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Endocannabinoid System

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Medicinal Cannabis and CBD in Mental Healthcare

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Abstract

The endocannabinoid system (ECS) was discovered in the early 1990s and is one of the most important neuroregulatory systems in the body. The ECS is responsible for homeostasis of most systems in the body. At a simplistic level, it is composed of endogenous ligands called endocannabinoids, cannabinoid receptors (CB1 and CB2 receptors), and enzymes that synthesize and degrade them. However, the ECS is actually more complex than this and there are other receptors and endocannabinoid-like substances involved in the ‘extended ECS’. CB1 receptors are particularly concentrated in the central nervous system and CB2 receptors are particularly concentrated in cells and tissues/organs of the immune system. However, cannabinoid receptors are also widely distributed throughout the body. In the nervous system, the classical understanding is that endocannabinoids are synthesized on demand in postsynaptic neurons and act as retrograde messengers, binding with cannabinoid receptors on presynaptic neurons to reduce neurotransmitter release from the presynaptic neuron. It is now known that there are also intracellular reservoirs and transporters of endocannabinoids. The ECS is critically involved in brain development, from the fetus through to adulthood. Dysfunction including deficiency of the ECS has been associated with a range of pathological disorders, including mental health conditions. The ECS plays a key role in the regulation of our mind and emotions and our reaction to stress. It is involved with the corticolimbic system and the HPA axis, both of which are key systems involved in regulation of stress and emotions. This chapter gives an overview of the ECS, as an understanding is necessary to later understand how medicinal cannabis may work in alleviating mental health disorders.

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O’Brien, K., Blair, P. (2021). Endocannabinoid System. In: Medicinal Cannabis and CBD in Mental Healthcare. Springer, Cham. https://doi.org/10.1007/978-3-030-78559-8_2

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