OTHER NAME(S). 2-[(1R,6R)Methylpropenylcyclohexenyl] pentylbenzene-1 ,3-diol, CBD. . Show More · Read Reviews (47). We learn a lot about the benefits of taking CBD but there is not much to find about CBD is a natural chemical derived from the cannabis plant. However, unlike THC, CBD is not psychoactive. which can cause a number of side effects including drowsiness, agitation, insomnia, sexual.
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More research is necessary, but these findings suggest that CBD may help to prevent or reduce withdrawal symptoms. After researching the safety and effectiveness of CBD oil for treating epilepsy, the FDA approved the use of CBD Epidiolex as a therapy for two rare conditions characterized by epileptic seizures in The types of seizures that characterize LGS or DS are difficult to control with other types of medication.
The FDA specified that doctors could not prescribe Epidiolex for children younger than 2 years. A physician or pharmacist will determine the right dosage based on body weight. Authors of a review noted that CBD has anti-seizure properties and a low risk of side effects for people with epilepsy. Findings suggested that CBD may also treat many complications linked to epilepsy, such as neurodegeneration, neuronal injury, and psychiatric diseases.
Another study, published in Current Pharmaceutical Design, found that CBD may produce effects similar to those of certain antipsychotic drugs, and that the compound may provide a safe and effective treatment for people with schizophrenia. However, further research is necessary. Some researchers have found that CBD may prove to combat cancer. Authors of a review published in the British Journal of Clinical Pharmacology found evidence that CBD significantly helped to prevent the spread of cancer.
The researchers also noted that the compound tends to suppress the growth of cancer cells and promote their destruction. They pointed out that CBD has low levels of toxicity. They called for further research into its potential as an accompaniment to standard cancer treatments. Doctors often advise people with chronic anxiety to avoid cannabis, as THC can trigger or amplify feelings of anxiousness and paranoia. However, authors of a review from Neurotherapeutics found that CBD may help to reduce anxiety in people with certain related disorders.
According to the review, CBD may reduce anxiety-related behaviors in people with conditions such as:. The authors noted that current treatments for these disorders can lead to additional symptoms and side effects, which can cause some people to stop taking them. No further definitive evidence currently links CBD to adverse effects, and the authors called for further studies of the compound as a treatment for anxiety. Type 1 diabetes results from inflammation that occurs when the immune system attacks cells in the pancreas.
Research published in by Clinical Hemorheology and Microcirculation found that CBD may ease this inflammation in the pancreas. This may be the first step in finding a CBD-based treatment for type 1 diabetes. A paper presented in the same year in Lisbon, Portugal, suggested that CBD may reduce inflammation and protect against or delay the development of type 1 diabetes. Acne treatment is another promising use for CBD.
The condition is caused, in part, by inflammation and overworked sebaceous glands in the body. A study published by the Journal of Clinical Investigation found that CBD helps to lower the production of sebum that leads to acne, partly because of its anti-inflammatory effect on the body.
Sebum is an oily substance, and overproduction can cause acne. Initial research published in the Journal of Alzheimer's Disease found that CBD was able to prevent the development of social recognition deficit in participants.
This means that CBD could help people in the early stages of Alzheimer's to keep the ability to recognize the faces of people that they know. This is the first evidence that CBD may slow the progression of Alzheimer's disease. Cannabis is legal for either medicinal or recreational use in some American states. Other states have approved the use of CBD oil as a hemp product but not the general use of medical marijuana.
Some state and federal laws differ, and current marijuana and CBD legislation in the U. There is an ever-changing number of states that do not necessarily consider marijuana to be legal but have laws directly related to CBD oil. The following information is accurate as of May 8, , but the laws change frequently.
However, state legislators generally approve the use of CBD oil at various concentrations to treat a range of epileptic conditions. A full list of states that have CBD-specific laws is available here. Different states also require different levels of prescription to possess and use CBD oil. In Missouri, for example, a person can use CBD of a particular composition if they can show that three other treatment options have failed to treat their epilepsy.
