The growing interest in medical cannabis has led to an influx of research around its many constituents, chiefly cannabidiol (CBD) and tetrahydrocannabinol (THC). While both cannabinoids have therapeutic value, they serve different medical roles and come with distinct profiles of effects and side-effects. This guide aims to elucidate the advantages of each, drawing on available evidence from peer-reviewed medical literature.
Advantages of CBD
CBD has shown significant promise as an anti-inflammatory agent. Its mechanism operates via the suppression of cytokine production, contributing to its anti-inflammatory effects[^1^]. This property is particularly useful for individuals suffering from chronic inflammatory conditions like arthritis and inflammatory bowel disease. Moreover, the anti-inflammatory properties of CBD can also be beneficial in skincare, specifically for conditions like acne and psoriasis. Therefore, CBD’s anti-inflammatory capabilities extend beyond internal conditions and may also offer skin health benefits.
Epilepsy is one area where CBD has proven to be exceptionally effective, specifically in drug-resistant types of the neurological disorder[^2^]. There are even FDA-approved medications based on CBD to treat certain forms of epilepsy. Its success in managing seizures has provided hope for patients who have found little to no relief from traditional antiepileptic medications. Further, it offers a relatively safe profile with fewer side effects compared to standard antiepileptic drugs.
Anxiety and Depression
Studies suggest that CBD can have a calming effect on the central nervous system, making it potentially useful for disorders like anxiety and depression[^3^]. The compound appears to interact with serotonin receptors, which play a crucial role in mood regulation. It’s an option that is gaining attention as a potential adjunct or even alternative to traditional pharmaceutical treatments, as it often comes with fewer side effects. Furthermore, CBD provides a quick onset of effects, which can be beneficial for acute anxiety episodes.
One of CBD’s significant advantages is that it is non-psychoactive, meaning it doesn’t result in the “high” that THC does, making it more approachable for a broader range of patients[^4^]. This feature allows it to be used in various settings, including those where psychoactive effects would be undesirable, such as in pediatric patients or older adults. Additionally, its non-psychoactive nature makes it more socially accepted and lessens the legal constraints surrounding its use.
Though the evidence is not as robust, CBD may assist in providing better quality sleep[^5^]. People who have insomnia or disrupted sleep patterns may find it beneficial. The calming effects of CBD can also help individuals fall asleep quicker and possibly extend the duration of deep sleep stages. It’s important to note that while CBD can assist with sleep, more research is needed to fully understand its mechanisms and optimal dosing for sleep-related issues.
Advantages of THC
THC is well-known for its analgesic effects, often providing effective relief from chronic pain conditions[^6^]. Its capacity to alleviate pain is one of the primary reasons it’s used in medical cannabis formulations. Many patients find it particularly useful for neuropathic pain, where traditional analgesics are often less effective. It can also be a good adjunct to opioid medications, potentially allowing for lower opioid dosing.
THC has been used to increase appetite in conditions like anorexia and cancer-related cachexia[^7^]. This can be extremely beneficial in chronic conditions where maintaining weight and nutritional status is a concern. Furthermore, the appetite-stimulating effects of THC can be useful in the elderly, who often suffer from reduced appetite and subsequent weight loss.
Nausea and Vomiting
THC has been used as an effective treatment for nausea and vomiting, particularly in chemotherapy patients[^8^]. It is often considered when other antiemetic medications have failed. Additionally, its quick onset of action can provide immediate relief, which is crucial in acute nausea settings. The benefits also extend to pregnant women suffering from morning sickness, although it’s imperative to consult a healthcare provider in such cases.
Though not a first-line treatment, THC has shown effectiveness in reducing intraocular pressure in glaucoma patients[^9^]. However, the effect is generally short-lived, and continual dosing is often impractical. Despite this, for some patients who have not responded well to other treatments, THC can provide temporary relief.
For some patients, the euphoric effect of THC can be considered an advantage, particularly for those dealing with anxiety or depression[^10^]. The mood-enhancing properties of THC can provide temporary relief from symptoms of depression and anxiety. However, it’s crucial to use it cautiously as excessive use can lead to dependency or exacerbate mental health conditions.
Side Effects: CBD vs THC
Though generally well-tolerated, both cannabinoids have their side effects. CBD is mostly associated with drowsiness, dry mouth, and occasional low blood pressure[^11^]. THC, on the other hand, can cause psychoactive effects, including paranoia and increased heart rate[^12^].
While cannabinoids offer an array of therapeutic effects, they are not suitable for everyone. People with certain medical conditions should consult healthcare providers for guided, thoughtful care. For specialized consultation, you can contact Dr. Caplan at CED Clinic.
Comparative Chart of Common Side Effects
|Elevated Heart Rate||Low||High||Low||Low||Low|
📗 Note: The diagram you see here is based on principles discussed in greater depth in “The Doctor-Approved Cannabis Handbook.” Enhance your knowledge by purchasing the book directly through this link 📗
- Nagarkatti, P., Pandey, R., Rieder, S. A., Hegde, V. L., & Nagarkatti, M. (2009). Cannabinoids as novel anti-inflammatory drugs. Future medicinal chemistry, 1(7), 1333–1349.
- Devinsky, O., Cross, J. H., Laux, L., Marsh, E., Miller, I., Nabbout, R., … & Wright, S. (2017). Trial of Cannabidiol for Drug-Resistant Seizures in the Dravet Syndrome. The New England journal of medicine, 376(21), 2011–2020.
- Blessing, E. M., Steenkamp, M. M., Manzanares, J., & Marmar, C. R. (2015). Cannabidiol as a Potential Treatment for Anxiety Disorders. Neurotherapeutics, 12(4), 825–836.
- Iffland, K., & Grotenhermen, F. (2017). An Update on Safety and Side Effects of Cannabidiol: A Review of Clinical Data and Relevant Animal Studies. Cannabis and cannabinoid research, 2(1), 139–154.
- Babson, K. A., Sottile, J., & Morabito, D. (2017). Cannabis, Cannabinoids, and Sleep: a Review of the Literature. Current psychiatry reports, 19(4), 23.
- Russo, E. B. (2008). Cannabinoids in the management of difficult to treat pain. Therapeutics and Clinical Risk Management, 4(1), 245–259.
- Walsh, D., Nelson, K. A., & Mahmoud, F. A. (2005). Established and potential therapeutic applications of cannabinoids in oncology. Supportive care in cancer, 13(3), 137–143.
- Tramèr, M. R., Carroll, D., Campbell, F. A., Reynolds, D. J., Moore, R. A., & McQuay, H. J. (2001). Cannabinoids for control of chemotherapy induced nausea and vomiting: quantitative systematic review. BMJ, 323(7303), 16–21.
- Tomida, I., Azuara-Blanco, A., & House, H. (2006). Effect of sublingual application of cannabinoids on intraocular pressure: a pilot study. Journal of Glaucoma, 15(5), 349–353.
- Denson, T. F., & Earleywine, M. (2006). Decreased depression in marijuana users. Addictive Behaviors, 31(4), 738–742.