Tuesday, January 13, 2015

Cannabidiol and medicinal marijuana, it's not an excuse to get high

By Jessica Adinolfi

Twenty-three states and the District of Columbia have legalized marijuana in some way.
In some states, it is legal for recreational use, and other states have passed medical marijuana laws allowing for limited use of cannabis, with types of medical conditions that allow for treatment varying from state to state.
The map below shows states that have legalized (or will soon legalize) marijuana use for medical and recreational purposes.


When it comes to the medicinal properties of cannabis, there are two main players: delta-9-tetrahydrocannabinol (THC) and cannabidiol (CBD).

So you know what THC is, but what is cannabidiol you ask?

CBD is the major nonpsychoactive component of Cannabis sativa.

       CBD may be used as therapy for the following ailments: refractory epilepsy, gout, rheumatism, malaria, pain, cancer, glaucoma, cachexia, severe nausea, and fever - and more recently HIV-associated neuropathic pain as well as spasms associated with multiple sclerosis (Welty 2014).

Once it's being pharmed, it will be accepted.

There have been difficulties, as with any controlled substance, on exploring and testing the effects of this potentially widespread therapeutic compound. Now that is legal, the potential health benefits can more thoroughly be investigated.


      How does CBD work?

       CBD pharmacological effects are mediated through receptors on the surface of certain cells, and even at low concentrations, effects have been observed. CBD actions on calcium balance may provide a basis for CBD neuroprotective properties. CBD is well tolerated in humans with doses up to 600 mg not resulting in psychotic symptoms. I wonder how many mg/jay?

Well that's weird, because according to the 4-week, double-blind, randomized clinical trial of CBD vs. amisulpride (a potent antipsychotic) to treat acute schizophrenia, both were shown to be effective antipsychotics (Fig. 2 & 5, below), but CBD “displayed a markedly superior side-effect profile (Leweke 2012)."

Look at the anandamide on that one!
CBD moderately inhibits the degradation of anandamide, which is known to be involved in the regulation of pain, mood, and cognition. Elevated levels of anandamide in cerebrospinal fluid is inversely correlated with psychotic symptoms.

So...more anandamide = less crazy

       Schizophrenia involves multiple brain neurotransmitters including some that target the same cell surface receptors as THC.

So, the results suggest that inhibition of anandamide deactivation may contribute to the antipsychotic effects of CBD potentially representing a completely new mechanism in the treatment of schizophrenia! (Leweke 2012).

CBD may also be helpful with treating Alzheimer's disease (AD), because it reduces some of the negative aspects and induces beneficial effects. A consistent trait of AD is glial activation (AKA activation of nervous system tissues), which is considered to be responsible for the ongoing inflammatory condition occurring in AD brain (Moreno 2011).

       CBD has been shown to inhibit calcium responses in a variety of cells, including these nervous system cells. This is important, because the intracellular calcium concentration affects important cell signaling functions, and it's involved in nervous system cell activation. By simulating conditions produced by dying neurons, it was shown that CBD reduced calcium by up to 25% (see figure below).

As the concentration of CBD increased, the concentration in calcium decreased. This was seen for CBD and also for a synthetic CBD mimic (WIN).

Additionally, CBD (and CBD mimics) affected nervous system cell migration causing them to aggregate, which may be beneficial for degradation of dead neurons and other harmful junk.

Given that CBD lacks psychoactivity, it may represent a novel therapeutic approach for Alzheimer's disease (Moreno 2011).

This video is a bit long, but totally worth it

Okay, so you're you not epileptic or schizophrenic, and you don't have Alzheimer's disease. What can CBD do for you?

       Social Anxiety Disorder (SAD) is one of the most common anxiety conditions with impairment in social life, of which the fear of public speaking is the signature manifestation. To evaluate the potential use of CBD for anxiety treatment, a study was done comparing healthy control patients and treatment-naive SAD patients who received CBD or a placebo. Because the fear of public speaking is one of the main symptoms of this disorder, a simulation public-speaking test (SPST) was used.

       Psychological measurements and physiological measurements were taken from each patient at different phases of the SPST (initial, anticipatory, speech, and post-speech). The state-anxiety level and other subjective states were evaluated using the Visual Analogue Mood Scale (see figure below); and skin conductance, blood pressure, and heart rate were measured.

How are you feeling right now? Ya, me too.
       Differences were noticed between groups and between speech phases, except during the initial phase, when no differences were observed between groups. Likewise, there were no differences for physiological measurements between groups during the initial phase; however, physiological measures have not shown significant differences among the groups at any phase.

       Data supports that SAD patients that used CBD had significant reductions in anxiety, cognitive impairment, and discomfort in their speech performance – indicating that CBD inhibits the fear of speaking in public, one of the main symptoms of the disorder. Additionally, the observed effect of CBD for improving the self-evaluation during public speaking will influence the therapy of SAD patients (Bergamaschi 2011).

So, smoking marijuana will NOT cure cancer, but don't be SAD, because the good news is that with the legalization of cannabis there will be more studies and clinical trials for the therapeutic and medicinal uses of marijuana. Who knows maybe your grandma will be one of the next research patients?


Bergamaschi, M. et al. 2011. Cannabidiol reduces the anxiety induced by simulated public speaking in treatment-naive social phobia patients. Neuropsychopharmacology 36:1219-1226. 

        Leweke, F.M. et al. 2012. Cannabidiol enhances anandamide signaling and alleviates psychotic symptoms of schizophrenia. Translational Psychiatry 94:1-7.  

        Moreno, A.M. et al. 2011. Cannabidiol and other cannabinoids reduce microglial activation in vitro and in vivo: relevance to Alzheimer's disease. Molecular Pharmacology 79:964-973.

        Welty, T.E., A. Luebke, and B.E. Gidal. 2014. Cannabidiol: promise and pitfalls. Epilepsy Currents 14(5):250-252.




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