CBD and Anxiety 

A 2021 survey reported 1 in 4 Canadians aged 18 and older had symptoms of depression, anxiety or Post-Traumatic Stress Disorder (PTSD), which was an increase from 1 in 5 Canadians in 2020¹.  While there are available medications to treat anxiety, 40-60% patients do not experience a meaningful effect with them². Females in particular appear to be less likely to respond to standard medications³. Thus, there is a need for new treatments to help patients more effectively manage their anxiety.

Can cannabis help with anxiety?

Anxiety is one of the top three reasons patients seek out medical cannabis and the scientific evidence continues to support efficacy for cannabis in treating anxiety^4,5. In particular, there have been numerous studies published showing CBD can be an effective treatment for anxiety and related symptoms.

A recent study found a CBD extract (9.97 mg/ml CBD:0.23 mg/ml THC in MCT oil) delivered sublingually, significantly improved anxiety symptoms after only 1 week of treatment in most participants and this improvement was sustained for the entire 4 weeks of the study⁶.

The average daily dose was 34.73 ± 6.03 mg CBD:0.80 ± 0.14 mg THC per day⁶, which is one of the lowest doses to be reported as effective for reducing anxiety. This daily dose resulted in no intoxication or serious adverse events ⁶. The most common side effects were sleepiness/fatigue, increased energy and dry mouth and were primarily rated as mild⁶. Along with the improvement in their anxiety, the study reported significant improvements in mood, sleep, quality of life and in some aspects of cognitive function⁶.

Overall, this study found a daily dose of ~34 mg of a CBD extract resulted in rapid anti-anxiety effects and caused patients to experience ≥15% decrease in anxiety symptoms consistently during the 4 weeks of treatment⁶.

Additional studies have also found CBD-rich products effective at reducing anxiety.  And unlike other pharmaceuticals, CBD’s anxiolytic effects appear to occur quite quickly and remain consistent throughout the course of treatment. Similarly, to the above study, Shannon et al. found CBD to be effective at improving anxiety in 79% of their cohort within the first month of treatment⁷. This reduction in anxiety persisted over the 3-month evaluation period⁷.  Pacheco et al. found CBD significantly improved anxiety, depression and insomnia after 1 week of treatment and emotional exhaustion after 2 weeks of treatment in healthcare workers providing care during COVID-19⁸

CBD’s anxiolytic effects may even continue post treatment, with one study showing a CBD treated population of healthcare workers continued to have improved anxiety and emotional exhaustion for 1 month after CBD was discontinued⁹.

Acute Doses of CBD and Subjective Anxiety   

Several other studies have shown that acute doses of CBD (300 – 600 mg) reduce subjective anxiety in people who had generalized anxiety disorder or in participants who were asked to give an impromptu speech^10–13.  

CBD’s anxiolytic (i.e. anxiety-reducing) effects were also shown to be similar to a known anxiolytic drug, ipsapirone, in healthy participants who were required to give an impromptu speech as part of the study¹³. 

A Look at How Patients Found CBD Helpful  

Overall, CBD-rich products have been reported by patients to help with their anxiety. ⁷⁷. Retrospective observational studies reveal that the anxiolytic effects of CBD-rich products may be particularly beneficial in patients with moderate to severe anxiety¹⁴.Similarly, in a survey of 387 respondents asked about their CBD use, 42.6% supported CBD for treating their self-perceived anxiety¹⁵. Of those who supported CBD for their self-perceived anxiety, 86.5% reported that they felt less anxious and 58.9% thought about their problems less when trying to relax¹⁵. Respondents who used CBD for treating their self-reported anxiety had lower odds of using CBD in the evenings and were likely to consume sublingually (dosing under the tongue)¹⁵.   

It should also be noted that women had greater odds of using CBD for treating their self-perceived anxiety than males¹⁵. The age groups of 35-54 years and 55+ years old had lower odds of using CBD for treating self-perceived anxiety in comparison to the 18-34- year-old respondent group¹⁵.   

Though not specific to anxiety, more than half of the 387 respondents reported using a daily dose of less than 50 mg CBD via a sublingual route of administration and most people had been using CBD for 3-12 months (67.6%)¹⁵.

In Conclusion

At Aurora®, we always stay up to date on the latest scientific research surrounding the effectiveness of medical cannabis. We hope this information has been helpful to you in making the most well-informed decisions for your health and wellness.

