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Neurosci Biobehav Rev. 2019 Sep 30. pii: S0149-7634(19)30561-5. doi: 10.1016/j.neubiorev.2019.09.036. [Epub ahead of print]

How does cannabidiol (CBD) influence the acute effects of delta-9-tetrahydrocannabinol (THC) in humans? A systematic review.

Author information

1
Clinical Psychopharmacology Unit, University College London, Gower Street, London, WC1E 6BT, UK. Electronic address: abigail.freeman@ucl.ac.uk.
2
Clinical Psychopharmacology Unit, University College London, Gower Street, London, WC1E 6BT, UK.
3
Clinical Psychopharmacology Unit, University College London, Gower Street, London, WC1E 6BT, UK; Addiction and Mental Health Group (AIM), University of Bath, Bath, BA2 7AY, UK.
4
Centre for Outcomes, Research & Effectiveness (CORE), University College London, Gower Street, London, WC1E 6BT, UK.
5
Clinical Psychopharmacology Unit, University College London, Gower Street, London, WC1E 6BT, UK; Addiction and Mental Health Group (AIM), University of Bath, Bath, BA2 7AY, UK; National Addiction Centre, King's College London, London, SE5 8BB, UK.

Abstract

The recent liberalisation of cannabis regulation has increased public and scientific debate about its potential benefits and risks. A key focus has been the extent to which cannabidiol (CBD) might influence the acute effects of delta-9-tetrahydrocannabinol (THC), but this has never been reviewed systematically. In this systematic review of how CBD influences the acute effects of THC we identified 16 studies involving 466 participants. Ten studies were judged at low risk of bias. The findings were mixed, although CBD was found to reduce the effects of THC in several studies. Some studies found that CBD reduced intense experiences of anxiety or psychosis-like effects of THC and blunted some of the impairments on emotion and reward processing. However, CBD did not consistently influence the effects of THC across all studies and outcomes. There was considerable heterogeneity in dose, route of administration and THC:CBD ratio across studies and no clear dose-response profile emerged. Although findings were mixed, this review suggests that CBD may interact with some acute effects of THC.

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