Información general

Se han identificado más de 80 químicos, conocidos como cannabinoides, en la planta de Cannabis sativa. Si bien el delta-9-tetrahidrocannabinol (THC) es el principal ingrediente activo de la marihuana, el cannabidiol también se obtiene del cáñamo, que contiene solo cantidades muy pequeñas de THC.

La aprobación de la Ley Agrícola 2018 hizo legal la venta de cáñamo y productos de cáñamo en los EE. UU. 

Pero eso no significa que todos los productos de cannabidiol derivados del cáñamo sean legales. Dado que el cannabidiol se ha estudiado como un nuevo medicamento, no se puede incluir legalmente en alimentos o suplementos dietéticos. Además, el cannabidiol no se puede incluir en productos comercializados con declaraciones terapéuticas. El cannabidiol solo puede incluirse en productos "cosméticos" y solo si contiene menos de 0.3% de THC. Pero todavía hay productos etiquetados como suplementos dietéticos en el mercado que contienen cannabidiol. La cantidad de cannabidiol contenida en estos productos no siempre se informa con precisión en la etiqueta del producto.

El cannabidiol se usa más comúnmente para el trastorno convulsivo (epilepsia). También se usa para la ansiedad, el dolor, un trastorno muscular llamado distonía, enfermedad de Parkinson, enfermedad de Crohn y muchas otras afecciones, pero no hay evidencia científica que respalde estos usos.

El cannabidiol tiene efectos en el cerebro. La causa exacta de estos efectos no está clara. Sin embargo, el cannabidiol parece prevenir la descomposición de una sustancia química en el cerebro que afecta el dolor, el estado de ánimo y la función mental. Prevenir la descomposición de este químico y aumentar sus niveles en la sangre parece reducir los síntomas psicóticos asociados con afecciones como la esquizofrenia. El cannabidiol también podría bloquear algunos de los efectos psicoactivos del delta-9-tetrahidrocannabinol (THC). Además, el cannabidiol parece reducir el dolor y la ansiedad.

Probable efectivo/a para:

Trastorno convulsivo (epilepsia). Se ha demostrado que un producto específico de cannabidiol reduce las convulsiones en adultos y niños con diversas afecciones relacionadas con las convulsiones. Este producto es un medicamento recetado para tratar las convulsiones causadas por el síndrome de Dravet o el síndrome de Lennox-Gastaut. También se ha demostrado que reduce las convulsiones en personas con complejo de esclerosis tuberosa, síndrome de Sturge-Weber, síndrome de epilepsia relacionada con la infección febril (FIRES) y trastornos genéticos específicos que causan encefalopatía epiléptica. Pero no está aprobado para tratar estos otros tipos de convulsiones.

Posiblemente efectivo/a para:

Esclerosis múltiple (EM). Se ha demostrado que un producto de aerosol nasal con receta (Sativex, GW Pharmaceuticals) que contiene 9-delta-tetrahidrocannabinol (THC) y cannabidiol es efectivo para mejorar el dolor, la tensión muscular y la frecuencia de micción en personas con EM. Este producto se usa en más de 25 países fuera de los Estados Unidos. Pero existe evidencia inconsistente sobre la efectividad del cannabidiol para los síntomas de la esclerosis múltiple cuando se usa solo. Algunas investigaciones preliminares sugieren que el uso de un aerosol de cannabidiol debajo de la lengua podría mejorar el dolor y la tensión muscular, pero no los espasmos musculares, el cansancio, el control de la vejiga, la movilidad o el bienestar y la calidad de vida en pacientes con EM.

Desorden bipolar. Los primeros informes muestran que tomar cannabidiol no mejora los episodios maníacos en personas con trastornos bipolares.

Un tipo de enfermedad inflamatoria intestinal (enfermedad de Crohn). La investigación preliminar muestra que tomar cannabidiol no reduce la actividad de la enfermedad en adultos con enfermedad de Crohn.

Diabetes. La investigación preliminar muestra que tomar cannabidiol no mejora los niveles de glucosa en sangre, los niveles de insulina en sangre o la HbA1c en adultos con diabetes tipo 2.

