|Author||Diagnosis||Study design||Pharmacological agent||Strength of evidence||Group (n)||Duration||Age range (years)||Dose range (mg)||Scales to measure the clinical outcome||Clinical outcome||Common side effects||Reference number|
|Cooper et al., 2017||ADHD||RCT||Nabiximols||Level 2||Nabiximols = 15|
Placebo = 15
|6 weeks||18–55||Nabiximols oromucosal spray = 2.7 mg Δ9-THC and 2.5 mg CBD|
Mean dose = 4.7 sprays per day
Maximum dose = 14 sprays/day
|QbTest||- The experimental group had better scores compared to placebo group (Est = 0.17, 95%CI-0.40 to 0.07, p = 0.16, n = 15/11 active/placebo).|
- Nabiximols was associated with a nominally significant improvement in hyperactivity/impulsivity (p = 0.03) and a cognitive measure of inhibition (p = 0.05), and a trend towards improvement for inattention (p = 0.10) and executive learning (p = 0.11).
|Muscular seizures and spasms||34|
|Barchel et al., 2018||ASD and related comorbidities|
2. Sleep problems
|Open-label trial||CBD and Δ9-THC||Level 3||53||30–588 days|
Median duration = 66 days
Median age = 11 years
|CBD oil solution with CBD and Δ9-THC at 1:20 ratio|
16 mg/kg (maximal daily dose 600 mg)
CBD median IQR daily dose = 90 (45–143) mgΔ9-THC
0.8 mg/kg (maximal daily dose 40 mg).
THC median IQR daily dose = 7 (4–11) mg
|Not mentioned||- These patients were taking concomitant medications including stimulants, antipsychotics, anti-epileptics, melatonin, anti-depressants, alpha-agonists, and anti-muscarinic agents.|
- Out of 53 patients, 74.5% reported improvement in comorbid symptoms.
- About 68.4% reported improvement in hyperactivity, 67.6% in self-injurious behaviors, 71.4% in sleep problems, and 47.1% in anxiety symptoms.
|Somnolence and change in appetite||35|
|Bergamasci et al., 2011||Anxiety related to public speaking||RCT||CBD||Level 4||CBD = 12|
Placebo = 12
|Single dose||SAD-placebo = 22.8|
SAD-CBD = 24.6
Healthy = 23.3
|600 mg||Mini-SPIN, VAMS, SSPS, SSPS-N, BSS||- Pretreatment with a single dose of CBD significantly decreased anxiety, cognitive impairment and discomfort in speech performance. It also resulted in significantly decreased alertness in anticipatory speech.|
- There were significant effect of phases (F3.6,118.51/432.7; p < 0.001), group (F2,331/413.5; p < 0.001) and phases by group interaction (F7.2,118.5 1/4 6.4; p < 0.001).
- There were also significant differences between placebo and healthy control group at the initial (p < 0.018), anticipatory (p < 0.001), speech (p < 0.001) and post-speech (0.018) phases.
- The CBD group differs from the placebo (p < 0.012) and control (p < 0.007) groups during the speech phase
|No side effects were reported.||36|
|Shannon et al., 2019||Anxiety and insomnia||Retrospective chart review||CBD||Level 4||Anxiety = 47|
Sleep disorder = 25
|3 months||Sleep disorder = 18–72|
Mean age = 36.5 years
Anxiety = 18–70
Mean age = 34 years
|25–175 mgMost patients received 25 mg/day||HAM-A, PSQI||- Most patients received 25 mg/day CBD; a handful of patients received 50 or 75 mg/day. One patient with schizoaffective disorder and trauma was given up to 175 mg/day.|
- After 1 month of treatment, 79.2 and 66.7% of patients reported improvement in anxiety and sleep, respectively.
- After 2 months, 78.1 and 56.1% of patients reported improvement in anxiety and sleep, respectively, which were also observed at 3-month follow-up.
- Greater improvement in anxiety scores than sleep scores.
|- 2 patients discontinued treatment due to fatigue and 1 patient with a development disorder had increased sexually inappropriate behaviors, resulting in discontinuation|
- Transient mild sedation was also reported in some patients.
|Zuard et al., 2010||Bipolar disorder||Case report||CBD||Level 4||2||38 days||34 and 36||1–5 days for both participants: Placebo|
5–19 days: CBD 600 mg and olanzapine 10–15 mg
20–33 days: CBD 900–1200 mg
5–33 days: CBD 600–1200 mg
33–38 days: Placebo
|BPRS, YMRS||- Case 1: 37 and 33% improvement on BPRS and YMRS with CBD and olanzapine, but no additional improvement with CBD monotherapy.|
- Case 2: CBD failed to improve symptoms of bipolar disorder at any of the prescribed doses.
|No side effects were reported.||38|
|Shannon & Opila-Lehman., 2016||Posttraumatic stress disorder||Case report||CBD||Level 4||1||5 months of CBD||10||CBD oil 25 mg|
Liquid CBD 6–12 mg sublingual spray as needed for anxiety
|SDSC, SCARED||- CBD scores improved from 34 to 18 at endpoint, indicating no anxiety.|
- Sleep Disturbance Scale scores improved from 59 to 38, suggesting no problem with sleep.
|No side effects were reported.||39|
|Trainor et al., 2016||Tourette syndrome||Case report||Nabiximols||Level 4||1||4 weeks||26||Two oromucosal sprays of nabiximols BID|
Total dose = 10.8 mg Δ9-THC, 10 mg CBD per day
|YGTSS, ORVRS||- Using the ORVRS to evaluate tics, motor tics were reduced by 85% and vocal tics by 90%|
- Number of affected body areas decreased.
- mprovement of 35% on YGTSS.
|No side effects were reported.||40|
|Pichler et al., 2018||Tourette syndrome||Case report||Cannabis tincture|
THC combined with CBD
|Level 4||1||2 months||47||34 drops cannabis tincture 3 times a day = 10 mg Δ9-THC combined with 20 mg of CBD||YGTSS||- With the combination of Δ9-THC and CBD, there was significant improvement in tic frequency and severity.|
- Scores decreased from 73/100 to 44/100 on YGTSS.
- Patient reported improvement in quality of life and enhanced social activity.