Psychology Department, Bar-Ilan University, Ramat Gan, Israel.
Gonda Brain Research Center, Bar-Ilan University, Ramat Gan, Israel.
Curr Neuropharmacol. 2020;18(2):87-96. doi: 10.2174/1570159X17666190903103923.
Mood disorders are the most prevalent mental conditions encountered in psychiatric practice. Numerous patients suffering from mood disorders present with treatment-resistant forms of depression, co-morbid anxiety, other psychiatric disorders and bipolar disorders. Standardized essential oils (such as that of Lavender officinalis) have been shown to exert clinical efficacy in treating anxiety disorders. As endocannabinoids are suggested to play an important role in major depression, generalized anxiety and bipolar disorders, Cannabis sativa was suggested for their treatment. The endocannabinoid system is widely distributed throughout the body including the brain, modulating many functions. It is involved in mood and related disorders, and its activity may be modified by exogenous cannabinoids. CB1 and CB2 receptors primarily serve as the binding sites for endocannabinoids as well as for phytocannabinoids, produced by cannabis inflorescences. However, 'cannabis' is not a single compound product but is known for its complicated molecular profile, producing a plethora of phytocannabinoids alongside a vast array of terpenes. Thus, the "entourage effect" is the suggested positive contribution derived from the addition of terpenes to cannabinoids. Here, we review the literature on the effects of cannabinoids and discuss the possibility of enhancing cannabinoid activity on psychiatric symptoms by the addition of terpenes and terpenoids. Possible underlying mechanisms for the anti-depressant and anxiolytic effects are reviewed. These natural products may be an important potential source for new medications for the treatment of mood and anxiety disorders.
心境障碍是精神科实践中最常见的精神疾病。许多患有心境障碍的患者表现出治疗抵抗性的抑郁症、共病性焦虑症、其他精神障碍和双相情感障碍。标准的精油（如薰衣草精油）已被证明在治疗焦虑症方面具有临床疗效。由于内源性大麻素被认为在重度抑郁症、广泛性焦虑症和双相情感障碍中发挥重要作用，因此大麻被用于治疗这些疾病。内源性大麻素系统广泛分布于全身，包括大脑，调节许多功能。它与情绪和相关障碍有关，其活性可能被外源性大麻素改变。CB1 和 CB2 受体主要作为内源性大麻素和植物大麻素（由大麻花序产生）的结合位点。然而，“大麻”不是单一的化合物产品，而是以其复杂的分子特征而闻名，它除了产生大量的植物大麻素外，还产生大量的萜烯。因此，“伴生效应”是指萜烯对大麻素的添加所带来的积极贡献。在这里，我们回顾了有关大麻素作用的文献，并讨论了通过添加萜烯和萜类化合物来增强大麻素对精神症状的活性的可能性。还回顾了抗抑郁和抗焦虑作用的可能潜在机制。这些天然产物可能是治疗情绪和焦虑障碍的新药物的重要潜在来源。
