Nearly a decade ago, a team of researchers hailing from the University of São Paulo, Brazil, worked with a group of 24 participants diagnosed with social anxiety disorder. Divided into groups, the participants received a dose of cannabidiol (CBD), and the researchers asked them to perform a simulated public speaking test. Through both psychological and physiological assessments, the groups receiving pretreatment with CBD had “significantly reduced anxiety, cognitive impairment and discomfort in their speech performance.”
In the world of CBD for anxiety, this single experimental study has garnered the most global attention and spawned a decade of deeper research into the anti-anxiety powers of this cannabinoid. Since the publication of this study in Neuropsychopharmacology in 2011, CBD has become a household name with all types of CBD-infused products tucked neatly away into many people’s medicine cabinets.
Legalization has made this non-intoxicating cannabinoid more accessible around the world. Its usage has quickly spread, and perhaps for good reason: In the US, anxiety disorders are the most common mental illness. The Anxiety and Depression Association of America estimates that over 18 percent of the American population experiences a period of anxiety in any given year.
With COVID-19 heightening these rates of anxiety and putting everyone’s mental health to the test, more people may be reaching for CBD to find relief. Over the preceding years of research into CBD for anxiety disorders, has there been any progress?
Nearly a Decade On, Does the Research Confirm CBD is Anxiolytic?
A 2015 research review in Neurotherapeutics outlined the case for the treatment of anxiety with CBD. Unlike many areas of cannabis research, there is surprisingly a substantial body of work on CBD for stress and anxiety. In part, this may be thanks to the non-intoxicating properties of CBD (compared with its cousin cannabinoid, THC) and the ability to source CBD from hemp instead of medical or recreational varieties of cannabis.
Animal models of anxiety have helped researchers determine that the anxiolytic effects of CBD are dose-dependent and fall on a bell-shaped curve. There is a happy medium between too much and too little for the most anxiolytic impact. Animal models have also helped identify specific biological mechanisms, including CBD’s effects within the midbrain dorsal periaqueductal gray area of the brain (responsible for the production of “intense distress and dread”). Early studies have also pinpointed its work within the bed nucleus of the stria termialis area, which is responsible for our sustained fear response.
At this point, researchers have determined CBD activates the 5-HT1A receptor (a serotonin receptor). Previous research has confirmed the 5-HT1A receptor governs mood and certain psychological effects, specifically anxiety and depression. If CBD activates the 5-HT1A receptor, logically it may have anti-anxiety effects.
Human Experimentation and Clinical Trials Looking at CBD for Anxiety
The authors of “Cannabidiol as a Potential Treatment for Anxiety Disorders” also summarized human research into CBD and anxiety disorders. There has also been substantial clinical work completed within this area of cannabis research.
Beyond the Brasilian study on CBD’s anxiolytic effects during a simulated public speech, several newer studies also prove the cannabinoid’s anti-anxiety potential. For starters, scientific investigations have determined CBD mitigates the anxiety triggered by acute doses of THC. Higher doses of CBD have also reduced anxiety at baseline levels.
CBD is fascinating because it seemingly reduces anxiety in both people with an anxiety disorder and in healthy control subjects. One study looked at pretreatment with CBD before a nerve-wracking medical procedure (single-photon emission computed tomography imaging). Both cohorts, those with and those without anxiety, reaped the benefits of pretreatment.
What is notable about the current body of evidence is that most of it focuses on acute experiences of anxiety. As the authors explain, “Thus, overall, no outcome data are currently available regarding the chronic effects of CBD in the treatment of anxiety symptoms.” This is an area of study needing much more attention.
In conclusion, based on this summary of findings, “Preclinical evidence conclusively demonstrates CBD’s efficacy in reducing anxiety behaviors relevant to multiple disorders.” Thus far, the evidence supports CBD for specific disorders, including social anxiety, generalized anxiety, obsessive-compulsive, and post-traumatic stress disorders.
What the Future Holds for Treatment with CBD
Despite the wealth of evidence supportive of the anxiolytic properties of this little cannabinoid, it hasn’t yet reached any final phase clinical trials. At the time of this writing, four clinical trials are working on CBD for anxiety, but they are in the recruitment or pre-recruitment stages. There are also a handful of other CBD trials in the pre-recruitment stages, touching on symptoms of anxiety but targeting other medical conditions including cancer, Alzheimer’s, and Parkinson’s disease.
Unlike earlier research, many of these new trials will explore a much longer course of treatment from four to eight weeks. Their results will help paint a picture of CBD for the treatment of chronic anxiety disorders, well beyond the acute treatments explored thus far.
It will be a few more years before the Food and Drug Administration or any other governing body approves the use of CBD-derived pharmaceuticals for anxiety. But, thanks to the non-psychotropic and non-intoxicating nature of CBD, it’ll likely face much fewer bureaucratic hurdles and regulatory restrictions than other popular cannabinoids. Plus, with hemp now legal to grow, sell, and process across the country, and new and improved THC remediation technologies, it’s increasingly a widely available medicinal ingredient.