Sholler Dennis J, Schoene Lauren, Spindle Tory R
Behavioral Pharmacology Research Unit, Department of Psychiatry and Behavioral Sciences, Johns Hopkins University School of Medicine, Baltimore, Maryland, USA.
Curr Addict Rep. 2020 Sep;7(3):405-412. doi: 10.1007/s40429-020-00326-8. Epub 2020 Jul 25.
Global policy changes have increased access to products containing cannabidiol (CBD), a primary constituent of hemp and cannabis. The CBD product industry has experienced tremendous growth, in part, because CBD is widely touted as an effective therapeutic for myriad health conditions. However, only 1 CBD product (Epidiolex®) has been approved by the U.S. Food and Drug Administration (FDA) to date. There is substantial interest among consumers and the medical and scientific communities regarding the therapeutic potential of CBD, including for novel indications that are not recognized by the FDA. The purpose of this review was to synthesize available evidence from clinical research regarding the efficacy of CBD as a therapeutic.
Human laboratory studies and clinical trials (e.g., randomized controlled trials and single-arm, open label trials) evaluating the efficacy of CBD as a therapeutic were identified for various medical conditions, including epilepsy, anxiety, pain/inflammation, schizophrenia, various substance use disorders, post-traumatic stress disorder, and others. There is clear evidence supporting the utility of CBD to treat epilepsy. For other health conditions reviewed, evidence was often mixed and/or there was a general lack of well-powered randomized, placebo-controlled studies to draw definitive conclusions.
Rigorous, controlled evidence for the therapeutic efficacy of CBD is lacking for many health conditions. Possible concerns with the use of CBD as a therapeutic include the potential for adverse effects (e.g., liver toxicity), drug-drug interactions, and lack of sufficient regulatory oversight of retail CBD products.
全球政策变化使含有大麻二酚（CBD）的产品更容易获取，CBD是大麻和工业大麻的主要成分。CBD产品行业经历了巨大增长，部分原因是CBD被广泛吹捧为对多种健康状况有效的治疗方法。然而，迄今为止，只有一种CBD产品（Epidiolex®）获得了美国食品药品监督管理局（FDA）的批准。消费者以及医学和科学界对CBD的治疗潜力，包括对FDA未认可的新适应症，有着浓厚兴趣。本综述的目的是综合临床研究中关于CBD治疗功效的现有证据。
针对各种医疗状况，包括癫痫、焦虑、疼痛/炎症、精神分裂症、各种物质使用障碍、创伤后应激障碍等，确定了评估CBD治疗功效的人体实验室研究和临床试验（如随机对照试验和单臂开放标签试验）。有明确证据支持CBD治疗癫痫的效用。对于所综述的其他健康状况，证据往往参差不齐，而且通常缺乏足够有力的随机、安慰剂对照研究来得出明确结论。
对于许多健康状况，缺乏关于CBD治疗功效的严格、对照证据。将CBD用作治疗方法可能存在的问题包括不良反应（如肝毒性）的可能性、药物相互作用以及对零售CBD产品缺乏足够的监管。
