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CBD or THC?

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While there are over 100 cannabinoids produced by cannabis only few are produced in significant quantities. The most commonly studied phytocannabinoids are Δ9-tetrahydrocannabinol (THC) and cannabidiol (CBD).1 THC is the primary constituent responsible for the euphoric effects of cannabis. Beside its euphoric effects, THC is a potent anti-inflammatory and analgesic. Whereas, CBD is the non-euphoric component of the cannabis plant; results from pre-clinical studies suggests CBD has anti-inflammatory, analgesic, anti-nausea, anti-emetic, anti-psychotic, anxiolytic and anti-epileptiform effects.1 Potential medical benefits of THC and CBD are summarized as below.1,2

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Information on side effects associated with the therapeutic use of cannabinoids is limited. Cannabis/cannabinoids are generally well tolerated; however, side effects are usually observed with high dose of cannabinoids.1 Some of the potential side effects associated with THC and CBD are summarized as below:

THC1,3 CBD4-6
- Tachycardia (dose-related) - Elevated aminotransferase levels
- Orthostatic hypotension - Diarrhea
- Dry mouth - Loss of appetite
- Increased appetite - Vomiting
- Paranoia - Weight loss
- Psychomotor impairment - Somnolence
- Somnolence - Rash
- Dizziness - Fatigue
- “High state” (euphoria, relaxation, distorted perception) - Insomnia
- Anxiety/nervousness Headache

In summary, both THC and CBD have potential medical benefits and are generally considered safe. However, the possibility of side effects and drug-drug interactions should be considered and caution should be exercised when initiating treatment with cannabinoids.

References

  1. Health Canada, "Information for Health Care Professionals: Cannabis (marihuana, marijuana) and the cannabinoids, 2018". Available at: https://www.canada.ca/en/health-canada/services/drugsmedication/cannabis/information-medical-practitioners/information-health-care-professionalscannabis-cannabinoids.html
    2.National Academies of Sciences, Engineering, and Medicine. The Health Effects of Cannabis and Cannabinoids: The Current State of Evidence and Recommendations for Research, The National Academies Press (2017).
    3.Canadian Pharmacists Association. Cannabis monograph, April 2018.
    4.Arzimanoglou A, Brandl U, Cross H, et al. Epilepsy and cannabidiol: A guide to treatment. Epileptic Disord 2020:22(1): 1–14.
    5.Huestis MA, Solimini R, Pichini S, et al. Cannabidiol adverse effects and toxicity. Curr Neuropharmacol. 2019;17:974–89.
    6.Santos RGD, et al. Serious adverse effects of cannabidiol (CBD): a review of randomized controlled trials. Expert Opin Drug Metab Toxicol. 2020;1–10.
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