# Cannabinoid Therapies in Less-Common Disorders: Clinical Evidence and Formulation Strategies

**Authors:** Silvia Afonso, Joana Gonçalves, Ana T. Brinca, Luana M. Rosendo, Tiago Rosado, Ana Paula Duarte, Eugenia Gallardo

PMC · DOI: 10.3390/diseases14020083 · 2026-02-23

## TL;DR

This review explores how cannabinoids may help treat rare disorders beyond their known uses, focusing on new clinical evidence and drug delivery methods.

## Contribution

The paper provides a critical synthesis of recent clinical evidence and formulation strategies for cannabinoids in less-common disorders.

## Key findings

- Cannabinoids show potential in treating rare conditions like refractory epilepsies and movement disorders.
- Advanced formulations like nanocarriers aim to improve bioavailability and patient response consistency.
- Negative outcomes in some trials highlight challenges in methodology and pharmacology.

## Abstract

Background/Objectives: Cannabinoids are increasingly recognised for their therapeutic potential beyond well-established indications such as chronic pain, multiple sclerosis, and specific epileptic syndromes. Recent advances have highlighted their possible role in less-common or orphan diseases, opening new avenues for pharmaceutical research and clinical application. Methods: This review provides a critical synthesis of the most recent evidence (2020–2025), available in PubMed and Scopus, regarding the use of cannabinoids in conditions including refractory epilepsies beyond Dravet and Lennox–Gastaut syndromes, movement disorders such as dystonia and Tourette syndrome, rare dermatological diseases like epidermolysis bullosa, and emerging data in Crohn’s disease. Results: Negative outcomes, such as those reported in Fragile X syndrome trials, are also discussed as instructive examples of methodological and pharmacological challenges. Particular attention is given to the optimisation of pharmaceutical formulations and advanced separation technologies, including oromucosal sprays, transdermal gels, and novel nanocarrier systems, which aim to overcome issues of bioavailability and variability in patient response. Finally, safety concerns, regulatory aspects, and the need for robust clinical trials are addressed. Conclusions: Overall, cannabinoids represent a promising yet underexplored therapeutic option in rare and complex disorders, warranting further investigation supported by innovative pharmaceutical approaches.

## Linked entities

- **Chemicals:** cannabinoids (PubChem CID 9852188)
- **Diseases:** multiple sclerosis (MONDO:0005301), Dravet syndrome (MONDO:0100135), Lennox–Gastaut syndrome (MONDO:0016532), Tourette syndrome (MONDO:0007661), epidermolysis bullosa (MONDO:0006541), Crohn’s disease (MONDO:0005011), Fragile X syndrome (MONDO:0010383)