Trastorno del movimiento marcado por contracciones musculares involuntarias (distonía). La investigación preliminar sugiere que tomar cannabidiol diariamente durante 6 semanas podría mejorar la distonía en un 20% a 50% en algunas personas. Se necesita una investigación de mayor calidad para confirmar esto.

Una condición hereditaria marcada por problemas de aprendizaje (síndrome de X frágil). La investigación preliminar descubrió que la aplicación de gel de cannabidiol podría reducir la ansiedad y mejorar el comportamiento en pacientes con síndrome de X frágil.

Una condición en la cual un trasplante ataca al cuerpo (enfermedad de injerto contra huésped o EICH). La enfermedad de injerto contra huésped es una complicación que puede ocurrir después de un trasplante de médula ósea. En las personas con esta afección, las células donantes atacan las propias células de la persona. La investigación preliminar muestra que tomar cannabidiol diariamente, comenzando 7 días antes del trasplante de médula ósea y continuando durante 30 días después del trasplante, puede extender el tiempo que le toma a una persona desarrollar GVHD.

Un trastorno cerebral heredado que afecta los movimientos, las emociones y el pensamiento (enfermedad de Huntington). La investigación preliminar muestra que tomar cannabidiol diariamente no mejora los síntomas de la enfermedad de Huntington.

Insomnio. La investigación preliminar sugiere que tomar 160 mg de cannabidiol antes de acostarse mejora el tiempo de sueño en personas con insomnio. Sin embargo, dosis más bajas no tienen este efecto. El cannabidiol tampoco parece ayudar a las personas a conciliar el sueño y puede reducir la capacidad de recordar sueños.

Esclerosis múltiple (EM). Existe evidencia inconsistente sobre la efectividad del cannabidiol para los síntomas de la esclerosis múltiple. Algunas investigaciones preliminares sugieren que el uso de un aerosol de cannabidiol debajo de la lengua podría mejorar el dolor y la tensión muscular en personas con EM. Sin embargo, no parece mejorar los espasmos musculares, el cansancio, el control de la vejiga, la capacidad de moverse o el bienestar y la calidad de vida.

Abstinencia de heroína, morfina y otras drogas opioides. La investigación preliminar muestra que tomar cannabidiol durante 3 días reduce los antojos y la ansiedad en personas con trastorno por consumo de heroína que no usan heroína ni ninguna otra droga opioide.

Enfermedad de Parkinson. Algunas investigaciones iniciales muestran que tomar cannabidiol diariamente durante 4 semanas mejora los síntomas psicóticos en personas con enfermedad de Parkinson y psicosis.

Esquizofrenia. La investigación sobre el uso de cannabidiol para los síntomas psicóticos en personas con esquizofrenia es conflictiva. Algunas investigaciones preliminares sugieren que tomar cannabidiol cuatro veces al día durante 4 semanas mejora los síntomas psicóticos y podría ser tan efectivo como el medicamento antipsicótico amisulprida. Sin embargo, otra investigación preliminar sugiere que tomar cannabidiol durante 14 días no es beneficioso. Los resultados contradictorios pueden estar relacionados con la dosis de cannabidiol utilizada y la duración del tratamiento.

Dejar de fumar. La investigación preliminar sugiere que la inhalación de cannabidiol con un inhalador durante una semana podría reducir la cantidad de cigarrillos fumados en aproximadamente un 40% en comparación con el valor inicial.

Un tipo de ansiedad marcada por el miedo en algunos o todos los entornos sociales (trastorno de ansiedad social). Algunas investigaciones preliminares muestran que tomar cannabidiol 300 mg al día no mejora la ansiedad durante el discurso público en personas con un trastorno de ansiedad social. Sin embargo, otra investigación temprana en personas con trastorno de ansiedad social sugiere que tomar una dosis más alta (400-600 mg) puede mejorar la ansiedad asociada con un examen público o pruebas de imágenes médicas. Además, algunas investigaciones en personas que no tienen trastorno de ansiedad social muestran que tomar 300 mg de cannabidiol podría reducir la ansiedad durante la oratoria.

Otras condiciones.

Se necesita más evidencia para calificar la efectividad del cannabidiol para estos usos.

