The Entourage Effect in Cannabis Medicinal Products: A Comprehensive Review

Area of Science:

• Pharmacology
• Neuroscience
• Phytochemistry

Background:

• The
• entourage effect
• of medicinal cannabis suggests synergistic interactions between cannabinoids and terpenes.
• Understanding these interactions is crucial for optimizing therapeutic applications.

Purpose of the Study:

• To systematically review the literature on the physiological effects of cannabis terpenes and terpenoids.
• To evaluate the evidence for the
• entourage effect
• of terpenes in enhancing cannabinoid efficacy.

Main Methods:

• A systematic literature review was conducted using the PRISMA model.
• Searches were performed in PubMed/MEDLINE, Web of Science, and EBSCO databases.
• Keywords and Boolean phrases, including MeSH terms, were utilized.

Main Results:

• No evidence supports neuroprotection or anti-aggregation by
• α-pinene
• and
• β-pinene
• against
• β-amyloid
• toxicity.
• α-pinene
• ,
• β-pinene
• , and terpinolene showed modest lipid peroxidation inhibition.
• Myrcene exhibited topical anti-inflammatory properties, but no added benefit with CBD.
• Various terpenes suggest individual benefits: myrcene (relaxation), linalool (sleep), D-limonene (analgesia), caryophyllene (analgesia), valencene (cartilage), borneol (pain/seizures), and eucalyptol (muscle pain).

Conclusions:

• While terpenes possess individual therapeutic properties, scientific evidence for their synergistic or additive enhancement of cannabinoid efficacy, the
• entourage effect
• , is currently unproven.
• Further clinical trials are necessary to validate the proposed
• entourage effects
• of cannabis terpenes.