From the Guidelines
Long-term CBD-only use is generally considered safe for most adults, but caution is warranted due to potential liver enzyme elevation and drug-induced liver injury, particularly at high doses above 300 mg/day. When considering long-term CBD use, it is essential to weigh the potential benefits against the risks, prioritizing morbidity, mortality, and quality of life as outcomes. According to the ASCO guideline 1, the pooled proportion of elevated liver enzymes was 0.07 (95% CI, 0.05 to 0.12), whereas the pooled proportion of those with drug-induced liver injury was 0.03 (95% CI, 0.10 to 0.06).
Some key points to consider when using CBD long-term include:
- Monitoring liver enzymes, especially when using high doses, as dose-related, reversible transaminase elevations have been reported 1
- Starting with a low dose (5-10mg) and gradually increasing until the minimum effective dose is found
- Taking CBD consistently, preferably with fatty foods to improve absorption
- Being aware of potential side effects, such as fatigue, diarrhea, appetite changes, and potential drug interactions with medications metabolized by cytochrome P450 enzymes
- Choosing high-quality products with third-party testing to verify CBD content and confirm the absence of contaminants
It is also crucial to consider the potential long-term side effects of CBD use, including:
- Psychiatric risks, such as an increased risk for developing depressive disorders and exacerbating psychiatric disorders in vulnerable individuals 1
- Cardiovascular side effects, such as arrhythmias and orthostatic hypotension, although there is no evidence that cumulative lifetime use is associated with a higher incidence of cardiovascular disease or associated mortality 1
- Respiratory risks, although conflicting data exist regarding cannabis use and respiratory disease, often confounded by concomitant nicotine use 1
Ultimately, consulting a healthcare provider before starting CBD, especially if taking other medications or having existing health conditions, is essential to ensure safe and effective use.
From the Research
Long-Term CBD Use
- Long-term use of CBD has been studied in various contexts, including its potential therapeutic effects on neurological disorders such as epilepsy, multiple sclerosis, Parkinson's disease, and Alzheimer's disease 2, 3, 4.
- CBD has been shown to have a favorable safety and abuse liability profile, with no acute psychotropic effects 2.
- Studies have demonstrated CBD's potential to improve cognition and neurogenesis, although more research is needed to determine its effectiveness as a monotherapy for cognitive dysfunction 2.
Therapeutic Effects
- CBD has been found to have significant therapeutic effects on epilepsy and Parkinson's disease, with potential applications in the treatment of other neurological disorders 3, 4.
- The neuroprotective effects of CBD may be related to its interaction with the endocannabinoid system and other molecular targets, such as the 5-HT1A receptor 3.
- CBD has also been shown to have anxiolytic effects, with potential applications in the management of anxiety disorders 5.
Safety and Efficacy
- CBD has been generally well-tolerated in studies, with minimal adverse effects reported, such as fatigue and sedation 5, 6.
- However, more research is needed to determine the optimal dosing strategy for CBD and its place in therapy for various neurological disorders 2, 5, 6.
- Clinical evidence for the effectiveness of CBD in multiple sclerosis is limited, and further studies are needed to fully understand its potential therapeutic effects 6.