Psycho-Babble Medication Thread 1103166

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CBD Oil as augmentation to meds or stand-alone?

Posted by mtom on February 8, 2019, at 10:20:05

I posted this to "Alternatives" and subsequently found past discussions in the "Medications" board so reposting. Perhaps no-one has anything new to add, but just in case....

Interested in hearing from those who have tried CBD Oil either as an augmentation to other meds, or a stand-alone therapy.

Some Background:
Here in Canada Medicinal Cannabis has been legal for a number of years. It must be prescribed by a Doctor and provided by Government regulated Licensed Producers. (Although I have heard of Pot Shops selling it, all cannabis "use" was recently legalized in Canada but licensing shops to sell it without a prescription is still in process). Right now, GPs usually refer "medical" patients to the previously licensed Doctor run Medical Cannabis Clinics for prescriptions. Based on your medical history and health conditions, they prescribe a product and dosage they feel is suitable, and suggest high quality providers from their experience, although you are free to choose any licensed provider who offers a product in line with your prescription. Some of the providers here have been and are involved in ongoing research and published papers. Although there has been quite a bit of in vitro and animal research, clinical human trials are still scanty (there have been some), they are ongoing. Much of the past research has been done or is in process in Canada, Europe and Israel, often in collaborations, where regulations have been more "research friendly". I've been reading about increased research in the U.S., but ongoing frustrations with regulations. Based on a combination of research and apparently abundant anecdotal evidence, medical cannabis is being prescribed in Canada for a variety of conditions including mood, anxiety and sleep disorders, chronic pain and inflammatory conditions, epilepsy and more.
I understand that in the U.S. most CBD is currently produced from Hemp due to the trace amounts of THC. This is not the case in Canada where regular but specially bred cannabis strains are used for Medical CBD and the THC content of different products varies from very low amounts, to more significant amounts, depending on the patients conditions and as prescribed by the Doctor. And at least some brands include small amounts of the naturally occurring terpenes.

 

Re: CBD Oil as augmentation to meds or stand-alone?

Posted by linkadge on February 9, 2019, at 13:20:40

In reply to CBD Oil as augmentation to meds or stand-alone?, posted by mtom on February 8, 2019, at 10:20:05

Yes, I have been using medical cannabis with very good success (almost 1 year now).

My depression is improved (basically in remission) as is my anxiety and insomnia. The biggest improvement is in my insomnia. I use a combination of CBD and THC. Probably in the ratio ratio CBD:THC = 2:1.

I still use 300mg of lithium and occasionally a bit of mirtazapine. I have not used benzodiazapines in about a year (I was previously a chronic user).

The main issue for CBD is cost. For THC, it is cheap to get a large effect. For CBD, doses in the 100's of mg could cose you $10+ a day, without coverage, which is too high for me.


I use between 20-50mg a day of CBD and 1-2mg of THC a day. However, I don't use THC daily.


Cannabis has don't wonders for my sypmptom profile: undersleeping, overthinking, anxiety, low appetite, anhedonia etc. I can use a higher THC product 2-3 times a week and have not had any issues with tollerance or withdrawal.

Suprisingly, the most significant effect is on rumination. After using THC, I just want to move forward. I can 'see' how the rumination isn't helping me and I can very easily chose then to let go.


Linkadge


 

Re: CBD Oil as augmentation to meds or stand-alone?

Posted by mtom on February 9, 2019, at 15:28:35

In reply to Re: CBD Oil as augmentation to meds or stand-alone?, posted by linkadge on February 9, 2019, at 13:20:40

Thanks much Linkadge for sharing optimistic story. My symptom profile is similar to yours except I also have Joint pain from an autoimmune condition (Lupus).

The product I was prescribed for my symptoms is usually started at 12.5 mg CBD/day in divided morning and evening doses, with a suggested weekly titration schedule over 6 weeks or until desired effect is reached, up to as high as 75 mg in 2 divided doses. But due to my concerns about past hypersensitivity to medications and possible interactions with those I still take, they reduced this for me to 8.75 per day to start, most of that in the evening, and titrating up in small increments every 3 to 7 days based on effect. This sublingual oil also contains 2% THC. I received it yesterday, have been a bit nervous about taking it but will try tomorrow morning.

