis of the adverse effects of CBD across a range of indications. From all hemp constituents, cannabidiol (CBD) is currently the compound with highest interest. In contrast to https://ecosoberhouse.com/article/is-cannabidiol-addictive-the-effects-of-cbd/ ∆
9-THC, the major narcotic constituent of hemp, CBD is a non-psychotropic cannabinoid. It is currently being tested for its possible antispasmodic, anti-inflammatory, anxiolytic and antiemetic effects as a drug, e.g. for the treatment of epilepsy

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. The marketing of CBD products is based on the current “hype” around medicinal hemp products, whereby the CBD products are offered as a supposedly safe alternative, promised as being free of psychotropic components or their adverse effects

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Now, cannabinoid receptors are also abundant in the brain and the spinal cord, but studies show that the lower brainstem contains only a few cannabinoid receptors. So, even if you take high CBD doses, there won’t be enough cannabinoid receptors to activate and significantly affect our physiological parameters. The interest in cannabis products and CBD has exploded nationally over the last decade and the current trend is to legalize marijuana and make CBD available without strict regulations or control to the general public.

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Users with impaired liver function are at higher risk to experience toxic effects than healthy individuals. There are no data available yet to differentiate reliably between the risks of different age groups, gender or ethnicity. The CB1 receptors are predominantly located in the brain, with a wide distribution. The highest densities are found in the frontal cerebral cortex (higher functioning), hippocampus (memory, cognition), basal ganglion and cerebellum (movement), and striatum (brain reward).

In a randomized, double-blind, placebo-controlled trial, CBD was efficacious in reducing atonic seizures in patients with Lennox-Gastaut syndrome, also taking clobazam, valproate, lamotrigine, levetiracetam, or rufinamide [65]. Treatment-related AEs, including somnolence, were mostly mild and occurred in 62% of 86 patients treated with 20 mg/kg/day CBD for 14 weeks. Severe AEs included sedation occurring in 23% of 86 patients receiving CBD; 14% patients treated with CBD and one (1%) treated with placebo withdrew from the study.

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There are no compatible data available comparing OTC CBD with placebo regarding increased risk of suicidality. The studies are utilizing a controlled CBD form without any significant THC content, studies have small patient numbers and the follow-up windows are short. Major toxic effects have been reported with the use of CBD, being more depressed one of them and even suicidal ideations [52, 56]. In vitro, CBD is found to be a microglial stabilizer which is similar to the medication lithium which could be beneficial for depression and mood stabilization [54]. Several human studies have shown some positive results of CBD in anxiety conditions as well. The effect of CBD on the amygdala was studied in brain imaging studies and showed a decrease in activation in the amygdala after administration of CBD [46].