PrometheusGeneral

Compound or practice · Supplement

CBD (Cannabidiol)

A non-intoxicating cannabinoid with rock-solid epilepsy evidence and promising-but-unsettled anxiety and sleep data.

Overall grade
Grade B
Last revised
4
graded outcomes
2
references listed
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A structured monograph in Prometheus's bundled library. Its grades are the monograph's own reading of the evidence, not a peer-reviewed review.

1 at grade A · 1 at grade B · 2 at grade C — 4 graded rows

What is known

Each outcome with its grade (how strong the evidence is, A to D), the size of the effect where the entry records one, and how often studies agree.

  • Rare epilepsies (Rx)Evidence grade A

    Purified, prescription

    Largehigh

  • AnxietyEvidence grade B

    Higher doses

    Moderatemixed

  • SleepEvidence grade C

    Indirect

    Smallmixed

  • Chronic painEvidence grade C

    Unclear

    Smallmixed

What is uncertain

Read off the same rows as above. Nothing here is added that the entry does not itself record.

  • Thin evidence: Sleep (grade C); Chronic pain (grade C).
  • Studies disagree: Anxiety (mixed agreement).
  • Caution with Statins: CBD inhibits CYP3A4 and can raise levels of many drugs, including some statins.
  • Caution with Sedative: Additive sedation with other calming agents.

Interactions

Documented pairings with supplements and medicines. A medicine on this list is a conversation for whoever prescribes it.

  • StatinsCaution

    CBD inhibits CYP3A4 and can raise levels of many drugs, including some statins.

  • SedativeCaution

    Additive sedation with other calming agents.

The evidence in words

What it is

Cannabidiol is a non-psychoactive compound from cannabis/hemp; a purified prescription form (Epidiolex) treats rare epilepsies.

How it works

It acts on multiple targets — serotonin 5-HT1A, TRPV1, and endocannabinoid tone — rather than the CB1 'high' receptor, giving anxiolytic and anticonvulsant effects.

What the evidence shows

For specific epilepsies, purified CBD is proven (grade A, prescription). For anxiety, human trials (often acute-stress models) are encouraging but doses are high and consumer products vary wildly. Sleep and chronic-pain evidence is mixed. A real issue is quality: label accuracy is poor, and CBD inhibits liver enzymes that clear many drugs.

How to use it

Consumer anxiety/sleep doses in studies are often higher than product labels suggest (tens to hundreds of mg). Start low, choose third-party-tested products with a COA, and separate from other medications.

Safety & interactions

Generally well tolerated (fatigue, diarrhea, appetite changes); high doses can raise liver enzymes. Clinically important: CBD inhibits CYP3A4/CYP2C19 and can raise levels of many drugs — check interactions before combining. statins — CBD inhibits CYP3A4 and can raise levels of many drugs, including some statins. sedative — Additive sedation with other calming agents.

Bottom line

Proven for certain epilepsies; a reasonable, if unsettled, option for anxiety and sleep — if you buy tested product and respect the drug interactions.

Questions people ask

Will CBD get me high?

No — it's non-intoxicating. THC is the psychoactive cannabinoid.

Why do doses vary so much?

Consumer products are poorly regulated and often mislabeled; research doses are frequently far higher. Buy products with a certificate of analysis.

Related reading

Entries that share this one's tags or conditions.

Sources

As this entry records them: title, journal and year. None carries a DOI or PubMed id, so none is linked as a verified paper. Each link searches PubMed for the title; check that what you find is what the entry describes.

  1. 1.Cannabidiol in Dravet syndrome (Epidiolex) — N Engl J Med, 2017. Search PubMed (opens in a new tab)
  2. 2.CBD for anxiety: review — Neurotherapeutics, 2015. Search PubMed (opens in a new tab)

Last revised . A grade is this entry's reading of the evidence, not medical advice.