Cannabidiol

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Not to be confused with cannabinol or cannabinodiol.
Cannabidiol
Cannabidiol.svg
CBD-3D-balls.png
Systematic (IUPAC) name
2-[(1R,6R)-6-isopropenyl-3-methylcyclohex-2-en-1-yl]-5-pentylbenzene-1,3-diol
Clinical data
Trade names Epidiolex
AHFS/Drugs.com International Drug Names
Legal status
Legal status
Pharmacokinetic data
Bioavailability 13-19% (oral),[2] 11-45% (mean 31%; inhaled)[3]
Biological half-life 9 h[2]
Identifiers
CAS Number 13956-29-1 YesY
ATC code None
PubChem CID 644019
IUPHAR/BPS 4150
ChemSpider 24593618 YesY
UNII 19GBJ60SN5 YesY
Chemical data
Formula C21H30O2
Molar mass 314.4636
Physical data
Melting point 66 °C (151 °F)
Boiling point 180 °C (356 °F)
(range: 160–180 °C)[4]
  (verify)

Cannabidiol (CBD) (INN)[5] is one of at least 113 active cannabinoids identified in cannabis.[6][7] It is a major phytocannabinoid, accounting for up to 40% of the plant's extract.[8] CBD is considered to have a wide scope of potential medical applications - due to clinical reports showing the lack of side effects, particularly a lack of psychoactivity (as is typically associated with ∆9-THC), and non-interference with several psychomotor learning and psychological functions.

Research[edit]

The bud of a Cannabis sativa flower coated with trichomes bearing cannabidiol and other cannabinoids

Epilepsy[edit]

Dravet syndrome is a rare form of epilepsy that is difficult to treat. It is a catastrophic form of intractable epilepsy that begins in infancy. Initial seizures are most often prolonged events and in the second year of life other seizure types begin to emerge.[9] A number of high profile and anecdotal reports have sparked interest in treatment of Dravet syndrome with cannabidiol.[10]

Some cannabis/hemp extract preparations containing CBD are marketed as dietary supplements and claim efficacy against Dravet Syndrome. One such preparation is marketed under the tradename Charlotte's Web Hemp Extract.[11][12] Blended/suspended in oil, the supplement contains 0.3% THC[13] (see Legal status below, classified as hemp).

GW Pharmaceuticals is seeking FDA approval to market a liquid formulation of pure plant-derived CBD, under the trade name Epidiolex (containing 99% cannabidiol and less than 0.10% Δ9-THC) as a treatment for Dravet syndrome. Epidiolex was granted fast-track status and is in late stage trials following positive early results from the drug.[10][14][15][16][17]

A 2014 review stated that cannabidiol has been claimed, anecdotally, to be of benefit in helping people with epilepsy. Information in the review stated that there is no established mechanism of action and the lack of high-quality evidence in this area precluded conclusions being drawn.[18]

A newer 2016 review in The New England Journal of Medicine states that since 2013, data has been collected on patients with severe epilepsy (Dravet’s syndrome and the Lennox–Gastaut syndrome). Among 137 patients treated with Epidiolex (qualifies chemically as hemp, see Legal status below), the median reduction in the number of seizures was 54%.[19]

Schizophrenia[edit]

A 2016 Leweke et al. review stated that THC-dominant cannabis carries the highest risk for psychotic disorders and an increased risk of psychosis. In contrast, cannabidiol (CBD) produced the reduction of psychotic symptoms due to a significant increase of anandamide levels. This supports the hypothesis that cannabidiol exerts its antipsychotic properties by a moderate inhibition of the FAAH enzyme (which is known to break down anandamide). Data on the antipsychotic effects of cannabidiol in schizophrenia is still limited, but with promising initial results and a lack of side-effects. With current trials limited to 6 weeks of treatment at maximum, information on long-term efficacy and tolerability is not available yet.[20]

CBD clearly reversed synthetic THC (Nabilone induced) psychoactive effects. CBD had opposite effects to THC on activation of the striatum, prefrontal cortex and medial temporal cortex.[21]

Safety[edit]

CBD safety in humans has been studied in multiple small studies, suggesting that it is well tolerated at doses of up to 1500 mg/day (p.o.) or 30 mg (i.v.).[22]

Pharmacodynamics[edit]

Cannabidiol has a very low affinity for CB1 and CB2 receptors but acts as an indirect antagonist of their agonists.[23][24] While one would assume that this would cause cannabidiol to reduce the effects of THC, it may potentiate THC's effects by increasing CB1 receptor density or through another CB1-related mechanism.[25] It may also extend the duration of the effects of THC via inhibition of the cytochrome P-450-3A and 2C enzymes.[26]

Recently, it was found to be an antagonist at the putative new cannabinoid receptor, GPR55, a GPCR expressed in the caudate nucleus and putamen.[27] Cannabidiol has also been shown to act as a 5-HT1A receptor partial agonist,[28] an action which may be involved in its antidepressant,[29][30] anxiolytic,[30][31] and neuroprotective[32][33] effects. Cannabidiol is an allosteric modulator of μ and δ-opioid receptors.[34] Cannabidiol's pharmacological effects have also been attributed to PPAR-γ receptor agonism and intracellular calcium release.[8]