Anyone considering CBD oil should speak with a local healthcare provider. They can provide information about safe CBD sources and local laws surrounding usage. This is one of more than 80 active chemicals in marijuana. The new product was approved to treat seizures associated with two rare, severe forms of epilepsy in patients two years of age and older.
Many small-scale studies have looked into the safety of CBD in adults. They concluded that adults tend to tolerate a wide range of doses well.
Researchers have found no significant side effects on the central nervous system , the vital signs, or mood, even among people who used high dosages.
The most common side effect was tiredness. Also, some people reported diarrhea and changes in appetite or weight. Concerning the product that the FDA approved to treat two types of epilepsy, researchers noticed following adverse effects in clinical trials:.
The patient information leaflet notes that there is a risk of worsening depression or suicidal thoughts. It is important to monitor anyone who is using this drug for signs of mood change. Research suggests that a person taking the product is unlikely to form a dependency. There is often a lack of evidence regarding the safety of new or alternative treatment options.
Usually, researchers have not performed the full array of tests. Anyone who is considering using CBD should talk to a qualified healthcare practitioner beforehand. When drugs do not have FDA approval, it can be difficult to know whether a product contains a safe or effective level of CBD.
Unapproved products may not have the properties or contents stated on the packaging. It is important to note that researchers have linked marijuana use during pregnancy to impairments in the fetal development of neurons. Regular use among teens is associated with issues concerning memory, behavior, and intelligence. CBD-based products come in many forms. Some can be mixed into different foods or drinks or taken with a pipette or dropper. Others are available in capsules or as a thick paste to be massaged into the skin.
Some products are available as sprays to be administered under the tongue. Recommended dosages vary between individuals, and depend on factors such as body weight, the concentration of the product, and the health issue.
Due to the lack of FDA regulation for most CBD products, seek advice from a medical professional before determining the best dosage.
As regulation in the U. After discussing dosages and risks with a doctor, and researching regional local laws, it is important to compare different brands of CBD oil.
There is a selection of CBD products available for purchase online. CBD has been tested and approved for one specific use. Does this mean it is safe and will soon have approval for other uses? The research is emerging to support the use of CBD for numerous conditions, as well as looking closely at safety, side effects, and long-term effects.
There are some valid concerns about long-term use that must be tested before CBD can be recommended for other diseases. As one approach to pain management, it is seen as an alternative option to the addicting narcotics.
The use of CBD oil might complement a medical approach to treating physical and mental diseases. It is worth discussing with your doctor. We picked linked items based on the quality of products, and list the pros and cons of each to help you determine which will work best for you.
We partner with some of the companies that sell these products, which means Healthline UK and our partners may receive a portion of revenues if you make a purchase using a link s above. Article last updated by Yvette Brazier on Fri 27 July All references are available in the References tab.
Cannabidiol as a potential treatment for anxiety disorders. Neurotherapeutics, 12 4 , — Long-term cannabidiol treatment prevents the development of social recognition memory deficits in Alzheimer's disease transgenic mice [Abstract].
Journal of Alzheimer's Disease, 42 4 , 1,—1, Pharmacology and potential therapeutic role in epilepsy and other neuropsychiatric disorders. Epilepsia, 55 6 , — An updated review of the research on the risks and harms associated to the use of marijuana. Highlights of prescribing information: Early phase in the development of cannabidiol as a treatment for addiction: Opioid relapse takes initial center stage.
Experimental cannabidiol treatment reduces early pancreatic inflammation in type 1 diabetes [Abstract]. Clinical Hemorheology and Microcirculation, 64 4 , — Cannabidiol as potential anticancer drug. High Id1-levels were also found in breast, prostate, brain, and head and neck tumor cells, which were highly aggressive. In contrast, Id1 expression was low in noninvasive tumor cells.
Id1 seems to influence the tumor cell phenotype by regulation of invasion, epithelial to mesenchymal transition, angiogenesis, and cell proliferation. There only seems to exist one study that could not show an adverse CBD effect on embryogenesis.