Doctor Clinic follow-up every 3 months or can book one sooner if issues occur (that's covered by our Medicare in Canada, product is not covered, but a portion is tax-deductible).

I thought I'd add that with recent legalization of recreational and non-prescription use in Canada (still being sorted out as far as licensing/regulating those suppliers), there have been concerns expressed about the future supply chain.....

> Yes, I have been using medical cannabis with very good success (almost 1 year now).
>
> My depression is improved (basically in remission) as is my anxiety and insomnia. The biggest improvement is in my insomnia. I use a combination of CBD and THC. Probably in the ratio ratio CBD:THC = 2:1.
>
> I still use 300mg of lithium and occasionally a bit of mirtazapine. I have not used benzodiazapines in about a year (I was previously a chronic user).
>
> The main issue for CBD is cost. For THC, it is cheap to get a large effect. For CBD, doses in the 100's of mg could cose you $10+ a day, without coverage, which is too high for me.
>
>
> I use between 20-50mg a day of CBD and 1-2mg of THC a day. However, I don't use THC daily.
>
>
> Cannabis has don't wonders for my sypmptom profile: undersleeping, overthinking, anxiety, low appetite, anhedonia etc. I can use a higher THC product 2-3 times a week and have not had any issues with tollerance or withdrawal.
>
> Suprisingly, the most significant effect is on rumination. After using THC, I just want to move forward. I can 'see' how the rumination isn't helping me and I can very easily chose then to let go.
>
>
> Linkadge
>
>
>

 

Re: CBD Oil as augmentation to meds or stand-alone?

Posted by bleauberry on February 10, 2019, at 13:06:02

In reply to CBD Oil as augmentation to meds or stand-alone?, posted by mtom on February 8, 2019, at 10:20:05

CBD is being used as part of a stack in cocktails of meds and herbs, as well as mono therapy.

If it were me I would have no problem adding to Prozac, Zyprexa, Ritalin, whatever, any of them. I might hesitate slightly with Parnate or Nardil. But even there I think it is safe.

> I posted this to "Alternatives" and subsequently found past discussions in the "Medications" board so reposting. Perhaps no-one has anything new to add, but just in case....
>
> Interested in hearing from those who have tried CBD Oil either as an augmentation to other meds, or a stand-alone therapy.
>
> Some Background:
> Here in Canada Medicinal Cannabis has been legal for a number of years. It must be prescribed by a Doctor and provided by Government regulated Licensed Producers. (Although I have heard of Pot Shops selling it, all cannabis "use" was recently legalized in Canada but licensing shops to sell it without a prescription is still in process). Right now, GPs usually refer "medical" patients to the previously licensed Doctor run Medical Cannabis Clinics for prescriptions. Based on your medical history and health conditions, they prescribe a product and dosage they feel is suitable, and suggest high quality providers from their experience, although you are free to choose any licensed provider who offers a product in line with your prescription. Some of the providers here have been and are involved in ongoing research and published papers. Although there has been quite a bit of in vitro and animal research, clinical human trials are still scanty (there have been some), they are ongoing. Much of the past research has been done or is in process in Canada, Europe and Israel, often in collaborations, where regulations have been more "research friendly". I've been reading about increased research in the U.S., but ongoing frustrations with regulations. Based on a combination of research and apparently abundant anecdotal evidence, medical cannabis is being prescribed in Canada for a variety of conditions including mood, anxiety and sleep disorders, chronic pain and inflammatory conditions, epilepsy and more.
> I understand that in the U.S. most CBD is currently produced from Hemp due to the trace amounts of THC. This is not the case in Canada where regular but specially bred cannabis strains are used for Medical CBD and the THC content of different products varies from very low amounts, to more significant amounts, depending on the patients conditions and as prescribed by the Doctor. And at least some brands include small amounts of the naturally occurring terpenes.

