This section of the website is intended for Healthcare Professionals
Cannabis has been used for its pharmacological effects for over 4,800 years1, whilst ‘cannabinoids’ have been identified as the chemicals within cannabis plants that are pharmacologically active.1
Cannabinoids can also occur naturally in the human body, as well as being synthetically created in lab. As a result, cannabinoids are classified based on their specific origin.
Cannabinoids can be categorised into one of three classes:
Cannabinoids found in the plant Cannabis sativa, of which over 100 have been identified1
Cannabinoids produced by the body that target cannabinoid receptors (CB1 and CB2)2
Best characterised phytocannabinoids
In recent years, a vast amount of research has been conducted on isolating, characterising and identifying the therapeutic uses of cannabinoids. The ones studied and understood in the greatest detail can be found below.
- CBD = cannabidiol
- One of the major cannabinoids derived from cannabis or synthesised1
- Clinical trials are evaluating its potential treatment in neurological and psychiatric conditions3,4
- Cannabidiol has a very low affinity for cannabinoid receptor CB1 and so is lacking euphoric side effects1
- CBDV = cannabidivarin
- Rodent studies in both models of epilepsy and autism spectrum disorder5,6
- Clinical trials are evaluating CBDV for potential anticonvulsant properties7
- THC = tetrahydrocannabinol (most commonly delta 9)
- One of the major cannabinoids derived from cannabis or synthesised2
- Primarily responsible for marijuana’s psychotropic properties2
- Recreational and therapeutic uses1
- THCV = tetrahydrocannabivarin
- Studies in rodent models of Parkinson’s disease, as well as insulin sensitivity (a model of diabetes)8,9
- Being investigated for potential use in type 2 diabetes10
The endocannabinoid system
The endocannabinoid system was first described in the late 1980s, when the CB1 receptor was discovered. This was closely followed by the discovery of the CB2 receptor in the early 1990s.1 Both are G protein-coupled receptors.1 More recent evidence tells us that cannabinoids also interact with the G protein-coupled receptor 55 (GPR55), transient receptor potential vanilloid 1 (TRPV1) receptor and peroxisome proliferator-activated receptors (PPARs).11
The endocannabinoid system is widespread and is thought to affect many physiological processes including: appetite, cancer, cardiovascular diseases, fertility, immune functions, memory, neuroprotection, and pain modulation.11
Synthetic cannabinoids are created in the lab to mimic existing known cannabinoids in both structure and effect. With over 40 years of therapeutic history, they have been found to be a relatively safe classification of cannabinoid. Side effects are predictable, dose-related, and typically mild to moderate.1
The number of conditions for which synthetic cannabinoids have been investigated and used, with the existence of these compounds on many national formularies, suggests for many clinicians they remain a potential therapeutic option for treating intractable chronic and debilitating diseases and symptoms; provided patients are informed of potential side effects and are carefully monitored.1
Pertwee R. Handbook of Cannabis. Preface. Oxford University Press; 2014.
Epidyolex Summary of Product Characteristics.
McGuire P, et al. Am J Psychiatry 2018;175(3):225–231.
Iannotti FA, et al. ACS Chem Neurosci 2014;5:1131–1141.
Zamberletti E, et al. Front Cell Neurosci 2019;13:367.
Morano A, et al. Epilepsia Open 2016;1(3–4):145–151.
García C, et al. British Journal of Pharmacology. 2011;163(7):1495-1506.
Wargent E, et al. Nutrition & Diabetes. 2013;3(5):e68-e68.
Jadoon K, et al. Diabetes Care. 2016;39(10):1777-1786.
Battista N, et al. Frontiers in Behavioral Neuroscience. 2012;6(9):1–7.
PubChem. Compound summary for CID 5284592, Nabilone. Accessed: September 2020.