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Does the "Entourage Effect" in Cannabinoids Exist? A Narrative Scoping Review.

João Luís Q Simei1, José Diogo R Souza1, João Roberto Lisboa1

  • 1Department of Neuroscience and Behavior, Ribeirão Preto Medical School, University of São Paulo, Ribeirão Preto, Brazil.

Cannabis and Cannabinoid Research
|August 3, 2023
PubMed
Summary

The entourage effect (EE) in cannabis research suggests synergistic interactions between cannabinoids. However, current evidence for its clinical efficacy and safety is limited, necessitating further research and cautious interpretation.

Keywords:
cannabisendocannabinoid systementourage effectmedical cannabinoidsmedical cannabisphytocannabinoids

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Area of Science:

  • Pharmacology
  • Cannabinoid Science
  • Medical Botany

Background:

  • The entourage effect (EE) concept emerged in the 1990s, contrasting with early research on isolated cannabinoids like CBD and THC.
  • Increased understanding of the endocannabinoid system and discovery of new phytocannabinoids have popularized the EE in scientific and marketing contexts.

Purpose of the Study:

  • To critically review the literature and market application of the "entourage effect (EE)" concept.
  • To explore current evidence for a more nuanced understanding of the EE and its implications for cannabinoid-based medicine.

Main Methods:

  • A comprehensive literature review was conducted.
  • Analysis of relevant studies and reviews focused on clinical efficacy, safety, and regulation of cannabinoid products.

Main Results:

  • The EE is recognized as a synergistic phenomenon where cannabis components modulate therapeutic actions.
  • Limited evidence supports the EE as a stable, predictable phenomenon, impacting its clinical efficacy, safety, and regulatory basis.
  • Insufficient evidence exists for the clinical efficacy and safety of cannabinoid products based on the EE hypothesis.

Conclusions:

  • The EE has significant implications for medical cannabinoid use and prescription.
  • Critical evaluation of the EE's application is essential, requiring more research for clinical efficacy, safety, and regulatory frameworks.
  • Regulators, industry, media, and healthcare providers should exercise caution regarding the EE hypothesis until scientifically proven.