Study register · detail
No benefit demonstrated
GRADE
Moderate
91 citations
Samplen = 46 Pat.
Durationfour drug administration visits
ControlCannabis without CBD
EndpointHopkins Verbal Learning Task
Blindingdoppelblind
DesignRCT (double-blind, cross-over)
Cannabinoidkombination
Max. dose40.0 mg
Routeinhalativ
Key finding
CBD did not reduce the acute harmful effects of THC on memory, psychosis or other parameters at any dose tested.
Summary
n=46 healthy, occasional cannabis users; RCT with 4 CBD:THC ratios (0:1, 1:1, 2:1, 3:1). THC (10 mg) induced positive psychotic symptoms on the PANSS (d=0.69, p<0.00001); no CBD dose (10/20/30 mg) significantly modulated this effect. No protection by CBD against acute psychotomimetic THC effects at clinically relevant CBD:THC ratios.
P
PopulationHealthy, occasional cannabis users, n=46
I
InterventionVaporized cannabis with 10 mg THC + 0/10/20/30 mg CBD (CBD:THC ratios 0:1, 1:1, 2:1, 3:1), crossover
C
ControlCannabis without CBD (0 mg CBD, 10 mg THC)
O
OutcomeNo significant modulation of THC-induced impairment of delayed verbal memory recall by CBD (no significant CBD effect); THC alone impaired verbal memory recall (t(45)=3.399, d=0.50, p=0.001) and induced positive psychotic symptoms (PANSS: t(45)=-4.709, d=0.69, p=2.41×10⁻⁵), without significant attenuation by CBD
Confidence in the evidence
Moderate
The third of four GRADE levels, the effect estimate is probably reliable.
Downgraded for
Imprecision
Quality profile
Sample size
★★★★★
Blinding
Double-blind
Effect size
No benefit
Citations / year
★★★★★
Authors
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Abstract
As countries adopt more permissive cannabis policies, it is increasingly important to identify strategies that can reduce the harmful effects of cannabis use. This study aimed to determine if increasing the CBD content of cannabis can reduce its harmful effects. Forty-six healthy, infrequent cannabis users participated in a double-blind, within-subject, randomised trial of cannabis preparations varying in CBD content. There was an initial baseline visit followed by four drug administration visits, in which participants inhaled vaporised cannabis containing 10 mg THC and either 0 mg (0:1 CBD:THC), 10 mg (1:1), 20 mg (2:1), or 30 mg (3:1) CBD, in a randomised, counter-balanced order. The primary outcome was change in delayed verbal recall on the Hopkins Verbal Learning Task. Secondary outcomes included change in severity of psychotic symptoms (e.g., Positive and Negative Syndrome Scale [PANSS] positive subscale), plus further cognitive, subjective, pleasurable, pharmacological and physiological effects. Serial plasma concentrations of THC and CBD were measured. THC (0:1) was associated with impaired delayed verbal recall (t(45) = 3.399, d = 0.50, p = 0.001) and induced positive psychotic symptoms on the PANSS (t(45) = -4.709, d = 0.69, p = 2.41 × 10<sup>-5</sup>). These effects were not significantly modulated by any dose of CBD. Furthermore, there was no evidence of CBD modulating the effects of THC on other cognitive, psychotic, subjective, pleasurable, and physiological measures. There was a dose-response relationship between CBD dose and plasma CBD concentration, with no effect on plasma THC concentrations. At CBD:THC ratios most common in medicinal and recreational cannabis products, we found no evidence that CBD protects against the acute adverse effects of cannabis. This should be considered in health policy and safety decisions about medicinal and recreational cannabis.
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