Serious adverse effects of cannabidiol (CBD): a review of randomized controlled trials

doi:10.1080/17425255.2020.1754793

Paper

Serious adverse effects of cannabidiol (CBD): a review of randomized controlled trials

Published Apr 9, 2020 · R. G. dos Santos, F. Guimarães, J. Crippa

Expert Opinion on Drug Metabolism & Toxicology

Q1 SJR score

50

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0

Influential Citations

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Abstract

ABSTRACT Introduction Recent trials using cannabidiol (CBD) have shown that most acute and prolonged adverse effects of CBD are mild to moderate, with rare serious adverse effects (SAEs). This review focused on analyzing SAEs of CBD and their possible relation to drug–drug interactions. Areas covered We systematically analyzed the SAEs reported in randomized controlled trials (RCTs) involving the administration of oral CBD for at least 1 week in both healthy volunteers and clinical samples. Expert opinion SAEs related to CBD in RCT are rare and include mainly elevated transaminases, convulsion, sedation, lethargy, and upper respiratory tract infections. Elevated transaminases are related to concomitant valproate use, while sedation, lethargy, and upper respiratory tract infections are related to concomitant clobazam use. Epileptic patients should be monitored when using CBD concomitantly with these and other antiepileptic drugs for other possible drug–drug interactions.

Systematic Review

Study Snapshot

CBD has rare serious adverse effects, mainly elevated transaminases, convulsions, sedation, lethargy, and upper respiratory tract infections, which may be related to drug-drug interactions.

PopulationOlder adults (50-71 years)

Sample size24

MethodsObservational

OutcomesBody Mass Index projections

ResultsSocial networks mitigate obesity in older groups.

Paper

Serious adverse effects of cannabidiol (CBD): a review of randomized controlled trials

References

Neuropharmacological Effects of the Main Phytocannabinoids: A Narrative Review.

THC and CBD, the main phytocannabinoids in cannabis, have diverse therapeutic and adverse effects, with THC being used for nausea, appetite stimulation, and chronic pain, while CBD is used for treatment-resistant epilepsy.

Adjunctive Cannabidiol in Patients with Dravet Syndrome: A Systematic Review and Meta-Analysis of Efficacy and Safety

Adjunctive CBD effectively reduced convulsive seizure frequency in patients with Dravet syndrome, but had a higher rate of adverse events.

Abrupt withdrawal of cannabidiol (CBD): A randomized trial

Abrupt discontinuation of short-term CBD treatment in healthy volunteers did not result in withdrawal syndrome.

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

Medicinal cannabis shows encouraging evidence for treating various psychiatric disorders, but caution is needed due to potential safety concerns.

Pharmacology and drug interactions of cannabinoids.

Cannabidiol (CBD) shows potential in treating epilepsy, but its effectiveness depends on the formulation and quality control of approved drugs, as well as interactions with other drugs.

Benefits and harms of medical cannabis: a scoping review of systematic reviews

Cannabis-based medicines may have mixed benefits and harms, with minor side effects common and serious harms reported in many reviews, making conclusions difficult due to inconsistent findings and lack of rigorous evidence.

Cannabinoids for the treatment of mental disorders and symptoms of mental disorders: a systematic review and meta-analysis.

Cannabinoids show limited evidence for improving mental disorders, with very low quality evidence suggesting a small improvement in anxiety symptoms for individuals with other medical conditions.

Efficacy and adverse event profile of cannabidiol and medicinal cannabis for treatment-resistant epilepsy: Systematic review and meta-analysis

Cannabidiol is more effective than placebo for treatment-resistant epilepsy, with a favorable long-term adverse event profile compared to short-term treatment.

Citations

Research and Clinical Practice Involving the Use of Cannabis Products, with Emphasis on Cannabidiol: A Narrative Review

More basic and clinical research is needed to gain approval for CBD as a therapeutic for broader clinical indications, despite its growing global appeal.

Cannabidiol prescribing in the United States: An analysis of real-world data

Off-label prescribing and co-prescribing of medications with known interactions with cannabidiol is prevalent in the United States.

The Potential Role of Cannabidiol in Cosmetic Dermatology: A Literature Review

CBD shows potential in cosmetic dermatology due to its anti-oxidant, anti-inflammatory, moisturizing, and anti-acne properties, but more clinical studies are needed for a more comprehensive evaluation.

Liver disorders in substance abusers

Substance abuse disorders can lead to various liver disorders, including hepatitis, liver failure, and cirrhosis, with alcohol being the most common agent responsible for liver damage.

Clinical guidance for cannabidiol‐associated hepatotoxicity: A narrative review

CBD use is associated with significant liver enzyme elevations and drug-induced liver injury, requiring clear clinical guidance for diagnosis and management.