Las calificaciones de efectividad están basadas en evidencia. La FDA no regula las hierbas y los suplementos dietéticos como los medicamentos recetados. Las hierbas y los suplementos dietéticos se pueden vender sin NINGUNA prueba de efectividad o seguridad. Toda la literatura médica se evalúa para determinar las clasificaciones de efectividad basadas en la mejor evidencia científica. Cada producto está clasificado para un uso o condición particular. Si un producto se usa para tratar más de una afección, puede encontrar diferentes clasificaciones de efectividad para cada uso.

EFECTIVO: Este producto ha pasado una revisión científica rigurosa (similar y tan rigurosa como la revisión de medicamentos realizada por la FDA) ... y resultó ser eficaz para un uso específico.

PROBABLEMENTE EFECTIVO: las referencias científicas de buena reputación generalmente coinciden en que el producto es efectivo para un uso específico ... y al menos dos estudios científicamente rigurosos (que involucran al menos a varios cientos de pacientes) encontraron que el producto es probablemente efectivo ... y los estudios se publican en revistas científicas acreditadas.

POSIBLEMENTE EFECTIVO: Referencias científicas de buena reputación sugieren que el producto podría funcionar para un uso específico ... y al menos un estudio (en humanos) encontró que el producto podría ser eficaz.

POSIBLEMENTE INEFECTIVO: Referencias científicas de buena reputación sugieren que el producto podría no funcionar para un uso específico ... y al menos un estudio (en humanos) encontró que el producto podría no ser efectivo.

PROBABLEMENTE INEFECTIVO: las referencias científicas de buena reputación generalmente coinciden en que el producto no es efectivo para un uso específico ... y al menos dos estudios científicamente rigurosos encontraron que el producto probablemente no sea efectivo ... y los estudios se publican en revistas científicas acreditadas.

INEFECTIVO: La mayoría de las referencias científicas acreditadas coinciden en que el producto no es efectivo para un uso específico ... y no hay estudios confiables en humanos que demuestren que el producto sea efectivo.

EVIDENCIA INSUFICIENTE: Si sabemos que se están haciendo afirmaciones sobre un producto pero no hay información científica disponible sobre la efectividad o ineficacia del producto, se lo haremos saber.

Cuando se toma por vía oral: el cannabidiol es POSIBLEMENTE SEGURO cuando se toma por vía oral o se rocía debajo de la lengua de manera adecuada. El cannabidiol en dosis de hasta 300 mg al día se ha tomado por vía oral de forma segura durante hasta 6 meses. Se han tomado dosis más altas de 1200-1500 mg al día de forma segura por hasta 4 semanas. Un producto recetado de cannabidiol está aprobado para tomarse por vía oral en dosis de hasta 10-20 mg / kg al día. Los aerosoles de cannabidiol que se aplican debajo de la lengua se han usado en dosis de 2.5 mg por hasta 2 semanas.

Algunos efectos secundarios reportados del cannabidiol incluyen sequedad de boca, presión arterial baja, aturdimiento y somnolencia. También se han informado signos de lesión hepática en algunos pacientes, pero esto es menos común.

Cuando se aplica a la piel: no hay suficiente información confiable para saber si el cannabidiol es seguro o cuáles son los efectos secundarios.

Precauciones especiales y advertencias:

Embarazo y lactancia: Cannabidiol POSIBLEMENTE NO ES SEGURO de usar si está embarazada o amamantando. Los productos de cannabidiol pueden contaminarse con otros ingredientes que pueden ser dañinos para el feto o el bebé. Manténgase seguro y evite su uso.

Niños: un producto de prescripción de cannabidiol es POSIBLEMENTE SEGURO cuando se toma por vía oral todos los días. La dosis más común utilizada es de 10 mg / kg al día. Se pueden usar dosis más altas de 15-20 mg / kg al día en algunos niños, pero es más probable que estas dosis más altas causen efectos secundarios. Este producto está aprobado para su uso en ciertos niños de 2 años de edad y mayores, pero se ha utilizado en niños de hasta 1 año de edad.

Enfermedad hepática: las personas con enfermedad hepática pueden necesitar dosis más bajas de cannabidiol en comparación con pacientes sanos.

Enfermedad de Parkinson: algunas investigaciones preliminares sugieren que tomar altas dosis de cannabidiol podría empeorar el movimiento muscular y los temblores en las personas con enfermedad de Parkinson.

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