 

Re: CBD Oil as augmentation to meds or stand-alone? » linkadge

Posted by mtom on April 26, 2019, at 11:40:54

In reply to Re: CBD Oil as augmentation to meds or stand-alone?, posted by linkadge on February 9, 2019, at 13:20:40

Hi Linkadge,

I started CBD Oil in Feb, low doses. Initially I felt some effect on reducing anxiety. However I was becoming light-headed and my blood pressure became very low (side effects I've read about). These effects reduced over a week or 2 and I started titrating up gradually, eventually as high as 17 mg CBD per day divided in 2 doses. My product also contains a very small amount of THC, less than 2 mg/ml (25 mg/ml of CBD). (again Medical Cannabis is prescribed by Doctors specializing in Cannabis in Canada and provided by government licensed & regulated suppliers).

At this dose I started getting other side-effects, notably bouts of intense fatigue throughout the day, and I think it started interacting with my escitalopram which I still take at low dose of 5 mg/day (could not tolerate higher doses). My morning anxiety and jitteriness increased which had been side-effects of higher doses of escitalopram. I think the CBD may have been interacting - I've read this is possible as both are metabolized by some of the same liver CYP 450 enzymes.

No affect on depression yet. How long did that take for you?

I had a new consult with Cannabis Doctor who suggested I back off dose (I already had), and go slow. But he believes the ideal dose for me would eventually be about 12.5 mg per day CBD, less than the first Doctor I saw who suggested I titrate up to 18.75 mg per day.

I also have Lupus, and this doctor put more emphasis on treating that although I'm equally interested in reducing anxiety and depression, which he said CBD will also help with. CBD Doctors seem to think it's the best thing since sliced bread, he told me 95% of patients benefit from it for all sorts of conditions.

Did you have any side-effects at any point, e.g. when titrating dose up? Did they go away over time? Between the light-headedness, then jitteriness and fatigue, I started avoiding driving as much as possible for a while until after I reduced my dose. I still have to take benzos for anxiety, although a little less lately. Thanks!

> Yes, I have been using medical cannabis with very good success (almost 1 year now).
>
> My depression is improved (basically in remission) as is my anxiety and insomnia. The biggest improvement is in my insomnia. I use a combination of CBD and THC. Probably in the ratio ratio CBD:THC = 2:1.
>
> I still use 300mg of lithium and occasionally a bit of mirtazapine. I have not used benzodiazapines in about a year (I was previously a chronic user).
>
> The main issue for CBD is cost. For THC, it is cheap to get a large effect. For CBD, doses in the 100's of mg could cose you $10+ a day, without coverage, which is too high for me.
>
>
> I use between 20-50mg a day of CBD and 1-2mg of THC a day. However, I don't use THC daily.
>
>
> Cannabis has don't wonders for my sypmptom profile: undersleeping, overthinking, anxiety, low appetite, anhedonia etc. I can use a higher THC product 2-3 times a week and have not had any issues with tollerance or withdrawal.
>
> Suprisingly, the most significant effect is on rumination. After using THC, I just want to move forward. I can 'see' how the rumination isn't helping me and I can very easily chose then to let go.
>
>
> Linkadge
>
>
>

 

Surprised so few commented on Cannabis CBD because

Posted by mtom on April 26, 2019, at 16:55:04

In reply to CBD Oil as augmentation to meds or stand-alone?, posted by mtom on February 8, 2019, at 10:20:05

According to a statistic I just read, there were 342,000 "Registered Medical Cannabis" users in Canada as of Sept 2018. And over 2 million in the U.S.

I know that in Canada, many people are taking it for mood disorders, as well as chronic pain disorders, chemotherapy side-effects, autoimmune disorders, MS, Epilepsy and others.

Maybe, as has been pointed out, most posters to this board tend to be those "not" happy with their current protocols. Maybe Medical Cannabis users are happy with the results and therefore not monitoring this site?

I know there are many other discussion boards out there on Cannabis, but I don't like the Privacy Policies of most so don't post to those.

 

Re: Surprised so few commented on Cannabis CBD because

Posted by chumbawumba on May 18, 2019, at 17:21:25

In reply to Surprised so few commented on Cannabis CBD because, posted by mtom on April 26, 2019, at 16:55:04

The only thing that CBD does for me is attenuate the anxiety I get from smoking drug strain cannabis. On it's own I feel no effect from it. Even pretty substantial doses, 100 mg of vaporized pure crystalline CBD does nothing for me.

 

Re: CBD Oil as augmentation to meds or stand-alone?

