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大麻二酚治疗精神障碍的药理学特性:批判性综述。

Pharmacological properties of cannabidiol in the treatment of psychiatric disorders: a critical overview.

机构信息

Department of Neurosciences and Mental Health,Fondazione IRCCS Ca' Granda Ospedale Maggiore Policlinico,University of Milan,Milan,Italy.

Department of Pathophysiology and Transplantation,University of Milan,Milan,Italy.

出版信息

Epidemiol Psychiatr Sci. 2018 Aug;27(4):327-335. doi: 10.1017/S2045796018000239. Epub 2018 May 23.

Abstract

Cannabidiol (CBD) represents a new promising drug due to a wide spectrum of pharmacological actions. In order to relate CBD clinical efficacy to its pharmacological mechanisms of action, we performed a bibliographic search on PUBMED about all clinical studies investigating the use of CBD as a treatment of psychiatric symptoms. Findings to date suggest that (a) CBD may exert antipsychotic effects in schizophrenia mainly through facilitation of endocannabinoid signalling and cannabinoid receptor type 1 antagonism; (b) CBD administration may exhibit acute anxiolytic effects in patients with generalised social anxiety disorder through modification of cerebral blood flow in specific brain sites and serotonin 1A receptor agonism; (c) CBD may reduce withdrawal symptoms and cannabis/tobacco dependence through modulation of endocannabinoid, serotoninergic and glutamatergic systems; (d) the preclinical pro-cognitive effects of CBD still lack significant results in psychiatric disorders. In conclusion, current evidences suggest that CBD has the ability to reduce psychotic, anxiety and withdrawal symptoms by means of several hypothesised pharmacological properties. However, further studies should include larger randomised controlled samples and investigate the impact of CBD on biological measures in order to correlate CBD's clinical effects to potential modifications of neurotransmitters signalling and structural and functional cerebral changes.

摘要

大麻二酚(CBD)具有广泛的药理作用,代表了一种有前途的新药。为了将 CBD 的临床疗效与其作用机制相关联,我们在 PUBMED 上进行了文献检索,以了解所有关于 CBD 作为治疗精神症状的治疗方法的临床研究。迄今为止的研究结果表明:(a)CBD 可能通过促进内源性大麻素信号和大麻素受体 1 拮抗作用,对精神分裂症发挥抗精神病作用;(b)CBD 给药可能通过改变特定脑区的脑血流和 5-羟色胺 1A 受体激动作用,对广泛性社交焦虑症患者产生急性抗焦虑作用;(c)CBD 通过调节内源性大麻素、5-羟色胺能和谷氨酸能系统,可能减轻戒断症状和大麻/烟草依赖;(d)CBD 在精神疾病中的临床前认知增强作用仍缺乏显著结果。总之,目前的证据表明,CBD 通过几种假设的药理特性有能力减轻精神病、焦虑和戒断症状。然而,进一步的研究应该包括更大的随机对照样本,并研究 CBD 对生物措施的影响,以便将 CBD 的临床效果与神经递质信号和大脑结构和功能变化的潜在改变联系起来。

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