## Full-text entities

- **Genes:** TRPA1 (transient receptor potential cation channel subfamily A member 1) [NCBI Gene 8989] {aka ANKTM1, FEPS, FEPS1, p120}, CYP1A1 (cytochrome P450 family 1 subfamily A member 1) [NCBI Gene 1543] {aka AHH, CP11, CYP1, CYPIA1, P1-450, P450-C}, CYP1A2 (cytochrome P450 family 1 subfamily A member 2) [NCBI Gene 1544] {aka CP12, CYPIA2, P3-450, P450(PA)}, CYP2C19 (cytochrome P450 family 2 subfamily C member 19) [NCBI Gene 1557] {aka CPCJ, CYP2C, CYPIIC17, CYPIIC19, P450C2C, P450IIC19}, HTR1A (5-hydroxytryptamine receptor 1A) [NCBI Gene 3350] {aka 5-HT-1A, 5-HT1A, 5HT1a, ADRB2RL1, ADRBRL1, G-21}, TRPV1 (transient receptor potential cation channel subfamily V member 1) [NCBI Gene 7442] {aka VR1}, CYP2D6 (cytochrome P450 family 2 subfamily D member 6 (gene/pseudogene)) [NCBI Gene 1565] {aka CPD6, CYP2D, CYP2D7AP, CYP2D7BP, CYP2D7P2, CYP2D8P2}, PPIG (peptidylprolyl isomerase G) [NCBI Gene 9360] {aka CARS-Cyp, CYP, SCAF10, SRCyp}, TRPM8 (transient receptor potential cation channel subfamily M member 8) [NCBI Gene 79054] {aka LTRPC6, LTrpC-6, TRPP8, trp-p8}, CNR2 (cannabinoid receptor 2) [NCBI Gene 1269] {aka CB-2, CB2, CX5}, GPR55 (G protein-coupled receptor 55) [NCBI Gene 9290] {aka LPIR1}, PPARG (peroxisome proliferator activated receptor gamma) [NCBI Gene 5468] {aka CIMT1, FPLD3, GLM1, NR1C3, PPARG1, PPARG2}, CYP2C9 (cytochrome P450 family 2 subfamily C member 9) [NCBI Gene 1559] {aka CPC9, CYP2C, CYP2C10, CYPIIC9, P450-2C9, P450IIC9}, CYP3A4 (cytochrome P450 family 3 subfamily A member 4) [NCBI Gene 1576] {aka CP33, CP34, CYP3A, CYP3A3, CYPIIIA3, CYPIIIA4}, ADORA1 (adenosine A1 receptor) [NCBI Gene 134] {aka RDC7}, CNR1 (cannabinoid receptor 1) [NCBI Gene 1268] {aka CANN6, CB-R, CB1, CB1A, CB1K5, CB1R}
- **Diseases:** neurological, psychiatric, and sleep-related conditions (MESH:D001523), Crohn's disease (MESH:D003424), Tourette syndrome (MESH:D005879), agitation (MESH:D011595), cancer (MESH:D009369), epileptic syndromes (MESH:D000073376), psychosis (MESH:D011618), orthostatic hypotension (MESH:D007024), ADHD (MESH:D001289), , dermatological, gastrointestinal, psychiatric, and sleep-related conditions (MESH:D005767), neuropsychiatric comorbidity (MESH:C000631768), diabetes (MESH:D003920), weight loss (MESH:D015431), Dermatological Disorders (MESH:D000168), toxicity (MESH:D064420), anxiety (MESH:D001007), neuroinflammation (MESH:D000090862), cannabis use disorder (MESH:D002189), schizophrenia (MESH:D012559), dizziness (MESH:D004244), dysphoria (MESH:D019052), anorexia (MESH:D000855), inflammation (MESH:D007249), gastrointestinal symptoms (MESH:D012817), liver abnormalities (MESH:D008107), headache (MESH:D006261), injury to (MESH:D014947), Movement, Neurodegenerative, Psychiatric, and Sleep Disorders (MESH:D019636), somnolence (MESH:D006970), spasticity (MESH:D009128), dystonia (MESH:D004421), Epilepsies (MESH:D004827), pain (MESH:D010146), epidermolysis bullosa (MESH:D004820), sleep disorders (MESH:D012893), colon cancer (MESH:D015179), osteoarthritis (MESH:D010003), Fragile X syndrome (MESH:D005600), seizure (MESH:D012640), multiple sclerosis (MESH:D009103), Dravet and Lennox-Gastaut Syndromes (MESH:D065768), tuberous sclerosis complex (MESH:D014402), oncological (MESH:D000072716), inflammatory hyperalgesia (MESH:D006930), Dravet (MESH:D004831), spinal cord injury (MESH:D013119), tics (MESH:D020323), Movement (MESH:D009069), pruritus (MESH:D011537), developmental and epileptic encephalopathies (MESH:C562695), cognitive impairment (MESH:D003072), Neurological and Neurodevelopmental Disorders (MESH:D009422), vomiting (MESH:D014839), dry mouth (MESH:D014987), nausea and vomiting (MESH:D020250), AIDS (MESH:D000163), focal epilepsies (MESH:D004828), tachycardia (MESH:D013610), depression (MESH:D003866), obesity (MESH:D009765)
- **Chemicals:** cannabicyclol (MESH:C022213), Dronabinol (MESH:D013759), Delta-9-tetrahydrocannabivarin (MESH:C003403), valproate (MESH:D014635), fatty acid (MESH:D005227), oil (MESH:D009821), polymers (MESH:D011108), sertraline (MESH:D020280), adenosine (MESH:D000241), Ca2+ (-), cannabitriol (MESH:C012226), benzodiazepines (MESH:D001569), CBC (MESH:C010695), tacrolimus (MESH:D016559), clobazam (MESH:D000078306), oleic acid (MESH:D019301), CBG (MESH:C037036), warfarin (MESH:D014859), PLGA (MESH:D000077182), anandamide (MESH:C078814), topiramate (MESH:D000077236), cannabielsoin (MESH:C060665), cholesterol (MESH:D002784), Cesamet (MESH:C011941), CBD (MESH:D002185), ethanol (MESH:D000431), glucose (MESH:D005947), levetiracetam (MESH:D000077287), ROS (MESH:D017382), calcium (MESH:D002118), cyclic AMP (MESH:D000242), Nabiximols (MESH:C587251), Cannabinoid (MESH:D002186), transcutol HP (MESH:C010111), water (MESH:D014867), phospholipids (MESH:D010743), AMP (MESH:D000249), CBGA (MESH:C100679), CBDA (MESH:C006884), Delta-8-tetrahydrocannabinol (MESH:C035731), CBD hydroxyquinone (MESH:C073718), lipid (MESH:D008055), CBN (MESH:D002187), Endocannabinoid (MESH:D063388)
- **Species:** Mus musculus (house mouse, species) [taxon 10090], Canis lupus familiaris (dog, subspecies) [taxon 9615], Homo sapiens (human, species) [taxon 9606], C. indica [taxon 432337], Cannabis sativa (species) [taxon 3483], Cavia porcellus (domestic guinea pig, species) [taxon 10141]

## Figures

2 figures with captions in the complete paper: https://tomesphere.com/paper/PMC12939546/full.md

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Source: https://tomesphere.com/paper/PMC12939546