Posted by Fred23 on August 8, 2020, at 11:12:06

In reply to CBD Oil as augmentation to meds or stand-alone?, posted by mtom on February 8, 2019, at 10:20:05

The May 7, 2019 article "Meet the People Trading Their Anti-Anxiety Meds in for Cannabis" at
https://elemental.medium.com/meet-the-people-trading-their-anti-anxiety-meds-in-for-cannabis-c497f6dcc5f1 has some interesting points.

A lot of the effectiveness of CBD seems to hinge on both the relative amounts of THC and the terpenes.

(If one finds that the needed THC amount is too intoxicating for daily life, what is to be done?)

Since many marketed CBD products on weak on terpenes, it may be that we have to buy the terpenes separately?

 

Re: CBD Oil as augmentation to meds or stand-alone?

Posted by Mtom on August 8, 2020, at 14:14:12

In reply to Re: CBD Oil as augmentation to meds or stand-alone?, posted by Fred23 on August 8, 2020, at 11:12:06

> The May 7, 2019 article "Meet the People Trading Their Anti-Anxiety Meds in for Cannabis" at
> https://elemental.medium.com/meet-the-people-trading-their-anti-anxiety-meds-in-for-cannabis-c497f6dcc5f1 has some interesting points.
>
> A lot of the effectiveness of CBD seems to hinge on both the relative amounts of THC and the terpenes.
>
> (If one finds that the needed THC amount is too intoxicating for daily life, what is to be done?)
>
> Since many marketed CBD products on weak on terpenes, it may be that we have to buy the terpenes separately?

I tried 2 different "prescription" brands for several months each (can get Dr. scripts in Canada to order through regulated "Medical Cannabis" providers - and anxiety and depression do qualify for scripts). Both contained terpenes which they detailed, although terpene profile differed between the 2 brands. Also both contained a tiny fraction of THC which I'm guessing is likely just a function of the plants they use and the processing, can't 100% guarantee no THC. But they keep the terpenes in.

I found no difference despite the differing terpene profile. At first I thought it was helping with anxiety, but that soon faded (possible placebo effect? Although I'm not usually susceptible to that...). Then it seemed to make me tired, especially as I increased dose as instructed. Then I started wondering if it was interacting with other meds - both CBD and THC are metabolized by same enzymes as many other meds.

Instructions were to keep titrating up until desired effect. But that got too expensive.

The Cannabis Doctors (and they are real MDs) I consulted thought cannabis was essentially a wonder drug. They were very hyped on it.

I haven't researched recently, but when I did a while ago, dosages used in the small amount of published research at that time were so high the cost would be prohibitive.

Anyone else had any recent experiences with CBD being helpful in any way?

 

Re: CBD Oil as augmentation to meds or stand-alone?

Posted by Fred23 on August 9, 2020, at 9:48:01

In reply to CBD Oil as augmentation to meds or stand-alone?, posted by mtom on February 8, 2019, at 10:20:05

Some random items. I have more reading to do today.

Barlean's seminar "Terpenes: What They Are & Why You Want Them" at https://www.barleans.com/webinars#Terpenes, has some interesting points.

The "Cannabis Pharmacy" material by Michael Backes, has a lot of good info.

In the book "Cannabis and CBD for Health and Wellness" co-authored with Aliza Sherman, Dr. Junella Chin gives very specific presciptions, that include terpenes as a component.

Terpenes might not be making it into CBD products, and even if they are, if taken by the oral route are likely not effective.

 

Re: CBD Oil as augmentation to meds or stand-alone?

Posted by Fred23 on August 30, 2020, at 13:22:09

In reply to Re: CBD Oil as augmentation to meds or stand-alone?, posted by Mtom on August 8, 2020, at 14:14:12

> At first I thought it was helping with anxiety, but that soon faded (possible placebo effect? Although I'm not usually susceptible to that...). Then it seemed to make me tired, especially as I increased dose as instructed. Then I started wondering if it was interacting with other meds - both CBD and THC are metabolized by same enzymes as many other meds.

That may have something to do with CBD and THC having different tolerances that may develop. Supposedly CBD doesn't have a tolerance build up, while THC does, but since is the "secret sauce" in the entourage effect, when its effectiveness wears off, all that left is CBD. Hence the guides say to take a break every few months of two days, which lets the body reset.


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