An in vitro study could show that the development of two-cell embryos was not arrested at CBD concentrations of 6. Various studies have been performed to study CBD anticancer effects. CBD every 3 days for a total of 28 weeks, almost completely reduced the development of metastatic nodules caused by injection of human lung carcinoma cells A in nude mice.
The typical side effects of traditional anticancer medication, emesis, and collateral toxicity were not described in these studies.
Consequently, CBD could be an alternative to other MMP1 inhibitors such as marimastat and prinomastat, which have shown disappointing clinical results due to these drugs' adverse muscoskeletal effects.
Two studies showed in various cell lines and in tumor-bearing mice that CBD was able to reduce tumor metastasis. CBD downregulated Id1 at promoter level and reduced tumor aggressiveness. Moreover, to carry out these experiments, animals are often immunologically compromised, to avoid immunogenic reactions as a result to implantation of human cells into the animals, which in turn can also affect the results.
Another approach was chosen by Aviello et al. After 3 months, the number of aberrant crypt foci, polyps, and tumors was analyzed. The high CBD concentration led to a significant decrease in polyps and a return to near-normal levels of phosphorylated Akt elevation caused by the carcinogen.
Animal studies summarized by Bergamaschi et al. Chronic administration 14 days, 2. This effect could be inhibited by coadministration of a CB2R antagonist. The positive effects of CBD on hyperglycemia seem to be mainly mediated via CBD anti-inflammatory and antioxidant effects. In addition, treatment increased adiponectin and liver glycogen concentrations. CBD showed inhibition of testosterone oxidation in the liver.
Motor function was also tested on a rotarod, which was also not affected by CBD administration. Static beam performance, as an indicator of sensorimotor coordination, showed more footslips in the CBD group, but CBD treatment did not interfere with the animals' speed and ability to complete the test. Compared to other anticonvulsant drugs, this effect was minimal. CBD did not lead to adverse effects. In addition, psychomotor function and psychological functions were not disturbed.
Interestingly, the CYP2C19 inhibitor omeprazole, used to treat gastroesophageal reflux, could not significantly affect the pharmacokinetics of CBD. Unfortunately, it was not mentioned whether this effect was mediated via the cytochrome P complex. Another aspect, which has not been thoroughly looked at, to our knowledge, is that several cytochrome isozymes are not only expressed in the liver but also in the brain.
It might be interesting to research organ-specific differences in the level of CBD inhibition of various isozymes. Apart from altering the bioavailability in the overall plasma of the patient, this interaction might alter therapeutic outcomes on another level. Generally, more human studies, which monitor CBD-drug interactions, are needed. In a double-blind, placebo-controlled crossover study, CBD was coadministered with intravenous fentanyl to a total of 17 subjects.
This was followed by a single 0. This extensive tool tests, for example, 78 adverse effects divided into 23 categories corresponding to organ systems or body parts. No respiratory depression or cardiovascular complications were recorded during any test session. The results of the evaluation of pharmacokinetics, to see if interaction between the drugs occurred, were as follows. No effect was evident for urinary CBD and metabolite excretion except at the higher fentanyl dose, in which CBD clearance was reduced.
Importantly, fentanyl coadministration did not produce respiratory depression or cardiovascular complications during the test sessions and CBD did not potentiate fentanyl's effects.
No correlation was found between CBD dose and plasma cortisol levels. CBD did not worsen the adverse effects e. Coadministration was safe and well tolerated, paving the way to use CBD as a potential treatment for opioid addiction. A Dutch study compared subjective adverse effects of three different strains of medicinal cannabis, distributed via pharmacies, using VAS.
The 12 adjectives used for this study were as follows: This strain showed significantly lower levels of anxiety and dejection. Moreover, appetite increased less in the high CBD strain.
The review by Bergamaschi et al. This holds especially true for the extrapyramidal motor side effects elicited by classical antipsychotic medication. Order of drug administration was pseudorandomized across subjects, so that an equal number of subjects received any of the drugs during the first, second, or third session in a double-blind, repeated-measures, within-subject design. This effect was caused by opposite neural activation of relevant brain areas.
