CBD (cannabidiol) is the second most abundant cannabinoid in cannabis, after THC (tetrahydrocannabinol).[4] 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 is CBD?
What are CBD’s main benefits?
Human research on CBD has focused on two rare forms of epilepsy: Dravet syndrome and Lennox-Gastaut syndrome.[5] In humans and animals, CBD has shown promise as a treatment for a wide variety of ailments, notably anxiety,[6][7][8][9][10] depression,[8] pain,[11][12][13][14] inflammation,[15][16] and cancer.[17]
Unlike cannabis and THC, CBD doesn’t impair coordination, judgment, or memory.[18] 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 of pure CBD".
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).[19][20][21]
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,[22][23][24] stress and depression via the 5HTI-alpha receptor,[25][26] and inflammation via the A2A receptors.[27]
Unfortunately, CBD seems to work better in combination with THC.
What are other names for Cannabidiol (CBD)?
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 epileptic 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,[1][2] and (iii) high-fat and high-calorie meals can greatly increase CBD absorption,[3] properly dosing CBD products is very, very difficult.
Research FeedRead all studies
Does cannabis use influence propofol dose requirements?
In this meta-analysis of 11 observational studies, the participants who reported cannabis use required higher doses of propofol to achieve sedation or anesthesia than those who did not use cannabis.
CBD-rich cannabis for symptoms of autism spectrum disorder?
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Does CBD impair learning and memory?
Can CBD improve anxiety in women with breast cancer?
Frequently asked questions
What is CBD?
What are CBD’s main benefits?
Human research on CBD has focused on two rare forms of epilepsy: Dravet syndrome and Lennox-Gastaut syndrome.[5] In humans and animals, CBD has shown promise as a treatment for a wide variety of ailments, notably anxiety,[6][7][8][9][10] depression,[8] pain,[11][12][13][14] inflammation,[15][16] and cancer.[17]
Unlike cannabis and THC, CBD doesn’t impair coordination, judgment, or memory.[18] 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 of pure CBD".
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).[19][20][21]
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.
Aren’t CBD products legal?
What makes CBD products unreliable?
Quick answer:
The only CBD pharmaceutical approved in the U.S. (Epidiolex®) is approved only for two rare types of epilepsy. Nonpharmaceutical CBD products are widely available, but they often contain a lot more or less CBD than stated on the label, and even sometimes some THC.[1][2]
CBD products might also contain some of the same contaminants frequently found in cannabis: metals, molds, bacteria, pesticides, aflatoxins, synthetic cannabinoids,[29][30] and residual solvents from the production process (hexane, benzene, xylene, toluene, acetone, ethanol, and isopropyl alcohol).[31]
What makes CBD evidence poor?
Quick answer:
A 2019 review noted that human trials were few,[32] and they still are few in 2022. Most studies are in animals, and animal studies often translate poorly to humans[33] (CBD appears to be more bioavailable for rodents than for humans, notably[34]).
Moreover, what human trials we have didn’t last very long,[35] so we don’t know much about the long-term effects of CBD. For example, like cannabis itself, CBD has been touted as a potential cancer treatment,[36] yet CBD-induced receptor activation could theoretically worsen certain types of cancer, such as colon cancer.[37]
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,[22][23][24] stress and depression via the 5HTI-alpha receptor,[25][26] and inflammation via the A2A receptors.[27]
Unfortunately, CBD seems to work better in combination with THC.
Research Breakdown
References
Examine Database References
- Depression Symptoms - Timo Woelfl, Cathrin Rohleder, Juliane K Mueller, Bettina Lange, Anne Reuter, Anna Maria Schmidt, Dagmar Koethe, Martin Hellmich, F Markus LewekeEffects of Cannabidiol and Delta-9-Tetrahydrocannabinol on Emotion, Cognition, and Attention: A Double-Blind, Placebo-Controlled, Randomized Experimental Trial in Healthy VolunteersFront Psychiatry.(2020 Nov 13)
- Anxiety Symptoms - Linares IM, Zuardi AW, Pereira LC, Queiroz RH, Mechoulam R, Guimarães FS, Crippa JACannabidiol presents an inverted U-shaped dose-response curve in a simulated public speaking testBraz J Psychiatry.(2019 Jan-Feb)
- Anxiety Symptoms - Hundal H, Lister R, Evans N, Antley A, Englund A, Murray RM, Freeman D, Morrison PDThe effects of cannabidiol on persecutory ideation and anxiety in a high trait paranoid groupJ Psychopharmacol.(2018 Mar)
- Schizophrenia symptoms - 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)
- Schizophrenia symptoms - 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)
- Crohn's Disease Symptoms - 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)
- Anxiety Symptoms - 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)
- Anxiety Symptoms - Zuardi AW, Shirakawa I, Finkelfarb E, Karniol IGAction of cannabidiol on the anxiety and other effects produced by delta 9-THC in normal subjectsPsychopharmacology (Berl).(1982)
- Anxiety Symptoms - Zuardi AW, Cosme RA, Graeff FG, Guimarães FSEffects of ipsapirone and cannabidiol on human experimental anxietyJ Psychopharmacol.(1993 Jan)
- Ulcerative Colitis Symptoms - 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)
- Seizure Frequency - 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)
- Seizure Frequency - Devinsky O, Marsh E, Friedman D, Thiele E, Laux L, Sullivan J, Miller I, Flamini R, Wilfong A, Filloux F, Wong M, Tilton N, Bruno P, Bluvstein J, Hedlund J, Kamens R, Maclean J, Nangia S, Singhal NS, Wilson CA, Patel A, Cilio MRCannabidiol in patients with treatment-resistant epilepsy: an open-label interventional trialLancet Neurol.(2016 Mar)
- Seizure Frequency - Hess EJ, Moody KA, Geffrey AL, Pollack SF, Skirvin LA, Bruno PL, Paolini JL, Thiele EACannabidiol as a new treatment for drug-resistant epilepsy in tuberous sclerosis complexEpilepsia.(2016 Oct)
- Pain - 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)
- Pain - Palmieri B, Laurino C, Vadalà MShort-Term Efficacy of CBD-Enriched Hemp Oil in Girls with Dysautonomic Syndrome after Human Papillomavirus VaccinationIsr Med Assoc J.(2017 Feb)
- Pain - Wade DT, Robson P, House H, Makela P, Aram JA preliminary controlled study to determine whether whole-plant cannabis extracts can improve intractable neurogenic symptomsClin Rehabil.(2003 Feb)