CBD Dosing – More Is Not Always Better

When considering cannabidiol (CBD), the key to experiencing maximal benefits and the least side effects is optimal dosing. Since the medical use of CBD has been a controversial societal topic, there has been a lack of scientific consensus on therapeutic dosages that are both safe and effective. Many studies attempt to raise the upper limits of dosing to discover new therapeutic avenues. However, this raises a major question; how much is too much CBD?

Most investigational CBD research examines the effects of doses between 150 mg to 600 mg. The current trends of research suggest that there is a U-shaped curve in the effects of varying CBD doses in different scenarios related to performance anxiety [1]. In a study that examined how CBD can alleviate anxiety associated with public speaking, researchers found that dosages of 300 mg were significantly effective at reducing reported feelings of anxiety [1]. In contrast, dosages of 150 mg and 600 mg were not found to significantly reduce subjective anxiety. However, studies that examined the relationship between 600 mg of CBD and blood pressure have found a significant reduction in blood pressure and arterial stiffness in those who were administered 600 mg of CBD, compared to placebo [2].

An important point is that most current research indicates that CBD dosages of less than approximately 10 mg/kg/day (or roughly 750 mg/day for the average 165-pound person) seem to have minimal side effect profiles [3]. However, dosages above 10 mg/kg/day have been found to harbor a significantly increased number of adverse effects. In those who took CBD in doses of 20 mg/kg/day, participants reported diarrhea, reduced appetite, vomiting, fatigue, abnormal liver function tests, increased body temperature, and upper respiratory tract infections [4-6].

At the end of the day, the “optimal dose” of CBD for any individual is a personalized one. However, understanding the basics of effective CBD dosing and the potential side effects can help serve as a guide toward individualized treatment strategies.

 

References

  1. Linares IM, Zuardi AW, Pereira LC, et al. Cannabidiol presents an inverted U-shaped dose-response curve in a simulated public speaking test. Braz J Psychiatry. 2019;41(1):9-14. doi:10.1590/1516-4446-2017-0015
  2. Sultan SR, O’Sullivan SE, England TJ. The effects of acute and sustained cannabidiol dosing for seven days on the haemodynamics in healthy men: A randomised controlled trial. Br J Clin Pharmacol. 2020;86(6):1125-1138. doi:10.1111/bcp.14225
  3. Millar SA, Stone NL, Bellman ZD, Yates AS, England TJ, O’Sullivan SE. A systematic review of cannabidiol dosing in clinical populations. Br J Clin Pharmacol. 2019;85(9):1888-1900. doi:10.1111/bcp.14038
  4. Devinsky O, Cross JH, Wright S. Trial of Cannabidiol for drug‐resistant seizures in the Dravet syndrome. N Engl J Med. 2017;377(7):699‐ 10.1056/NEJMc1708349
  5. Thiele EA, Marsh ED, French JA, et al. Cannabidiol in patients with seizures associated with Lennox‐Gastaut syndrome (GWPCARE4): a randomised, double‐blind, placebo‐controlled phase 3 trial. Lancet. 2018. 10.1016/s0140-6736(18)30136-3
  6. Devinsky O, Patel AD, Cross JH, et al. Effect of Cannabidiol on drop seizures in the Lennox‐Gastaut syndrome. N Engl J Med. 2018;378(20):1888‐ 10.1056/NEJMoa1714631

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