In addition, no effects on peripheral cardiovascular measures such as heart rate and blood pressure were measured. A randomized, double-blind, crossover, placebo-controlled trial was conducted in 16 healthy nonanxious subjects using a within-subject design. The doses were selected to only evoke neurocognitive effects without causing severe toxic, physical, or psychiatric reactions. The physiological parameters, heart rate and blood pressure, were also monitored and no significant difference between the placebo and the CBD group was observed.
A case study describes a patient treated for cannabis withdrawal according to the following CBD regimen: Hepatic enzymes were also measured daily, but no effect was reported. Naturalistic studies with smokers inhaling cannabis with varying amounts of CBD showed that the CBD levels were not altering psychomimetic symptoms. CBD might work to alleviate disorders of addiction, by altering the attentive salience of drug cues.
The study did not further measure side effects. CBD can also reduce heroin-seeking behaviors e. This was shown in the preclinical data mentioned earlier and was also replicated in a small double-blind pilot study with individuals addicted to opioids, who have been abstinent for 7 days.
One hour after the video session, subjective craving was already reduced after a single CBD administration. The effect persisted for 7 days after the last CBD treatment. Interestingly, anxiety measures were also reduced after treatment, whereas no adverse effects were described.
A pilot study with 24 subjects was conducted in a randomized, double-blind, placebo-controlled design to evaluate the impact of the ad hoc use of CBD in smokers, who wished to stop smoking. Pre- and post-testing for mood and craving of the participants was executed. Craving was assessed using the Tiffany Craving Questionnaire On day 1 and 7, exhaled CO was measured to test smoking status. Sedation, depression, and anxiety were evaluated with the MRS.
At day 7, the anxiety levels for placebo and CBD group did not differ. CBD did not increase depression in contrast to the selective CB1 antagonist rimonabant.
CBD might weaken the attentional bias to smoking cues or could have disrupted reconsolidation, thereby destabilizing drug-related memories. To the best of our knowledge, no acute studies were performed that solely concentrated on CBD glycemic effects. Moreover, the only acute study that also measured CBD effect on appetite was the study we described above, comparing different cannabis strains.
Growth hormone and prolactin levels were unchanged. Compared to the healthy individuals, the cortisol levels increased less after TSST in the 32 at-risk individuals. The CBD group showed less reduced cortisol levels but differences were not significant. Truly chronic studies with CBD are still scarce.
Nonetheless, we also included these studies with repeated CBD treatment, because we think that compared to a one-time dose of CBD, repeated CBD regimens add value and knowledge to the field and therefore should be mentioned here. These results are supported by another study described in the review by Grotenhermen et al. CBD was administered on average with three other drugs, including clobazam The coadministration led to an alteration of blood levels of several antiepileptic drugs.
In the case of clobazam this led to sedation, and its levels were subsequently lowered in the course of the study.
A first pilot study in healthy volunteers in by Mincis et al. Clinical chronic lasting longer than a couple of weeks studies in humans are crucial here but were mostly still lacking at the time of writing this review.
They hopefully will shed light on the inconsistencies observerd in animal studies. Chronic studies in humans may, for instance, help to test whether, for example, an anxiolytic effect always prevails after chronic CBD treatment or whether this was an artifact of using different animal models of anxiety or depression.
In a 4-week open trial, CBD was tested on Parkinson's patients with psychotic symptoms. This led to a reduction of their psychotic symptoms. Moreover, no serious side effects or cognitive and motor symptoms were reported. No adverse effects were observed and her symptoms improved. The same positive outcome was registered in another study described by Bergamaschi et al. The respective treatment was maintained for three additional weeks.
This was the case for three patients in the CBD group and five patients in the amisulpride group. CBD treatment was accompanied by a substantial increase in serum anandamide levels, which was significantly associated with clinical improvement, suggesting inhibition of anandamide deactivation via reduced FAAH activity. In addition, the FAAH substrates palmitoylethanolamide and linoleoyl-ethanolamide both lipid mediators were also elevated in the CBD group.
