Title:The “Entourage Effect”: Terpenes Coupled with Cannabinoids for the Treatment of Mood Disorders and Anxiety Disorders
Volume: 18
Issue: 2
Author(s): Sari Goldstein Ferber, Dvora Namdar, Danielle Hen-Shoval, Gilad Eger, Hinanit Koltai, Gal Shoval*, Liat Shbiro and Aron Weller
Affiliation:
- Geha Mental Health Center, Petah Tiqva,Israel
Keywords:
Cannabidiol, terpenes, mood disorders, depression, anxiety, entourage.
Abstract: Mood disorders are the most prevalent mental conditions encountered in psychiatric
practice. Numerous patients suffering from mood disorders present with treatment-resistant forms
of depression, co-morbid anxiety, other psychiatric disorders and bipolar disorders. Standardized
essential oils (such as that of Lavender officinalis) have been shown to exert clinical efficacy in
treating anxiety disorders. As endocannabinoids are suggested to play an important role in major
depression, generalized anxiety and bipolar disorders, Cannabis sativa was suggested for their
treatment. The endocannabinoid system is widely distributed throughout the body including the
brain, modulating many functions. It is involved in mood and related disorders, and its activity may
be modified by exogenous cannabinoids. CB1 and CB2 receptors primarily serve as the binding
sites for endocannabinoids as well as for phytocannabinoids, produced by cannabis inflorescences.
However, ‘cannabis’ is not a single compound product but is known for its complicated molecular
profile, producing a plethora of phytocannabinoids alongside a vast array of terpenes. Thus, the
“entourage effect” is the suggested positive contribution derived from the addition of terpenes to
cannabinoids. Here, we review the literature on the effects of cannabinoids and discuss the possibility
of enhancing cannabinoid activity on psychiatric symptoms by the addition of terpenes and terpenoids.
Possible underlying mechanisms for the anti-depressant and anxiolytic effects are reviewed.
These natural products may be an important potential source for new medications for the
treatment of mood and anxiety disorders.