[Psychiatric aspects of commercially available products containing cannabidiol]

Cannabidiol (CBD) has gained sustained public, medical, and scientific attention in recent years. The prevalence of use of commercially available products containing CBD (CPC) is correspondingly high.

Overview of the benefits and risks of CPC, taking into account certain aspects related to CBD as a pharmaceutical active ingredient.

Selective literature search in the PubMed database.

Currently, only one primarily CBD-containing drug is approved in Germany (Epidyolex®). CBD demonstrates good safety and tolerability. Elevated transaminases, sedation, decreased appetite, diarrhea, sleep disturbances, infections, and weight loss are possible side effects. CBD modulates the endocannabinoid system and interacts with numerous other molecular targets. CBD is metabolized via CYP2C19, CYP3A4, and UGT. The potential for pharmacokinetic interactions with CBD has not been well studied, but is theoretically high. The potential for abuse of CBD is negligible when administered orally, but should be investigated more thoroughly for inhalation and higher-dose use. Studies have found significant discrepancies between the stated and actual CBD content in many CPC; THC was frequently detected. There is no evidence supporting the health benefits typically claimed by manufacturers for ≤ 4.3 mg of oral CBD/kg/day, but there are indications of significant hepatotoxicity at ≥ 4.3 mg of oralCBD/kg/day.

There is no robust evidence of health benefits associated with CPC. However, given the levels of exposure, product deficiencies, and the EFSA safety concerns, it must be assumed that there are relevant health risks (particularly hepatotoxicity) associated with the use of CPC.