CBD showed less serum prolactin increase predictor of galactorrhoea and sexual dysfunction , fewer extrapyramidal symptoms measured with the Extrapyramidal Symptom Scale, and less weight gain. Moreover, electrocardiograms as well as routine blood parameters were other parameters whose effects were measured but not reported in the study.
CBD better safety profile might improve acute compliance and long-term treatment adherence. A press release by GW Pharmaceuticals of September 15th, , described 88 patients with treatment-resistant schizophrenic psychosis, treated either with CBD in addition to their regular medication or placebo.
Important clinical parameters improved in the CBD group and the number of mild side effects was comparable to the placebo group. Moreover, neurological and physiological examinations were performed, which neither showed signs of CBD toxicity nor severe side effects. The study also illustrated that CBD was well tolerated. CBD in addition to their regular epilepsy medication.
Another clinical study lasting at least 3 months with children and young adults with various forms of epilepsy, who were treated with the CBD drug Epidiolex, was presented at the American Academy for Neurology in In a few cases, severe side effects occurred, but it is not clear, if these were caused by Epidiolex.
The largest CBD study conducted thus far was an open-label study with Epidiolex in patients mainly children, the average age of the participants was 11 suffering from severe epilepsy, who could not be treated sufficiently with standard medication. Ten percent of the patients reported side effects tiredness, diarrhea, and exhaustion. After extensive literature study of the available trials performed until September , CBD side effects were generally mild and infrequent.
The only exception seems to be a multicenter open-label study with a total of patients aged 1—30 years, with treatment-resistant epilepsy.
This led to a reduction in seizure frequency. It is therefore difficult to put the side effect frequency into perspective. Attributing the side effects to CBD is also not straightforward in severely sick patients.
Thus, it is not possible to draw reliable conclusions on the causation of the observed side effects in this study. This rating instrument comprised the following factors: This assessment instrument analyzes adverse medication effects, including psychic, neurologic, autonomic, and other manifestations.
Using various safety outcome variables, clinical tests, and the cannabis side effect inventory, it was shown that there were no differences between the placebo group and the CBD group in the observed side effects. The occurrence of various degrees of GVHD was compared with historical data from patients, who had only received the standard treatment. This resulted in lower resistin levels compared to baseline.
The hormone resistin is associated with obesity and insulin resistance. Compared to baseline, glucose-dependent insulinotropic peptide levels were elevated after CBD treatment. This incretin hormone is produced in the proximal duodenum by K cells and has insulinotropic and pancreatic b cell preserving effects. CBD was well tolerated in the patients. However, with the comparatively low CBD concentrations used in this phasetrial, no overall improvement of glycemic control was observed.
When weight and appetite were measured as part of a measurement battery for side effects, results were inconclusive. For instance, the study mentioned above, where 23 children with Dravet syndrome were treated, increases as well as decreases in appetite and weight were observed as side effects. However, in the safety analysis group, consisting of subjects, 10 showed decreased weight and 12 had gained weight. Both these factors were not controlled for in the reviewed studies.
This review could substantiate and expand the findings of Bergamaschi et al. First, more studies researching CBD side effects after real chronic administration need to be conducted. Many so-called chronic administration studies, cited here were only a couple of weeks long.
Second, many trials were conducted with a small number of individuals only. To perform a throrough general safety evaluation, more individuals have to be recruited into future clinical trials. Third, several aspects of a toxicological evaluation of a compound such as genotoxicity studies and research evaluating CBD effect on hormones are still scarce.
Especially, chronic studies on CBD effect on, for example, genotoxicity and the immune system are still missing. Last, studies that evaluate whether CBD-drug interactions occur in clinical trials have to be performed. In conclusion, CBD safety profile is already established in a plethora of ways. However, some knowledge gaps detailed above should be closed by additional clinical trials to have a completely well-tested pharmaceutical compound. The study was commissioned by the European Industrial Hemp Association.
