A systematic review of cannabidiol dosing in clinical populations

Abstract

Aims Cannabidiol (CBD) is a cannabis‐derived medicinal product with potential application in a wide‐variety of contexts; however, its effective dose in different disease states remains unclear. This review aimed to investigate what doses have been applied in clinical populations, in order to understand the active range of CBD in a variety of medical contexts. Methods Publications involving administration of CBD alone were collected by searching PubMed, EMBASE and ClinicalTrials.gov . Results A total of 1038 articles were retrieved, of which 35 studies met inclusion criteria covering 13 medical contexts. Twenty‐three studies reported a significant improvement in primary outcomes (e.g. psychotic symptoms, anxiety, seizures), with doses ranging between <1 and 50 mg/kg/d. Plasma concentrations were not provided in any publication. CBD was reported as well tolerated and epilepsy was the most frequently studied medical condition, with all 11 studies demonstrating positive effects of CBD on reducing seizure frequency or severity (average 15 mg/kg/d within randomised controlled trials). There was no signal of positive activity of CBD in small randomised controlled trials (range n = 6–62) assessing diabetes, Crohn's disease, ocular hypertension, fatty liver disease or chronic pain. However, low doses (average 2.4 mg/kg/d) were used in these studies. Conclusion This review highlights that CBD has a potential wide range of activity in several pathologies. Pharmacokinetic studies as well as conclusive phase III trials to elucidate effective plasma concentrations within medical contexts are severely lacking and highly encouraged.

Medicinal cannabis for psychiatric disorders: a clinically-focused systematic review

“…CBD dosage (based on current evidence) varies according to disorder, age, weight, and potentially pharmacogenetic differences. Most research tends to focus on a range of 200 mg-800 mg per day [111]. In respect to THC-containing formulas, it has been advised to be cautious exceeding 20 mg per day due to potential side effects [112], and people may find a psychotropic effect with as little as 1 mg-2.5 mg per dose.…”

Chronic Cannabidiol Administration Fails to Diminish Blood Pressure in Rats with Primary and Secondary Hypertension Despite Its Effects on Cardiac and Plasma Endocannabinoid System, Oxidative Stress and Lipid Metabolism

“…Cannabidiol (CBD) is one of the most abundant cannabinoids derived from the Cannabis sativa plant and devoid of a psychoactive effect [1,2]. CBD binds to cannabinoid CB 1 and CB 2 receptors with much lower affinity than ∆ 9 -tetrahydrocannabinol (THC) [3] and interacts with GPR18, GPR55 and TRPV1 receptors [4]; it possesses a very marked antioxidant effect [5][6][7]. CBD is licensed for the treatment of some types of childhood epilepsy (Dravet and Lennox-Gastaut syndrome) in the United States [4,8] and, in combination with THC, for the treatment of multiple sclerosis-associated spasticity in Canada and in the European Union [4].…”

Zur klinischen Wirksamkeit von Präparaten aus dem Hanf

“…Zu anderen Indikationen für CBD liegen nur Pilotstudien vor, wie zur Behandlung schwerer, medikamentös schlecht kontrollierter Psychosen [27], bei Angstzuständen [3], neurodegenerativen Erkrankungen [8], zur Entwöhnung bei Nikotin-und Cannabis-Abusus [24]. Die in einem Review von 35 Studien eingesetzten Tagesdosen betrugen bis zu 50 mg/kg CBD [18]. Keine davon enthält Angaben zu Plasmakonzentrationen.…”

“…B. Adipositas, genetische Faktoren, Erkrankungen etc.) die Resorption und den Metabolismus von CBD beeinflussen [17], [18].…”