Dr. Frankel's Journal

Titration of THC and CBD, or What is Titration

August 21, 2012
Allan Frankel, MD

Titration, is the process of slowly increasing one medicine or one liquid, with another medicine, liquid or pretty much anything.

When relating to Cannabinoids, as dosable cannabis medicines are rapidly becoming available, it is becoming more and more important clinically to be able to titrate the cannabinoids. We all have so much to learn in this area, but these are my initial thoughts. I openly encourage comments.

1. For the majority of patients with simple anxiety/insomnia, it is very simple and rarely is any titration necessary. Generally 4 mg or 4 sprays/day is adquate.

2. For the seriously ill or seriously in pain,  just using “pure” whole plant CBD is inadequate; patients require THC. Now comes the titrating. I generally suggest the patient build up a base of CBD, with very little THC. Perhaps somewhere between 10 and 20 mg, we begin adding THC 2 mg (one spray), increased every other day. This seems to minimize the psychoactivity.

It is very clear clinically, at least in my experience, that adding THC to a baseline CBD regimen is a good way to initiate many patient’s programs. The baseline of CBD seems to greatly help the THC side effects.