The safety and efficacy of low oral doses of cannabidiol: An evaluation of the evidence

Summary & key facts

This review looked at studies where adults took oral cannabidiol, or CBD, at doses up to 400 mg per day. The researchers wanted to know if these lower doses—often sold as health supplements—actually help with health problems and whether they are safe. They found that clear benefits appeared mainly when people took about 300 to 400 mg a day. At those doses, there is evidence CBD can lower anxiety and can help some people who are dependent on other drugs. Effects on sleep problems, certain nerve-related disorders, and long-term pain were smaller and less consistent. Side effects did not clearly rise as doses went from about 60 to 400 mg per day. The authors say bigger and better studies are needed, especially to test doses below 300 mg per day.

Key facts:

• The review only looked at studies where adults took oral CBD at doses of 400 mg per day or less and where the product had very little THC, the intoxicating part of cannabis.
• Signs of benefit were strongest at doses around 300 to 400 mg per day, especially for reducing anxiety and helping drug-dependent people reduce use.
• When daily doses increased from about 60 mg to 400 mg, studies did not show a clear rise in side effects.
• Effects of these low-to-moderate CBD doses on sleep problems, neurological conditions, and chronic pain were smaller and inconsistent across studies.
• The paper notes that high oral CBD doses—much higher than 400 mg—are already supported for treating certain severe childhood epilepsies, but that question is separate from the low-dose products adults buy as supplements.
• The authors call for larger and more rigorous clinical trials to know whether doses below 300 mg per day are truly helpful for any condition.

Abstract

Abstract Global interest in the non‐intoxicating cannabis constituent, cannabidiol (CBD), is increasing with claims of therapeutic effects across a diversity of health conditions. At present, there is sufficient clinical trial evidence to support the use of high oral doses of CBD (e.g., 10–50 mg/kg) in treating intractable childhood epilepsies. However, a question remains as to whether “low‐dose” CBD products confer any therapeutic benefits. This is an important question to answer, as low‐dose CBD products are widely available in many countries, often as nutraceutical formulations. The present review therefore evaluated the efficacy and safety of low oral doses of CBD. The review includes interventional studies that measured the clinical efficacy in any health condition and/or safety and tolerability of oral CBD dosed at less than or equal to 400 mg per day in adult populations (i.e., ≥18 years of age). Studies were excluded if the product administered had a Δ 9 ‐tetrahydrocannabinol content greater than 2.0%. Therapeutic benefits of CBD became more clearly evident at doses greater than or equal to 300 mg. Increased dosing from 60 to 400 mg/day did not appear to be associated with an increased frequency of adverse effects. At doses of 300–400 mg, there is evidence of efficacy with respect to reduced anxiety, as well as anti‐addiction effects in drug‐dependent individuals. More marginal and less consistent therapeutic effects on insomnia, neurological disorders, and chronic pain were also apparent. Larger more robust clinical trials are needed to confirm the therapeutic potential of lower (i.e., <300 mg/day) oral doses of CBD.

Topics

Cannabis and Cannabinoid Research Epilepsy research and treatment Sleep and Wakefulness Research

Categories

Health Sciences Medicine Pharmacology

Tags

Addiction Adverse effect Anxiety Cannabidiol Cannabis Clinical trial Dosing Drug Internal medicine Medicine Pharmacology Psychiatry Therapeutic effect Tolerability

Substances

Cannabis

Conditions & symptoms

Addiction Anxiety Chronic Pain Sleep disorder Addiction or harmful habbits Anxiety or worry Chronic pain Poor sleep