Diagnosis research: Anxiety

May 9, 2023· highandfocused

Preclinical and clinical studies indicate that cannabidiol (CBD) has potential for use in the treatment of a wide range of neuropsychiatric disorders. It is characterized in particular by antipsychotic and anxiolytic (i.e. anti-anxiety) effects, but also has antiepileptic, antioxidant, anti-inflammatory and antidepressant effects. Cannabidiol is safe and well tolerated. 1
Existing preclinical evidence offers strong support for CBD as a treatment for generalized anxiety disorder, panic disorder, social anxiety disorder, obsessive-compulsive disorder, and posttraumatic stress disorder. Acute administration has been investigated, with few studies to date investigating chronic administration of CBD. 2
In studies on healthy volunteers and people suffering from various anxiety disorders, when CBD was administered in the form of capsules or oral sprays, only minimal side effects were observed, namely sedation. The overall results were positive and CBD was generally well tolerated. 3
Anxiety patients with poor sleep quality reported not only reduced anxiety but also improved sleep with long-term use, although this was variable. 4
Social phobia
CBD appears to have particularly interesting results in the treatment of social phobia. CBD has already been observed to have anti-anxiety and anti-depression effects in animal models. 5
In human studies, CBD was found to significantly reduce anxiety, cognitive impairment, and discomfort during speech performance. The placebo group showed higher levels of anxiety, cognitive impairment, discomfort, and alertness compared to the control group. 6
Good results were also confirmed in the long-term treatment of adolescents suffering from social phobia. CBD significantly reduced their anxiety according to two different rating scales. 7
Mechanisms of action
Stress is a major risk factor for the development of mood and anxiety disorders. Scientists have long wondered how to mitigate the harmful effects of stress – and how such a stress response occurs. It has been shown that there is a connection between stress-induced anxiety and insufficient levels of anandamide. Anandamide is a so-called endocannabinoid , or a cannabinoid produced by our body. 8
The endocannabinoid system – and therefore CBD – is involved in the formation of new neurons in the hippocampus. 9
Functional neuroimaging has confirmed that CBD affects cerebral blood flow and that CBD's anti-anxiety effect is related to its effects on activity in limbic and paralimbic brain regions. 10
Specifically, the reduction of anxiety due to CBD administration occurs in the brain through local neurotransmission mediated by serotonin receptors of the 5-HT1A type. 11
Thanks to animal studies, all of the molecular targets of cannabidiol have been identified over the years. 12
We now know that CBD acts as a non-competitive negative allosteric modulator of the CB1 receptor, as an inverse agonist of the CB2 receptor, and as an inhibitor of the reuptake of the endocannabinoid anandamide. In addition, CBD also activates serotonergic 5-HT1A receptors and vanilloid receptors. 13
THC or CBD?
The difference between the effects of the two main cannabinoids, THC and CBD, is now well-studied. It is generally believed that THC can induce feelings of anxiety, paranoia, and psychosis. In humans, THC is associated with anxiety, while CBD is associated with anxiety reduction.
Of course, more extensive clinical research will be needed to clarify the role of other cannabinoids or terpenes (compounds responsible for the taste and smell of cannabis). 14
Other case studies suggest that while CBD helps with social anxiety and has mostly positive effects in schizophrenia, it does not appear to be effective in mania. In contrast, THC does not appear to be effective against depression. 15
However, there have not been enough randomized, placebo-controlled studies to say for sure how much cannabinoids like CBD or THC help or do not help with anxiety disorders. 16
However, preliminary studies confirm the effectiveness of CBD against anxiety, depression and psychosis and emphasize that, unlike THC, it is not addictive and has an overall positive safety profile. 17
List of cited studies and reviews: