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Cannabidiol (CBD) and cannabidiolic acid (CBDA) are two major phytocannabinoids found in the Cannabis plant. CBD is a non-psychoactive cannabinoid approved as an adjunctive treatment for seizures associated with Lennox-Gastaut syndrome and Dravet syndrome, and is also used for symptomatic relief of neuropathic pain and other conditions. CBDA is the acidic precursor to CBD, present in raw cannabis; it converts to CBD through decarboxylation by heat or light. Both compounds interact with the endocannabinoid system but have distinct pharmacological profiles. CBD acts on multiple targets including negative allosteric modulation of the CB1 receptor, antagonism at GPR55 receptors, inhibition of adenosine reuptake, modulation of serotonin receptors (notably 5-HT1A), inhibition of fatty acid amide hydrolase (FAAH), and indirect effects on calcium channels. Its mechanisms contribute to anticonvulsant, analgesic, anti-inflammatory, anxiolytic, antipsychotic and neuroprotective effects[1][5][6][8]. The precise mechanism underlying its antiseizure activity remains unclear but may involve modulation of neuronal calcium movement[5][8]. CBDA has been less studied clinically but exhibits anti-inflammatory properties via selective inhibition of cyclooxygenase-2 (COX-2) enzyme activity in preclinical models[3]. It may also act on serotonin receptors. Epidiolex is a purified oral solution formulation containing CBD that has received regulatory approval for certain seizure disorders[1][5].
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