But without clinical trials in humans, psychologists say CBD’s effect on depression is still a hypothesis, and not an evidence-based treatment.
Cannabidiol and THC are just two of the plant’s more than 100 cannabinoids. THC is psychoactive, and CBD may or may not be, which is a matter of debate. THC can increase anxiety; it is not clear what effect CBD is having, if any, in reducing it. THC can lead to addiction and cravings; CBD is being studied to help those in recovery.
However, a double-blind study found healthy volunteers administered CBD had little to no change in their emotional reaction to unpleasant images or words, compared to the placebo group. “If it’s a calming drug, it should change their responses to the stimuli,” said Harriet de Wit, co-author of the study and a professor in the University of Chicago’s department of psychiatry and behavioral neuroscience. “But it didn’t.”
Tips for Better Sleep
Up in the wee hours of the night, stuck watching videos of puppies? CBD may be promising as a sleep aid; one of the side effects of the Epidiolex trials for epilepsy was drowsiness, according to Mr. MacKillop, a co-author of a review on cannabinoids and sleep. “If you are looking for new treatments for sleep, that may be a clue,” he said.
Just as hemp seedlings are sprouting up across the United States, so is the marketing. From oils and nasal sprays to lollipops and suppositories, it seems no place is too sacred for CBD. “It’s the monster that has taken over the room,” Dr. Brad Ingram, an associate professor of pediatrics at the University of Mississippi Medical Center, said about all the wild uses for CBD now. He is leading a clinical trial into administering CBD to children and teenagers with drug-resistant epilepsy.
While there is hope for treating other conditions with the plant extract, Epidiolex remains the only CBD-derived drug approved by the F.D.A. Most of the research on cannabidiol has been in animals, and its current popularity has outpaced science. “We don’t have the 101 course on CBD quite figured out yet,” said Ryan Vandrey, an associate professor of psychiatry and behavioral sciences at Johns Hopkins University School of Medicine.
A recent chart review of 72 psychiatric patients treated with CBD found that anxiety improved, but not sleep. “Over all, we did not find that it panned out as a useful treatment for sleep,” said Dr. Scott Shannon, assistant clinical professor of psychiatry at the University of Colorado, Denver and the lead author of the review in The Permanente Journal.
The takeaway? "I think CBD is a safe thing to try," says Dr. Danesh. But he urges patients to push for more research by putting pressure on representatives to get national bills passed that allow scientists to look closer at CBD and the conditions that respond to it.
Still, one of the biggest misconceptions about CBD is that it's a wonder drug. "A lot of times people think CBD is a cure-all, and it's not," Dr. Chin says. "You should also have a healthy lifestyle with plenty of exercise and good nutrition—CBD is not going to fix everything."
What should I look for when shopping for CBD products?
"Right now, you just have pharmacies trying to make some sort of sense out of it and say, 'Yes, it works for this,'" he says, "but that's not the way medicine is practiced—it should be based on evidence, and there's not a lot of evidence to really support these claims."
It's also crucial to buy third-party-tested CBD for quality assurance (more on this later). Because the FDA doesn't regulate CBD, it is possible to buy a product that is more or less potent than advertised, or even contains small amounts of THC.
Does CBD get you high? What are the actual benefits? Will it show up on a drug test? Here’s everything you need to know about the product that’s suddenly everywhere.
Onaivi ES, Green MR, Martin BR. Pharmacological characterization of cannabinoids in the elevated plus maze. J Pharmacol Exp Ther 1990;253(3):1002-9. View abstract.
Harvey DJ. Absorption, distribution, and biotransformation of the cannabinoids. Marijuana and Medicine. 1999;91-103.
Ames, F. R. and Cridland, S. Anticonvulsant effect of cannabidiol. S.Afr.Med.J. 1-4-1986;69(1):14. View abstract.
Special Precautions and Warnings
Ohlsson, A., Lindgren, J. E., Andersson, S., Agurell, S., Gillespie, H., and Hollister, L. E. Single-dose kinetics of deuterium-labelled cannabidiol in man after smoking and intravenous administration. Biomed.Environ Mass Spectrom. 1986;13(2):77-83. View abstract.
When applied to the skin: There isn’t enough reliable information to know if CBD is safe or what the side effects might be.
Matsuyama SS, Fu TK. In vivo cytogenetic effects of cannabinoids. J Clin Psychopharmacol 1981;1(3):135-40. View abstract.
Patrician A, Versic-Bratincevic M, Mijacika T, et al. Examination of a New Delivery Approach for Oral Cannabidiol in Healthy Subjects: A Randomized, Double-Blinded, Placebo-Controlled Pharmacokinetics Study. Adv Ther. 2019. View abstract.