Cannabidiol
Cannabidiol, or CBD, is the less-famous brother of tetrahydrocannabinol, or THC, the psychoactive element in cannabis. The plant was first employed medicinally — or for rituals — approximately 750 B.C., though alternative estimates exist.
THC and CBD are two of the plant’s over 100 cannabinoids. THC is psychoactive, but CBD may or may not be. THC can enhance anxiety; it’s unclear if CBD might reduce it. THC causes addiction and cravings; CBD may help people in recovery.
Hemp is cannabis with less than 0.3 percent THC. While last year’s Farm Bill legalized hemp, it also kept the FDA in charge of cannabis-derived products.
What is claimed?
CBD is said to help with anxiety, sadness, and PTSD. It also promotes sleep. The fact that CBD is “nonpsychoactive” and hence doesn’t get you high is part of its appeal (or the midnight pizza munchies).
Marketing is popping up like cannabis sprouts over the US. CBD is everywhere now, from oils and nasal sprays to lollipops and suppositories. “It’s the monster that has taken over the room,” said Dr. Brad Ingram, an associate pediatrician at the University of Mississippi Medical Center. He is directing a study using CBD to treat drug-resistant epilepsy in children and teenagers.
CBD works?
For its safety, cannabis has a lot of therapeutic potential, says James MacKillop, co-director of the Michael G. DeGroote Center for Medicinal Cannabis Research at McMaster University in Hamilton, Ontario.
After three randomized, double-blind, placebo-controlled clinical trials with 516 patients, the FDA authorized Epidiolex, a refined CBD extract, last year to treat uncommon seizure disorders in patients 2 years and older. These studies are the gold standard in medicine, where participants are randomly assigned to either a placebo or a drug group.
While other illnesses may be treated with the plant extract, Epidiolex is the only FDA-approved CBD-derived medicine. Cannabidiol has mostly been studied in animals, and its appeal has surpassed science. In a statement, Ryan Vandrey, associate professor of psychiatry and behavioral sciences at Johns Hopkins University School of Medicine, said:
Does CBD aid PTSD?
A four-minute conversation with little preparation time might be crippling for kids with social anxiety. For patients with social anxiety, CBD reduced uneasiness and cognitive impairment in a small study published in Neuropsychopharmacology.
Compared to the placebo group, healthy participants who were given CBD showed little to no change in their emotional reactions to unpleasant images or phrases. “A relaxing medicine should modify their responses to stimuli,” said Harriet de Wit, co-author of the study and professor of psychiatry and behavioral neuroscience at the University of Chicago. “No.”
Many troops return home scarred by battle and PTSD, avoiding certain activities, places, or persons. The VA is supporting the first study on CBD with psychotherapy.
“Our top therapies try to break the relationship between recollections of trauma and the fear response,” said research principal investigator Mallory Loflin, an assistant adjunct professor at UC San Diego. “We believe CBD, at least in animal models, can speed up the process.” Despite large-scale clinical trials, psychologists say there isn’t enough evidence to recommend this treatment.
CBD with sleep disorders?
Are you up late at night watching puppy videos? According to Mr. MacKillop, co-author of a review on cannabinoids and sleep, one of the Epidiolex trials for epilepsy was drowsiness. “That may be a clue,” he remarked.
He warns that the negative effects could have been due to pharmaceutical interactions. There is no randomized, placebo-controlled, double-blind investigation on CBD and sleep problems.
Anxiety improved but not sleep in a recent study of 72 mental patients treated with CBD. “Overall, we did not find it to be a useful treatment for sleep,” said Dr. Scott Shannon, lead author of the review in The Permanente Journal.
Depression can affect sleep. A review in Journal of Chemical Neuroanatomy found that CBD helped rats cope better with stressful situations and reduced depressive-like behavior. An email discussion with Sâmia Joca, a fellow at the Aarhus Institute of Advanced Studies in Denmark and associate professor at the University of Sao Paulo in Brazil, revealed that CBD appears to function faster than traditional antidepressants. Although it is difficult to identify sadness in animals, Ms. Joca and her colleagues found that CBD-treated mice and rats were more resilient in chronic stress situations.
But without human trials, experts argue CBD’s antidepressant impact is simply a hypothesis, not a proven treatment.