EIHA paid nova-Institute for the review. Iffland K, Grotenhermen F An update on safety and side effects of cannabidiol: National Center for Biotechnology Information , U. Journal List Cannabis Cannabinoid Res v. Published online Jun 1. Find articles by Kerstin Iffland.
Find articles by Franjo Grotenhermen. Author information Copyright and License information Disclaimer. This is an Open Access article distributed under the terms of the Creative Commons Attribution License, which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly cited.
This article has been cited by other articles in PMC. Relevant Preclinical Studies Before we discuss relevant animal research on CBD possible effects on various parameters, several important differences between route of administration and pharmacokinetics between human and animal studies have to be mentioned.
Open in a separate window. The reality is more complex, because CBD is lipophilic and, for example, will consequently accumulate in fat tissue. These calculations were made with the intention to give the reader an impression and an approximation of the supraphysiological levels used in in vitro studies.
CBD-drug interactions Cytochrome Pcomplex enzymes This paragraph describes CBD interaction with general drug -metabolizing enzymes, such as those belonging to the cytochrome P family. Neurological and neurospychiatric effects Anxiety and depression Some studies indicate that under certain circumstances, CBD acute anxiolytic effects in rats were reversed after repeated day administration of CBD. Psychosis and bipolar disorder Various studies on CBD and psychosis have been conducted.
Addiction CBD, which is nonhedonic, can reduce heroin-seeking behavior after, for example, cue-induced reinstatement. Neuroprotection and neurogenesis There are various mechanisms underlying neuroprotection, for example, energy metabolism whose alteration has been implied in several psychiatric disorders and proper mitochondrial functioning.
Immune system Numerous studies show the CBD immunomodulatory role in various diseases such as multiple sclerosis, arthritis, and diabetes. Cell migration Embryogenesis CBD was shown to be able to influence migratory behavior in cancer, which is also an important aspect of embryogenesis.
Cancer Various studies have been performed to study CBD anticancer effects. Food intake and glycemic effects Animal studies summarized by Bergamaschi et al. Genotoxicity and mutagenicity Jones et al. Acute Clinical Data Bergamaschi et al. Physiological effects In a double-blind, placebo-controlled crossover study, CBD was coadministered with intravenous fentanyl to a total of 17 subjects. Psychosis The review by Bergamaschi et al.
Addiction A case study describes a patient treated for cannabis withdrawal according to the following CBD regimen: Endocrine effects and glycemic including appetite effects To the best of our knowledge, no acute studies were performed that solely concentrated on CBD glycemic effects.
Physiological effects A first pilot study in healthy volunteers in by Mincis et al. Neurological and neuropsychiatric effects Anxiety Clinical chronic lasting longer than a couple of weeks studies in humans are crucial here but were mostly still lacking at the time of writing this review. Psychosis and bipolar disorder In a 4-week open trial, CBD was tested on Parkinson's patients with psychotic symptoms. Conclusion This review could substantiate and expand the findings of Bergamaschi et al.
Safety and side effects of cannabidiol, a Cannabis sativa constituent. Cannabis und Cannabinoide in der Medizin: Cannabidiol exerts sebostatic and antiinflammatory effects on human sebocytes. Controlled clinical trial of cannabidiol in Huntington's disease. Molecular targets of cannabidiol in neurological disorders. Exogenous cannabinoids as substrates, inhibitors, and inducers of human drug metabolizing enzymes:
Guidance on Using CBD
We'll take a look at two compounds, CBD vs THC, and compare them on a number of different It's sold in gels, gummies, oils, supplements, extracts, and more. CBD does not need to be made from marijuana and is legal when made from hemp. These side effects are part of the compound's psychoactive properties. A chemical compound found in the cannabis plant, CBD, or cannabidiol, is non- intoxicating and does not cause the noticeable euphoric effects associated with. THC creates a mind-altering "high" when a person smokes it or uses it . No further definitive evidence currently links CBD to adverse effects.