Disclosures
Agenda
Introduction
The Cannabis Plant
CBD and the Endocannabinoid System
CBD Binding
CBD's Impact on THC's Psychoactive Effects
Effects on Non-Endocannabinoid Signaling Systems
Is CBD Psychoactive?
CBD Conversion to THC
Drug Interactions, CBD Pharmacology, and CBD Products
Metabolism
Drug: Drug Interactions
CBD and Warfarin
CBD and Methadone
CBD and Anti-epileptic Drugs
Initiating CBD Anti-epileptic Therapy
CBD and Hepatic Impairment
CBD and Fatty Foods
Discontinuing CBD Anti-epileptic Therapy
Adverse Effects of Oral CBD
Forms of CBD
Common Modes of Administration
Full Spectrum, Broad Spectrum, CBD Isolate & Whole Plant CBD
Topical CBD
MedWatch
Accuracy of CBD Labels
Clinical Applications of CBD Therapy
Treatment Resistant Epilepsy and CBD
Prescribing Epidiolex (CBD)
Notifying the DEA
Mechanism of Action of Epidiolex
Treatment Resistant Epilepsy and CBD with THC
National Approval of CBD Products
Autism Spectrum Disorder
Parkinson’s Disease
Cancer Treatment
Arthritis
Depression
Pretreatment with CBD
CBD Research
Human vs. Animal Studies
CBD in Clinical Care Quizzes - Quiz 3 of 4
Some patients want to try CBD
Are the Medical Claims Valid?
Quality Control
Crossing the Border
CBD in Clinical Care Quizzes - Quiz 4 of 4

CBD’s Impact on THC’s Psychoactive Effects

CBD’s Impact on THC’s Psychoactive Effects

Does CBD dampen the psychoactive effects of THC by ways other than by decreasing the metabolism of anandamide and 2-AG?

Yes, there are at least 2 additional ways:

  1. CBD inhibits the first pass metabolism of delta-9-THC into 11-hydroxy-THC, which has stronger psychoactive properties than delta-9-THC (Russo).
  2. CBD has negative allosteric modulatory effects at CB1, and as a result, reduces THC’s binding ability to CB1 receptors and induce psychoactive effects (Brown, Ibeas , Zhornitsky).

References

  • Russo EA. Tale of two cannabinoids: The therapeutic rationale for combining tetrahydrocannabinol and cannabidiol. Med Hypotheses Oct 3, 2005.
  • Brown J, Winterstein A. Potential Adverse Drug Events and Drug–Drug Interactions with Medical and Consumer Cannabidiol (CBD) Use. J. Clin. Med 2019; 8(7): 989; https://doi.org/10.3390/jcm8070989
  • Ibeas Bih CI, Chen T, Nunn AV, Bazelot M, Dallas M, Whalley BJ. Molecular Targets of Cannabidiol in Neurological Disorders. Oct 2015; 12(4):699-730. doi: 10.1007/s13311-015-0377-3. PMID: 26264914; PMCID: PMC4604182
  • Zhornitsky S, Potvin S. Cannabidiol in humans-the quest for therapeutic targets. Pharmaceuticals (Basel) May 21, 2012; 5(5):529-52. doi: 10.3390/ph5050529. PMID: 24281562; PMCID: PMC3763649.