One of the two dominant cannabinoids present in the cannabis species is Cannabidiol (CBD). CBD has been subjecting to investigation since its discovery in 1940. It is for its potential of doing the treatment of a huge range of diseases and symptoms. Unlike its counterpart THC, CBD has a lack of intoxicating effects. It is those effects that facilitate a broader capacity of prescribing in diverse patient demographics.
CBD is not popular for interacting with the endocannabinoid system (ECS) similar to other cannabinoids. The influence of CBD on cannabinoid receptor 1 is established yet its numerous therapeutic impacts may occur potentially through varying mechanisms. CBD is also popular for inducing possible therapeutic effects by doing the modulation of ion channels. It is along with neurotransmitters, and a huge number of other processes in the central nervous system and immune system.
Safety of CBD
Various clinical trials throughout the world have assessed the safety of CBD at diverse doses in a huge range of diseases & settings. Some people have reported that they have faced side effects of CBD. However, some have recognized that it is a safe compound. And it is one of the major reasons that the Australian Department of Health has proposed low-dose CBD formulations. It has down scheduled to over-the-counter (OTC) medicines.
The Expert Committee on Drug Dependence of the World Health Organisation in 2018 has released a critical review on the efficacy and safety of CBD. It was the first time that in this manner a marijuana-derived substance has gone under reassessment. The reason is that it had restrictions under the 1961 single Convention on Narcotic Drugs.
The Committee has recommended that there should be an addition of a footnote. It should be to Schedule 1 of the 1961 Single Convention on Narcotic Drugs for reading. It should mention that preparation is comprising predominantly of cannabidiol. And that along with less than 0.2% of delta-9-tetrahydrocannabinol are not under international control. It is an excerpt from the recommendations of the Expert Committee on Drug Dependence.
This review has shown that one can tolerate CBD well on a large basis with a good safety profile. It is along with crucial potential therapeutic benefits across a large number of indications. The committee has also noticed the tendency of it to few and mild effects.
Presently the scheduling of this compound is happening in a similar category as ecstasy & heroin. It amends the scheduling of CBD under international law. However, this goes a long way for the acknowledgment of the evidence and safety- based potential CBD exhibits. Numerous times the finalization of this amendment became delay. And now it is earmarked for December 2020.
On a more local front, the TGA (Therapeutic Goods Administration) has done the conduction of a review. It was on the safety of low-dose CBD preparations. The safety review has concluded that CBD is having potential therapeutic applications in some conditions. It is without the supervision of a doctor if there is a restriction to doses <1mg/kg/day.
If there is any amendment in the scheduling of CBD. Then there is a possibility that CBD over-the-counter products will become legal from February 2021. It is another story that whether or not low-dose CBD formulations will be available instantly.
Vast Medicinal Possibilities of CBD
The general claim that cannabinoid medicines are a broadly applicable panacea has been misrepresented & overemphasized in the media. However, you can’t ignore that CBD shows promise for a huge range of conditions and symptoms.
CBD proposed to do the treatment of some of the less lauded conditions. It is inclusive of skin conditions, from psoriasis to acne, and however, even more, concerning presentations. For instance, MRSA bacterial infections are based on the current early clinical and preclinical evidence. Conditions that have a relation with autoimmune and neurological dysfunction have also shown positive clinical and preclinical outcomes.
Epilepsy Opened The Door For The Medicinal Potential Of CBD
Epilepsy is the major condition that is responsible for bringing CBD oil into the spotlight. There are a large number of reports of success in the reduction of seizures in treatment-resistant epileptic children sparked compassion. It is in the hearts of numerous people who would have otherwise never considered CBD. It is because of the stigma that has an association with marijuana.
Over the past two decades, an evidence-based understanding of CBD has been building. It is for the treatment of epilepsy. Studies done on animals have reported that CBD plays a crucial role in the protection of the brain from seizures. There is also an acknowledgment in the literature of its action as an anticonvulsant for particular seizure types. However, there is still no complete understanding of the mechanisms of action.
A systematic review of 2018 has pooled data from observational studies and controlled trials. It has been concluded that 48.5% of patients have reported more than 50% reduction in their seizures. Other significant findings were inclusive of enhanced quality of life scores. It is in addition to several reports of patients who were entirely seizure-free or who had meaningful enhances in seizure-free days.
There are a significant number of trials. These have examined the effects of CBD in epilepsy. which are making use of the product Epidiolex. There is a continuous review of this CBD product in Australia by TGA. It is with hopes that it is going to become registered and available. This registration and availability will be under the PBS (Pharmaceuticals Benefits Scheme) very soon. It will facilitate those patients who are having particular epileptic conditions to be subsidized for this CBD medication. It removes a significant financial barrier for accessing for some.
Some Patients May Require High Doses Of CBD
Most often there is an administration of CBD oil in much higher doses for epilepsy than for other conditions. It is when it is compared with other conditions. However, some recent studies were conducted for psychiatric indications. These have also recommended that there may be a requirement of 600-1000mg per day for seeing the effects. And these are likely to vary between patients.
Presently, there are not any other clinical trials instead of epilepsy that have defined a therapeutic dose range of CBD. And therefore, doctors are having the requirement of taking an approach of starting low and up titrating the dose for each patient. There are numerous observational reports which have shown that patients are reporting the benefits by themselves. It is with doses that are as low as 25mg/day. However, there is no systematic evaluation. There is still so much requirement for conducting further research.
For most common conditions therapeutic CBD dosing ranges from 2-20mg/kg/day for making a sweeping generalization. However, doses might often reach as much as 20-25mg/kg/day in adults in the case of epilepsy. And in children, these might reach as much as 10-20mg/kg/day. This varies which is greatly dependent on the individual presentation and condition of the patient. Smaller doses divided throughout the day for some patients are more appropriate. In contrast, specific individuals may get benefit from larger appropriate timely doses for the best therapeutic outcomes.