From the Department of Neurosciences and Behavior, Ribeirão Preto Medical School, University of São Paulo.
School of Pharmaceutical Sciences, University of Sao Paulo, São Paulo.
J Clin Psychopharmacol. 2023;43(4):339-349. doi: 10.1097/JCP.0000000000001691. Epub 2023 Jun 19.
Serotonergic hallucinogens and cannabinoids may alter the recognition of emotions in facial expressions (REFE). Cannabidiol (CBD) attenuates the psychoactive effects of the cannabinoid-1 agonist tetrahydrocannabinol. Ayahuasca is a dimethyltryptamine-containing hallucinogenic decoction. It is unknown if CBD may moderate and attenuate the effects of ayahuasca on REFE.
Seventeen healthy volunteers participated in a 1-week preliminary parallel-arm, randomized controlled trial for 18 months. Volunteers received a placebo or 600 mg of oral CBD followed by oral ayahuasca (1 mL/kg) 90 minutes later. Primary outcomes included REFE and empathy tasks (coprimary outcome). Tasks were performed at baseline and 6.5 hours, 1 and 7 days after the interventions. Secondary outcome measures included subjective effects, tolerability, and biochemical assessments.
Significant reductions (all P values <0.05) only in reaction times were observed in the 2 tasks in both groups, without between-group differences. Furthermore, significant reductions in anxiety, sedation, cognitive deterioration, and discomfort were observed in both groups, without between-group differences. Ayahuasca, with or without CBD, was well tolerated, producing mainly nausea and gastrointestinal discomfort. No clinically significant effects were observed on cardiovascular measurements and liver enzymes.
There was no evidence of interactive effects between ayahuasca and CBD. The safety of separate and concomitant drug intake suggests that both drugs could be applied to clinical populations with anxiety disorders and in further trials with larger samples to confirm findings.
血清素能致幻剂和大麻素可能会改变人们对面部表情情绪的识别(REFE)。大麻二酚(CBD)可减弱大麻素-1 激动剂四氢大麻酚的致幻作用。阿育吠陀是一种含有二甲色胺的致幻剂汤剂。目前尚不清楚 CBD 是否可以调节和减弱阿育吠陀对 REFE 的影响。
17 名健康志愿者参与了为期 18 个月的 1 周初步平行臂、随机对照试验。志愿者接受安慰剂或 600 毫克口服 CBD,90 分钟后口服阿育吠陀(1 毫升/公斤)。主要结局包括 REFE 和同理心任务(共同主要结局)。在干预前、6.5 小时、1 天和 7 天进行任务。次要结局指标包括主观效应、耐受性和生化评估。
在两项任务中,两组的反应时间均显著缩短(所有 P 值均<0.05),但组间无差异。此外,两组的焦虑、镇静、认知恶化和不适均显著减轻,组间无差异。阿育吠陀,无论是否含有 CBD,均耐受良好,主要引起恶心和胃肠道不适。心血管测量和肝酶未观察到临床显著影响。
阿育吠陀和 CBD 之间没有相互作用的证据。两种药物单独和同时使用的安全性表明,这两种药物都可以应用于焦虑障碍的临床人群,并在进一步的大样本试验中确认这一发现。