Department of Psychiatry, Yale University School of Medicine, New Haven, CT, USA.
VA Connecticut Healthcare System, West Haven, CT, USA.
Neuropsychopharmacology. 2018 Jan;43(1):142-154. doi: 10.1038/npp.2017.209. Epub 2017 Sep 6.
The plant Cannabis sativa, commonly called cannabis or marijuana, has been used for its psychotropic and mind-altering side effects for millennia. There has been growing attention in recent years on its potential therapeutic efficacy as municipalities and legislative bodies in the United States, Canada, and other countries grapple with enacting policy to facilitate the use of cannabis or its constituents for medical purposes. There are >550 chemical compounds and >100 phytocannabinoids isolated from cannabis, including Δ-tetrahydrocannabinol (THC) and cannabidiol (CBD). THC is thought to produce the main psychoactive effects of cannabis, while CBD does not appear to have similar effects. Studies conflict as to whether CBD attenuates or exacerbates the behavioral and cognitive effects of THC. This includes effects of CBD on THC-induced anxiety, psychosis, and cognitive deficits. In this article, we review the available evidence on the pharmacology and behavioral interactions of THC and CBD from preclinical and human studies, particularly with reference to anxiety and psychosis-like symptoms. Both THC and CBD, as well as other cannabinoid molecules, are currently being evaluated for medicinal purposes, separately and in combination. Future cannabis-related policy decisions should include consideration of scientific findings, including the individual and interactive effects of CBD and THC.
植物大麻，通常被称为大麻或 marijuana，已经被用于其精神和改变思维的副作用已有几千年了。近年来，人们越来越关注它的潜在治疗效果，因为美国、加拿大和其他国家的市政当局和立法机构正在制定政策，以促进大麻或其成分用于医疗目的。从大麻中分离出了 >550 种化学化合物和 >100 种植物大麻素，包括 Δ-四氢大麻酚 (THC) 和大麻二酚 (CBD)。THC 被认为产生大麻的主要精神活性作用，而 CBD 似乎没有类似的作用。研究表明 CBD 是否会减弱或加剧 THC 的行为和认知影响存在冲突。这包括 CBD 对 THC 引起的焦虑、精神病和认知缺陷的影响。在本文中，我们回顾了来自临床前和人体研究的关于 THC 和 CBD 的药理学和行为相互作用的现有证据，特别是关于焦虑和精神病样症状的证据。THC 和 CBD 以及其他大麻素分子目前正在分别和联合进行药用评估。未来与大麻相关的政策决策应包括对科学发现的考虑，包括 CBD 和 THC 的单独和相互作用的影响。
