martes, 5 de febrero de 2019

CBD Oil: Health Benefits and Risks

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By Karolina Brzozowska, M.Sc.Reviewed by Jennifer Logan, MD, MPH

There is a growing interest in CBD as a potential drug in the treatment of a wide spectrum of neurologic and neuropsychiatric disorders, including anxiety and epilepsy. However, the psychoactive and therapeutic effects and the mechanisms of action of CBD are not yet fully understood.

CBD oil next to cannabis plant (origin) - photo By ElRoi

ElRoi | Shutterstock

Cannabidiol (CBD) is a constituent of Cannabis sativa. It is one of at least 85 active cannabinoids identified within the cannabis plant and can be taken into the body via inhalation, as an aerosol spray into the cheek, or orally.

CBD Oil: Health Benefits

CBD oil is thought to have potential benefits for the treatment and management of a wide variety of disorders due to its antioxidant, anti-inflammatory, neuroprotective, antipsychotic, analgesic, and muscle relaxing effects, among others. Such a broad variety of effects is possible due to the ability of CBD to interact with a wide array of cannabinoid receptors that are used by the body’s endocannabinoid system.

In response to CBD, the endocannabinoid system modulates metabolic pathways through neurotransmitter release to affect cognition, pain sensation, appetite, memory, and sleep.

To date, most evidence supportive of CBD use relates to its effectiveness in treating epilepsy, including Dravet syndrome. This rare, genetic epileptic disorder begins within the first year of life and affects otherwise healthy infants. Dravet syndrome is the first disorder for which cannabadiol (oral solution) has been approved by the FDA. Another disorder for which CBD-based drugs may be used is the Lennox-Gastaut Syndrome.

A second area of promising research in the therapeutic use of CBD is for its anti-inflammatory effects. However, the use of CBD in routine medical practice is a hotly debated issue.

Cannabidiol’s properties as an anti-psychotic, mood-enhancing drug, or sleep aid remain largely unsubstantiated. CBD seems to be a more effective antioxidant than vitamins C or E, and has demonstrated superior neuroprotective properties. It may also help in the management of certain skin conditions such as acne and chronic diseases such as diabetes.

Care should be exercised in considering CBD use in patients with cancer, schizophrenia, rheumatoid arthritis, or multiple sclerosis. The complexity of these diseases, coupled with uncertainties surrounding CBD mechanisms of action require further investigation.

CBD Oil: Health Risks

According to the World Health Organization, CBD has not been associated with abuse or dependence potential in humans. There have been no reported cases of public health-related problems associated with CBD use to date.

CBD oil contains no added THC or terpenes; therefore, CBD does not produce the intoxicating effects associated with THC use. In fact, side effects are often opposite of the anxiety and disordered thinking usually associated with THC use.

CBD is generally well-tolerated, but some adverse effects may occur. Sleepiness, fatigue, malaise, weakness, diarrhea, decreased appetite, and sleeping problems (such as insomnia) may be caused or worsened by CBD use.

It is important to note that at present, CBD oil is primarily available as a dietary supplement. As such, its dose and purity is not regulated. To date, only 2 studies have been performed on humans to examine potential CBD side effects, and neither study included a control group.

More clinical research is needed to explore the possible effects of CBD on the liver enzymes and drug transporters, and to investigate possible interactions with other drugs. CBD should be examined for its ability to enhance or inhibit the therapeutic effects of other medications.