Research suggests that CBD may exert some of its pharmacological action through its inhibition of FAAH, which may in turn increase the levels of endocannabinoids, such as anandamide, produced by the body.[8] It has also been speculated that some of the metabolites of CBD have pharmacological effects that contribute to the biological activity of CBD.[35]

Pharmacokinetic interactions[edit]

There is some preclinical evidence to suggest that cannabidiol may reduce THC clearance, modestly increasing THC's plasma concentrations resulting in a greater amount of THC available to receptors, increasing the effect of THC in a dose-dependent manner.[36][37] Despite this, the available evidence in humans suggests no significant effect of CBD on THC plasma levels.[38]

Multiple studies have shown that the purported negative cognitive side effects caused by THC can be mitigated by regular CBD consumption.[39] These findings bolster the theorized pharmacokinetic interactions that cannabidiol reduces THC clearance.

Pharmaceutical preparations[edit]

Nabiximols (USAN, trade name Sativex) is an aerosolized mist for oral administration containing a near 1:1 ratio of CBD and THC. The drug was approved by Canadian authorities in 2005 to alleviate pain associated with multiple sclerosis.[40][41][42] Epidiolex, a drug with cannabidiol as its active pharmaceutical ingredient, received orphan drug status in the United States for treatment of Dravet syndrome in July 2015.[43]

Epidiolex is an oil formulation of CBD extracted from the cannabis plant undergoing clinical trials for refractory epilepsy syndromes.[44]

Chemistry[edit]

Cannabidiol is insoluble in water but soluble in organic solvents such as pentane. At room temperature, it is a colorless crystalline solid.[45] In strongly basic media and the presence of air, it is oxidized to a quinone.[46] Under acidic conditions it cyclizes to THC.[47] The synthesis of cannabidiol has been accomplished by several research groups.[48][49][50]

Biosynthesis[edit]

Cannabis produces CBD-carboxylic acid through the same metabolic pathway as THC, until the last step, where CBDA synthase performs catalysis instead of THCA synthase.[51]

Taura, F., Sirikantaramas, S., Shoyama, Y., Yoshikai, K., Shoyama, Y., Morimoto, S. (2007). "Cannabidiolic-acid synthase, the chemotype-determining enzyme in the fiber-type Cannabis sativa". FEBS Letters 581 (16): 2929–2934. doi:10.1016/j.febslet.2007.05.043

Isomerism[edit]

Cannabidiol numbering
7 double bond isomers and their 30 stereoisomers
Formal numbering Terpenoid numbering Number of stereoisomers Natural occurrence Convention on Psychotropic Substances Schedule Structure
Short name Chiral centers Full name Short name Chiral centers
Δ5-cannabidiol 1 and 3 2-(6-isopropenyl-3-methyl-5-cyclohexen-1-yl)-5-pentyl-1,3-benzenediol Δ4-cannabidiol 1 and 3 4 No unscheduled 2-(6-Isopropenyl-3-methyl-5-cyclohexen-1-yl)-5-pentyl-1,3-benzenediol.png
Δ4-cannabidiol 1, 3 and 6 2-(6-isopropenyl-3-methyl-4-cyclohexen-1-yl)-5-pentyl-1,3-benzenediol Δ5-cannabidiol 1, 3 and 4 8 No unscheduled 2-(6-Isopropenyl-3-methyl-4-cyclohexen-1-yl)-5-pentyl-1,3-benzenediol.png
Δ3-cannabidiol 1 and 6 2-(6-isopropenyl-3-methyl-3-cyclohexen-1-yl)-5-pentyl-1,3-benzenediol Δ6-cannabidiol 3 and 4 4  ? unscheduled 2-(6-Isopropenyl-3-methyl-3-cyclohexen-1-yl)-5-pentyl-1,3-benzenediol.png
Δ3,7-cannabidiol 1 and 6 2-(6-isopropenyl-3-methylenecyclohex-1-yl)-5-pentyl-1,3-benzenediol Δ1,7-cannabidiol 3 and 4 4 No unscheduled 2-(6-Isopropenyl-3-methylenecyclohex-1-yl)-5-pentyl-1,3-benzenediol.png
Δ2-cannabidiol 1 and 6 2-(6-isopropenyl-3-methyl-2-cyclohexen-1-yl)-5-pentyl-1,3-benzenediol Δ1-cannabidiol 3 and 4 4 Yes unscheduled 2-(6-Isopropenyl-3-methyl-2-cyclohexen-1-yl)-5-pentyl-1,3-benzenediol.png
Δ1-cannabidiol 3 and 6 2-(6-isopropenyl-3-methyl-1-cyclohexen-1-yl)-5-pentyl-1,3-benzenediol Δ2-cannabidiol 1 and 4 4 No unscheduled 2-(6-Isopropenyl-3-methyl-1-cyclohexen-1-yl)-5-pentyl-1,3-benzenediol.png
Δ6-cannabidiol 3 2-(6-isopropenyl-3-methyl-6-cyclohexen-1-yl)-5-pentyl-1,3-benzenediol Δ3-cannabidiol 1 2 No unscheduled 2-(6-Isopropenyl-3-methyl-6-cyclohexen-1-yl)-5-pentyl-1,3-benzenediol.png

Based on: Nagaraja, Kodihalli Nanjappa, Synthesis of delta-3-cannabidiol and the derived rigid analogs, Arizona University 1987.

