CANNABIDIOL IN CHRONIC PAIN AND PSYCHIATRIC DISORDERS

Abstract

Cannabidiol (CBD), a non-psychoactive compound from Cannabis sativa L., has been widely investigated for its therapeutic potential in various health conditions, with increasing evidence on its effects on chronic pain and psychiatric disorders. In relation to chronic pain, studies indicate that CBD works by modulating the endocannabinoid system, receptors such as TRPV1 and 5-HT1A, in addition to reducing pro-inflammatory cytokines. Animal research has shown that it reverses hypersensitivity in neuropathic pain and combines analgesic effects with antidepressants, unlike conventional medications such as fluoxetine, which only act on depression. Acute administration decreases the activity of serotonergic neurons, while repeated treatment increases this activity, reducing mechanical allodynia. For inflammatory and musculoskeletal pain (such as fibromyalgia and arthritis), CBD formulations or combinations with THC demonstrate improvement, with mild adverse effects (dizziness, drowsiness) and low risk of dependence. In the field of psychiatric disorders, CBD shows promising results. In anxiety, it reduces symptoms in generalized, social and panic disorders, with benefits similar to conventional medications, but without the risk of dependence. For depression, it works by increasing anandamide levels, with efficacy comparable to fluoxetine in animal models. In schizophrenia, studies from Unicamp and USP revealed that CBD has an antipsychotic effect equivalent to that of clozapine and haloperidol, but with fewer side effects, protecting oligodendrocytes and modulating the endocannabinoid system. It is also investigated for PTSD, helping to extinguish traumatic memories, and as an adjuvant in the management of insomnia. In Brazil, CBD has been regulated by Anvisa since 2015 and can be imported with a medical prescription. In 2019, a resolution regulating its manufacture and commercialization was approved, with ongoing discussions about expanding access, including cultivation for medicinal purposes. Despite advances, more studies are needed to fully elucidate its therapeutic potential and optimize its clinical applications.