Natural Compound

CBD Oil

Cannabidiol (CBD)

Evidence TierBWADA NOT PROHIBITED

tuneTypical Dose

25-100 mg per day

watchEffect Window

Acute (1-2 hours) for anxiety. Allow 2-4 weeks for chronic pain and sleep benefits.

check_circleCompliance

WADA NOT PROHIBITED

Overview

Clinical Summary

CBD oil contains cannabidiol, a non-intoxicating cannabinoid that affects endocannabinoid and serotonin-related signaling. It is used for anxiety, sleep, and pain symptoms, with variable product quality.

High-quality clinical evidence supports cannabidiol for certain seizure disorders at prescription-grade doses. For anxiety, sleep, and pain, small trials suggest modest improvements in some people, but results are inconsistent. Minority research explores anti-inflammatory effects and substance-use related outcomes. Benefits depend on dose and purity, and clinically meaningful drug interactions can occur through hepatic enzyme effects.

Multi-target compound acting as 5-HT1A agonist, TRPV1 modulator, and FAAH inhibitor. Increases endogenous anandamide levels.

Outcomes

What This Is Expected To Influence

Primary Outcomes

  • Seizure reduction in Dravet/Lennox-Gastaut epilepsy (FDA-approved)
  • Anxiolytic effects at acute 300mg doses

Secondary Outcomes

  • Mild sleep quality improvement
  • Chronic pain reduction (observational evidence)

Safety

Contraindications and Interactions

Contraindications

  • Severe liver disease
  • Active hepatitis
  • Concurrent high-dose valproate therapy
  • Pregnancy (caution)
  • Lactation

Side effects

  • Drowsiness/sedation
  • Diarrhea or GI upset (including vomiting)
  • Decreased appetite
  • Dry mouth
  • Fatigue
  • Rash or mild fever (less common)

Interactions

  • Clobazam (Critical) - CBD can increase active clobazam metabolite exposure (reported around 3x) and sedation. Dose reduction and monitoring are often needed.
  • Valproate (Probable/Moderate) - Additive hepatotoxicity risk. Monitor liver enzymes closely.
  • Warfarin (Probable/Moderate) - Increased INR has been reported. Monitor coagulation.
  • Stiripentol (Probable/Moderate) - Blood levels may increase when combined with CBD.
  • Drugs that are CYP3A4/CYP2C19/CYP2C9/CYP1A2 substrates (Probable/Moderate) - CBD inhibition may increase concentrations of susceptible medications/supplements (e.g., immunosuppressants, some statins, benzodiazepines, clopidogrel, PPIs, SSRIs, caffeine).
  • Drugs that cause drowsiness/sedation (Probable/Moderate) - Additive CNS depression risk.
  • THC (Probable/Moderate) - CYP-mediated increases in THC exposure may increase adverse effects and drug-testing risk.

Avoid if

  • Severe liver disease
  • Pregnancy or lactation
  • Subject to drug testing (full-spectrum products may contain THC)
  • Unmonitored use with clobazam, valproate, or warfarin

Evidence

Study-level References

cbd-oil-SRC-001RCT (Double-blind)
Sourceopen_in_new

Linares IM, et al. "Cannabidiol presents an inverted U-shaped dose-response curve in a simulated public speaking test." Front Pharmacol. 2019.

Population: Healthy Adults

Dose protocol: 150mg, 300mg, or 600mg CBD vs placebo, single acute dose

Key findings: 300 mg of CBD significantly reduced anxiety during public speaking compared to placebo. Lower (150mg) and higher (600mg) doses were less effective, indicating a bell-shaped dose-response curve.

Notes: Small sample (n=57). Single-dose design limits extrapolation to chronic anxiolytic use.

Paper content

300 mg of CBD significantly reduced anxiety during public speaking compared to placebo. Lower (150mg) and higher (600mg) doses were less effective, indicating a bell-shaped dose-response curve.

cbd-oil-SRC-002Randomized, double-blind crossover trial.
Sourceopen_in_new

Dujic G, Kumric M, Vrdoljak J, Sutlovic D, Dujic Z, Bozic J. Chronic Cannabidiol Administration Mitigates Excessive Daytime Sleepiness and Fatigue in Patients with Primary Hypertension: Insights from a Randomized Crossover Trial. Cannabis Cannabinoid Res. 2025;10(4):549-557. doi:10.1089/can.2024.0028. PMID:39187263.

Population: Patients with primary hypertension.

Dose protocol: CBD 225-450 mg/day for 5 weeks, double-blind crossover with washout (n=64)

Key findings: Reduced daytime sleepiness and fatigue in hypertensive patients. No overall quality of life improvement. Sleep quality and memory unchanged.

Notes: Crossover design with washout strengthens causal inference. Relevant for fatigue and daytime alertness.

Paper content

This double-blind randomized crossover trial tested chronic CBD (225-450 mg/day) for 5 weeks in 64 patients with primary hypertension. CBD reduced excessive daytime sleepiness scores, improved fatigue and vitality measures, and enhanced some psychological well-being dimensions compared to placebo. However, no overall quality of life benefit was observed, and memory and sleep quality metrics were unchanged. The crossover design with washout strengthens causal inference. The study suggests CBD may help with daytime alertness and energy in hypertensive patients, though the mechanism may reflect secondary effects rather than direct sleep architecture changes.

cbd-oil-SRC-003Randomized controlled trial.
Sourceopen_in_new

Kisiolek JN, Flores VA, Ramani A, Butler B, Haughian JM, Stewart LK. Eight Weeks of Daily Cannabidiol Supplementation Improves Sleep Quality and Immune Cell Cytotoxicity. Nutrients. 2023;15(19):4173. doi:10.3390/nu15194173. PMID:37836465.

Population: Healthy, college-aged adults.

Dose protocol: 50 mg CBD daily for 8 weeks vs placebo (n=28)

Key findings: Improved sleep quality and enhanced NK cell cytotoxicity. No changes in body composition or mental health.

Notes: Notable for using consumer-relevant dose (50 mg). Immune finding requires replication.

Paper content

This RCT tested daily 50 mg CBD capsules for 8 weeks in 28 healthy college-aged adults. The CBD group showed significant improvements in sleep quality and enhanced natural killer (NK) cell cytotoxicity compared to placebo. No changes were observed in body composition or mental health measures. The study is notable for using a low, consumer-relevant CBD dose (50 mg) rather than the higher pharmacological doses used in most clinical trials. The immune finding (enhanced NK cell function) is mechanistically interesting but requires replication before clinical significance can be established.

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