Conclusion: CBD may help with depression but more trials are needed.
Animal studies have shown that CBD has a positive effect on serotonin levels in the brain, and serotonin. Low levels of serotonin are thought to play a key role in mood as well as pain. 11
In addition, more trials are needed to investigate its use for numerous other conditions, such as muscle-spasticity in multiple sclerosis, Alzheimer’s disease, substance-abuse treatment, and diabetes protection.
6. Sleep disorders
CBD can interact with other medications used for epilepsy and some serious side effects have been reported, notably, a decrease in liver function when given to people already taking valproate.
Animal studies showed that topical CBD applications relieve pain and inflammation associated with arthritis with few side effects. The topical application of CBD is beneficial because CBD is poorly absorbed when taken by mouth and can cause gastrointestinal side effects. 6
Other trials of 300 mg of CBD in people with anxiety or depression showed that CBD appeared to preserve sleep architecture, meaning it was unlikely to have any negative effects on sleep quality. 10
A laboratory study found that CBD prevented human sebocytes from creating too much sebum in addition to having an anti-inflammatory effect, preventing inflammatory cytokines from activating. Because excessive sebum and inflammation are characteristic of acne, topical CBD could be an effective treatment for acne and may prevent or reduce future breakouts. 12,13
This year, 1,090 people have contacted poison control centers about CBD, according to the American Association of Poison Control Centers. Over a third are estimated to have received medical attention, and 46 were admitted into a critical care unit, possibly because of exposure to other products, or drug interactions. In addition, concern over 318 animals poured into the American Society for the Prevention of Cruelty to Animals’ Animal Poison Control Center.
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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.
Is CBD harmful?
But he cautions that the side effects could have been because of an interaction with other medications the children were taking to control the seizures. So far, there hasn’t been a randomized, placebo-controlled, double-blind trial (the gold standard) on sleep disorders and CBD.
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.
Many soldiers return home haunted by war and PTSD and often avoid certain activities, places or people associated with their traumatic events. The Department of Veterans Affairs is funding its first study on CBD, pairing it with psychotherapy.
Recently, the F.D.A. sent a warning letter to Curaleaf Inc. about its “unsubstantiated claims” that the plant extract treats a variety of conditions from pet anxiety and depression to cancer and opioid withdrawal. (In a statement, the company said that some of the products in question had been discontinued and that it was working with the F.D.A.)
Outside of these two disorders, CBD’s effectiveness in treating seizures is uncertain. Even with Epidiolex, it is uncertain whether the anti-seizure effects can be attributed to CBD or some other factor.
There is currently no known “correct” dose of CBD oil. Depending on individual needs and what is being treated, the daily dose may range between 5 and 25 mg.
Among the few human trials evaluating CBD’s anxiolytic effects was one published in the Brazilian Journal of Psychiatry in 2019. For this study, 57 men were given either CBD oil or a placebo before a public-speaking event. Anxiety was evaluated using physiological measures (such as blood pressure, heart rate, etc.) and a relatively reliable test for mood states known as the Visual Analog Mood Scale (VAMS).
Possible Side Effects
CBD shows promise in the treatment of anxiety disorders, suggests a 2015 review of studies in the journal Neurotherapeutics. According to the investigators, CBD demonstrated potent anxiolytic (anxiety-relieving) effects in animal research, albeit with counterintuitive results.
CBD oil is an extract of Cannabis indica or Cannabis sativa—the same plants that, when dried, make marijuana. CBD oil is believed by some to treat pain, reduce anxiety, and stimulate appetite in the same way that marijuana does, but without its psychoactive effects. CBD has also shown promise in treating certain types of seizures.
There is some evidence that CBD interacts with seizure medications such as Onfi (clobazam) and boosts their concentration in the blood. Further research is needed.
CBD oil may also increase liver enzymes (a marker of liver inflammation). People with liver disease should use CBD oil with caution, ideally under the care of a doctor who can regularly check blood liver enzyme levels.