References:

1. Statistics Canada. Survey on COVID-19 and Mental Health, February to May 2021. Published online 2021. https://www150.statcan.gc.ca/n1/daily-quotidien/210927/dq210927a-eng.htm
2. Bystritsky A. Treatment-resistant anxiety disorders. Mol Psychiatry. 2006;11(9):805-814. doi:10.1038/SJ.MP.4001852
3. Simon NM, Zalta AK, Worthington JJ, et al. Preliminary support for gender differences in response to fluoxetine for generalized anxiety disorder. Depress Anxiety. 2006;23(6):373-376. doi:10.1002/DA.20184
4. Wadsworth E, Leos-Toro C, Hammond D. Substance Use & Misuse Mental Health and Medical Cannabis Use among Youth and Young Adults in Canada Mental Health and Medical Cannabis Use among Youth and Young Adults in Canada. Published online 2019. doi:10.1080/10826084.2019.1691594
5. Walsh Z, Callaway R, Belle-Isle L, et al. Cannabis for therapeutic purposes: patient characteristics, access, and reasons for use. Int J Drug Policy. 2013;24(6):511-516. doi:10.1016/J.DRUGPO.2013.08.010
6. Dahlgren MK, Lambros AM, Smith RT, Sagar KA, El-Abboud C, Gruber SA. Clinical and cognitive improvement following full-spectrum, high-cannabidiol treatment for anxiety: open-label data from a two-stage, phase 2 clinical trial. Communications Medicine 2022 2:1. 2022;2(1):1-10. doi:10.1038/s43856-022-00202-8
7. Shannon S, Lewis N, Lee H, Hughes S. Cannabidiol in Anxiety and Sleep: A Large Case Series. Perm J. 2019;23:18-041. doi:10.7812/TPP/18-041
8. Pacheco JC, Souza JDS, Hallak JEC, et al. Cannabidiol as a Treatment for Mental Health Outcomes among Health Care Workers during the Coronavirus Disease Pandemic. J Clin Psychopharmacol. 2021;41(3):327-329. doi:10.1097/JCP.0000000000001405
9. Diogo Souza JS, Zuardi AW, Guimarães FS, et al. Maintained anxiolytic effects of cannabidiol after treatment discontinuation in healthcare workers during the COVID-19 pandemic. Front Pharmacol. Published online 2022. doi:10.3389/fphar.2022.856846
10. Bergamaschi MM, Queiroz RHC, Chagas MHN, et al. Cannabidiol reduces the anxiety induced by simulated public speaking in treatment-naïve social phobia patients. Neuropsychopharmacology. 2011;36(6):1219-1226. doi:10.1038/NPP.2011.6
11. Crippa JAS, Nogueira Derenusson G, Borduqui Ferrari T, et al. Neural basis of anxiolytic effects of cannabidiol (CBD) in generalized social anxiety disorder: a preliminary report. J Psychopharmacol. 2011;25(1):121-130. doi:10.1177/0269881110379283
12. Crippa J, Zuardi AW, Garrido GEJ, et al. Effects of Cannabidiol (CBD) on Regional Cerebral Blood Flow. Neuropsychopharmacology. 2004;29(2):417-426. doi:10.1038/sj.npp.1300340
13. Zuardi AW, Cosme RA, Graeff FG, Guimarães FS. Effects of ipsapirone and cannabidiol on human experimental anxiety. Journal of Psychopharmacology. 1993;7(Suppl 1):82-88. doi:DOI: 10.1177/026988119300700112
14. Rapin L, Gamaoun R, el Hage C, Arboleda MF, Prosk E. Cannabidiol use and effectiveness: real-world evidence from a Canadian medical cannabis clinic. J Cannabis Res. 2021;3(1). doi:10.1186/S42238-021-00078-W
15. Moltke J, Hindocha C. Reasons for cannabidiol use: a cross-sectional study of CBD users, focusing on self-perceived stress, anxiety, and sleep problems. J Cannabis Res. 2021;3(1):5. doi:10.1186/s42238-021-00061-5
16. Wan B angela, Diaz P, Blake A, et al. Efficacy of different varieties of medical cannabis in relieving symptoms. J Pain Manage. 2017;10(4):375-383.
17. Cahill SP, Lunn SE, Diaz P, Page JE. Evaluation of Patient Reported Safety and Efficacy of Cannabis From a Survey of Medical Cannabis Patients in Canada. Front Public Health. 2021;9:626853. doi:10.3389/fpubh.2021.626853