The effect of tetrahydrocannabinol:cannabidiol oromucosal spray on cognition: a systematic review.
Ehsan Motaghi, Masoumeh Ghasemi-Pirbaluti, Mohsen Rashidi, Masoud Alasvand, Patricia Di Ciano, Hooman Bozorgi
European Journal of Clinical Pharmacology March 2023 DOI: 10.1007/s00228-023-03454-y (opens in new tab)
Study at a glance
AI-extracted from the abstract| Characteristics | Systematic review Peer reviewed |
|---|---|
| Sample size | 510 |
| Population | People with multiple sclerosis (7 studies), Huntington's disease (1 study), and healthy volunteers (2 studies) |
| Intervention | THC:CBD oromucosal spray |
| Topics | CBD Cannabis |
| Keywords | Cannabinoid Multiple sclerosis Nabiximols Sativex |
| Key findings | Most evidence across ten studies indicated no significant difference in cognitive outcomes between THC:CBD oromucosal spray and control treatments, though results were somewhat inconsistent. The authors note considerable heterogeneity in dose and duration and call for more trials with longer follow-up and dose comparisons. |
Abstract
Previous studies have shown that tetrahydrocannabinol (THC), the main psychoactive component of cannabis, can impair cognitive abilities. There is also some evidence that cannabidiol (CBD), the most abundant non-intoxicating constituent of cannabis, can attenuate these effects. The purpose of this study was to investigate the effects of THC:CBD oromucosal spray (with equal parts THC and CBD) on cognition compared with control conditions in human studies. A systematic literature search was performed on four major bibliographic databases. Studies were included in the present review if they evaluated the cognitive effects of THC:CBD oromucosal spray compared with a control condition. Ten studies were identified (7 on patients with multiple sclerosis, 1 on those with Huntington, and 2 on healthy volunteers) with 510 participants in total. There was considerable heterogeneity among the studies in terms of dose and duration of administration. All studies have used an equal or nearly equal dose of THC and CBD. Although the results across studies were somewhat inconsistent, most evidence revealed that there is no significant difference between THC:CBD oromucosal spray and control treatments in terms of cognitive outcomes. However, more trials are needed with longer follow-up periods, and dose considerations, particularly comparing lower and higher doses of the spray.
Comparable studies
Other systematic reviews and meta-analyses on CBD, most cited first.
| Study | Year | Design | Participants |
|---|---|---|---|
| Neuroimaging in cannabis use: a systematic review of the literature Cannabis users and controls in neuroimaging studies | 2009 | Systematic review | |
| Cannabis, a cause for anxiety? A critical appraisal of the anxiogenic and anxiolytic properties | 2020 | Systematic review | |
| Effects of Cannabis on Impulsivity: A Systematic Review of Neuroimaging Findings | 2014 | Systematic review | |
| Association between formal thought disorder and cannabis use: a systematic review and meta-analysis Individuals along the psychosis continuum (healthy individuals, patients with... | 2022 | Meta-analysis | n = 5,191 |
| The Relationship Between Cannabis Use and Schizophrenia As a Risk Factor or For Its Therapeutic Potential: A Systematic Review of Evidence | 2025 | Systematic review |
Citations in the library
Cites 9
- The neuropsychopharmacology of cannabis: A review of human imaging studies Pharmacology & Therapeutics October 20, 2018
- Cannabidiol (CBD) content in vaporized cannabis does not prevent tetrahydrocannabinol (THC)-induced impairment of driving and cognition Psychopharmacology May 1, 2019
- Smoked Cannabis' Psychomotor and Neurocognitive Effects in Occasional and Frequent Smokers Journal of Analytical Toxicology March 4, 2015
- Therapeutic Effects of Prolonged Cannabidiol Treatment on Psychological Symptoms and Cognitive Function in Regular Cannabis Users: A Pragmatic Open-Label Clinical Trial. Cannabis and Cannabinoid Research March 1, 2018
- Clinical and Preclinical Evidence for Functional Interactions of Cannabidiol and Δ9-Tetrahydrocannabinol. Neuropsychopharmacology January 2018
and 4 more in the library