Henson Jeremy D, Vitetta Luis, Quezada Michelle, Hall Sean
Prince of Wales Clinical School, University of NSW, Sydney, NSW 2052, Australia.
Medlab Clinical Ltd., Sydney, NSW 2015, Australia.
J Clin Med. 2021 Dec 14;10(24):5852. doi: 10.3390/jcm10245852.
The stress response is a well-defined physiological function activated frequently by life events. However, sometimes the stress response can be inappropriate, excessive, or prolonged; in which case, it can hinder rather than help in coping with the stressor, impair normal functioning, and increase the risk of somatic and mental health disorders. There is a need for a more effective and safe pharmacological treatment that can dampen maladaptive stress responses. The endocannabinoid system is one of the main regulators of the stress response. A basal endocannabinoid tone inhibits the stress response, modulation of this tone permits/curtails an active stress response, and chronic deficiency in the endocannabinoid tone is associated with the pathological complications of chronic stress. Cannabidiol is a safe exogenous cannabinoid enhancer of the endocannabinoid system that could be a useful treatment for stress. There have been seven double-blind placebo controlled clinical trials of CBD for stress on a combined total of 232 participants and one partially controlled study on 120 participants. All showed that CBD was effective in significantly reducing the stress response and was non-inferior to pharmaceutical comparators, when included. The clinical trial results are supported by the established mechanisms of action of CBD (including increased N-arachidonylethanolamine levels) and extensive real-world and preclinical evidence of the effectiveness of CBD for treating stress.
应激反应是一种由生活事件频繁激活的明确生理功能。然而，有时应激反应可能是不适当的、过度的或持续时间过长的；在这种情况下，它可能会阻碍而非有助于应对压力源，损害正常功能，并增加躯体和心理健康障碍的风险。需要一种更有效且安全的药物治疗来抑制适应不良的应激反应。内源性大麻素系统是应激反应的主要调节系统之一。基础内源性大麻素张力抑制应激反应，对这种张力的调节允许/抑制活跃的应激反应，内源性大麻素张力的慢性缺乏与慢性应激的病理并发症相关。大麻二酚是一种安全的外源性内源性大麻素系统增强剂，可能是一种有效的应激治疗药物。目前已有7项关于大麻二酚治疗应激的双盲安慰剂对照临床试验，总计232名参与者，以及1项针对120名参与者的部分对照研究。所有研究均表明，大麻二酚在显著减轻应激反应方面有效，并且在纳入药物对照时，其效果不劣于对照药物。临床试验结果得到了大麻二酚既定作用机制（包括增加N-花生四烯酸乙醇胺水平）的支持，以及大麻二酚治疗应激有效性的大量现实世界和临床前证据的支持。