See also: Tetrahydrocannabinol#Isomerism, Abnormal cannabidiol.

Society and culture[edit]

Natural sources[edit]

Selective breeding by growers in the USA dramatically lowered the CBD content of cannabis; their customers preferred varietals that were more mind-altering due to a higher THC, lower CBD content.[52] To meet the demands of medical cannabis patients, growers are currently developing more CBD-rich strains.[53]

Legal status[edit]

Cannabidiol is not scheduled by the Convention on Psychotropic Substances. CBD does not cause the "high" associated with the ∆9-THC in marijuana. As the legal landscape and understanding about the differences in medical cannabinoids unfolds, it will be increasingly important to distinguish “medical marijuana” (with noted varying degrees of psychotropic effects and deficits in executive function) - from “medical CBD” (in which the high CBD and low THC content may mitigate psychosis).[54][55][56]

Various breeds/strains of "medical marijuana" are found to have a significant variety in the ratios of CBD-to-THC and are known to contain other non-psychotropic cannabinoids.[57][58] However it is only the amount of ∆9-THC that chemically gives a legal determination as to whether the plant material(s) used for the purposes of extracting CBD are considered hemp, or considered marijuana.

Any psychoactive marijuana, regardless of its CBD content, is derived from the flower (or bud) of the genus cannabis. Non-psychoactive hemp (also commonly-termed industrial hemp), regardless of its CBD content, is any part of the genus cannabis plant, whether growing or not, containing a ∆-9 tetrahydrocannabinol concentration of no more than three-tenths of one percent (0.3%) on a dry weight basis. Certain standards are required for the legal growth and production of hemp. The Colorado Industrial Hemp Program registers growers of industrial hemp and samples crops to verify that the THC concentration does not exceed 0.3% on dry weight basis.[59]

With Charlotte's Web bringing about increased demand for CBD-dominant cannabis, cultivating hemp has captured the attention of U.S. farmers looking to replace dwindling tobacco-growing revenues with renewed hemp "cash crops." In Kentucky, farmers are spurred on by the Industrial Hemp Research Program, established by James Comer, commissioner of agriculture. With backing from Senator Rand Paul, Comer’s legislation[60] created regulations for farmers to legally grow hemp.[61]

Joel Stanley, CEO of Stanley Brothers Social Enterprises, said they plan to invest at least $500,000 to grow therapeutic hemp in Kentucky for their Charlotte's Web cannabadiol oil, saying, "We want to make Charlotte's Web a Kentucky Proud product."[62] In addition, Paul and Comer were able to get a provision added to the federal Farm Bill that legalized hemp production in states like Kentucky to grow the crop. The Agricultural Act of 2014 was signed by President Obama.[63]

During recent years, there has been considerable legislative activity throughout the United States with respect to legalizing the agricultural production of industrial hemp. To date, approximately 11 states have legalized industrial hemp production, including: California, Colorado, Indiana, Maine, Montana, North Dakota, Oregon, South Carolina, Vermont, West Virginia, and Tennessee. Many other states have passed legislation authorizing the cultivation of industrial hemp for pilot projects or studies, including: Connecticut, Delaware, Hawaii, Illinois, Kentucky, Nebraska, and Utah. Additionally, the National Association of State Departments of Agriculture and the National Conference of State Legislatures have both adopted resolutions supporting revisions to the federal rules and regulations authorizing commercial production of industrial hemp.[64][65]

The United States Drug Enforcement Administration, the DEA, recently eased some of the regulatory requirements for those who are conducting FDA-approved clinical trials on cannabidiol (CBD).[66]

Several industrial hemp varieties can be legally cultivated in western Europe. A variety such as "Fedora 17" has a cannabinoid profile consistently around 1% cannabidiol (CBD) with THC less than 0.1%.[67]

Australia[edit]

Prescription Medicine (Schedule 4) for therapeutic use containing 2 per cent (2.0%) or less of other cannabinoids commonly found in cannabis (such as ∆9-THC).[68]

Canada[edit]

Cannabidiol is a Schedule II drug in Canada. Prescription medication.[69]

UK[edit]

Cannabidiol, in an oral-mucosal spray formulation combined with delta-9-tetrahydrocannabinol, is a prescription product available for relief of severe spasticity due to multiple sclerosis (where other anti-spasmodics have not been effective).[70]

EU[edit]

Cannabidiol is listed in EU Cosmetics Ingredient Database.[71]

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External links[edit]

  • Project CBD Non-profit educational service dedicated to promoting and publicizing research into the medical utility of cannabidiol.