Preclinical and clinical studies show CBD A review of potential side effects in humans found. Jul 27, People interested in managing their anxiety with CBD oil should look treatment for anxiety, it is unclear what dosage a person should use. We conducted a survey to see who was using CBD to manage anxiety, were they replacing prescriptions with CBD, and was the natural remedy working.
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These anxiety-related disorders are associated with a diminished sense of well-being, elevated rates of unemployment and relationship breakdown, and elevated suicide risk [ 1 — 3 ]. Currently available pharmacological treatments include serotonin reuptake inhibitors, serotonin—norepinephrine reuptake inhibitors, benzodiazepines, monoamine oxidase inhibitors, tricyclic antidepressant drugs, and partial 5-hydroxytryptamine 5-HT 1A receptor agonists.
Anticonvulsants and atypical antipsychotics are also used to treat PTSD. These medications are associated with limited response rates and residual symptoms, particularly in PTSD, and adverse effects may also limit tolerability and adherence [ 7 — 10 ]. The substantial burden of anxiety-related disorders and the limitations of current treatments place a high priority on developing novel pharmaceutical treatments.
CBD has broad therapeutic properties across a range of neuropsychiatric disorders, stemming from diverse central nervous system actions [ 11 , 12 ]. In recent years, CBD has attracted increasing interest as a potential anxiolytic treatment [ 13 — 15 ]. The purpose of this review is to assess evidence from current preclinical, clinical, and epidemiological studies pertaining to the potential risks and benefits of CBD as a treatment for anxiety disorders.
In total, 49 primary preclinical, clinical, or epidemiological studies were included. Neuroimaging studies that documented results from anxiety-related tasks, or resting neural activity, were included.
THC ratio , were included. Cannabis sativa , a species of the Cannabis genus of flowering plants, is one of the most frequently used illicit recreational substances in Western culture. The 2 major phyto- cannabinoid constituents with central nervous system activity are THC, responsible for the euphoric and mind-altering effects, and CBD, which lacks these psychoactive effects. Preclinical and clinical studies show CBD possesses a wide range of therapeutic properties, including antipsychotic, analgesic, neuroprotective, anticonvulsant, antiemetic, antioxidant, anti-inflammatory, antiarthritic, and antineoplastic properties see [ 11 , 12 , 16 — 19 ] for reviews.
Pharmacology relevant to these actions is detailed below. The primary mechanism by which eCBs regulate synaptic function is retrograde signaling, wherein eCBs produced by depolarization of the postsynaptic neuron activate presynaptic CB 1 Rs, leading to inhibition of neurotransmitter release [ 23 ].
Interactions with the TRPV1 receptor, in particular, appear to be critical in regulating the extent to which eCB release leads to inhibition or facilitation of presynaptic neurotransmitter release [ 25 ]. TRPV1 receptors are also expressed in the brain, including the amygdala, periaqueductal grey, hippocampus, and other areas [ 26 , 27 ].
The eCB system regulates diverse physiological functions, including caloric energy balance and immune function [ 28 ]. The eCB system is also integral to regulation of emotional behavior, being essential to forms of synaptic plasticity that determine learning and response to emotionally salient, particularly highly aversive events [ 29 , 30 ].
Activation of CB 1 Rs produces anxiolytic effects in various models of unconditioned fear, relevant to multiple anxiety disorder symptom domains reviewed in [ 30 — 33 ]. Regarding conditioned fear, the effect of CB 1 R activation is complex: CB 1 R activation may enhance or reduce fear expression, depending on brain locus and the eCB ligand [ 34 ]; however, CB 1 R activation potently enhances fear extinction [ 35 ], and can prevent fear reconsolidation.
Genetic manipulations that impede CB 1 R activation are anxiogenic [ 35 ], and individuals with eCB system gene polymorphisms that reduce eCB tone—for example, FAAH gene polymorphisms—exhibit physiological, psychological, and neuroimaging features consistent with impaired fear regulation [ 36 ]. Reduction of AEA—CB 1 R signaling in the amygdala mediates the anxiogenic effects of corticotropin-releasing hormone [ 37 ], and CB 1 R activation is essential to negative feedback of the neuroendocrine stress response, and protects against the adverse effects of chronic stress [ 38 , 39 ].
Accordingly, CB 1 R activation has been suggested as a target for anxiolytic drug development [ 15 , 43 , 44 ]. In addition to dose-dependent activation of TRPV1 channels, the anxiogenic versus anxiolytic balance of CB 1 R agonists also depends on dynamic factors, including environmental stressors [ 33 , 49 ].
In preclinical studies, 5-HT 1A R agonists are anxiolytic in animal models of general anxiety [ 51 ], prevent the adverse effects of stress [ 52 ], and enhance fear extinction [ 53 ]. They are expressed on serotonergic neurons in the raphe, where they exert autoinhibitory function, and various other brain areas involved in fear and anxiety [ 54 , 55 ].
Mechanisms underlying the anxiolytic effects of 5-HT 1A R activation are complex, varying between both brain region, and pre- versus postsynaptic locus, and are not fully established [ 56 ].
Initial studies of CBD in these models showed conflicting results: When tested over a wide range of doses in further studies, the anxiolytic effects of CBD presented a bell-shaped dose—response curve, with anxiolytic effects observed at moderate but not higher doses [ 61 , 90 ]. All further studies of acute systemic CBD without prior stress showed anxiolytic effects or no effect [ 62 , 65 ], the latter study involving intracerebroventricular rather than the intraperitoneal route.
No anxiogenic effects of acute systemic CBD dosing in models of general anxiety have yet been reported. As yet, few studies have examined chronic dosing effects of CBD in models of generalized anxiety. Anxiolytic effects in models used: Anxiolytic effects of CBD in models of generalized anxiety have been linked to specific receptor mechanisms and brain regions. The midbrain dorsal periaqueductal gray DPAG is integral to anxiety, orchestrating autonomic and behavioral responses to threat [ 91 ], and DPAG stimulation in humans produces feelings of intense distress and dread [ 92 ].
The bed nucleus of the stria terminalis BNST serves as a principal output structure of the amygdaloid complex to coordinate sustained fear responses, relevant to anxiety [ 93 ]. In the prelimbic cortex, which drives expression of fear responses via connections with the amygdala [ 94 ], CBD had more complex effects: As noted, CBD has been found to have a bell-shaped response curve, with higher doses being ineffective.
Stress is an important contributor to anxiety disorders, and traumatic stress exposure is essential to the development of PTSD. In a chronic study, systemic CBD prevented increased anxiety produced by chronic unpredictable stress, in addition to increasing hippocampal AEA; these anxiolytic effects depended upon CB 1 R activation and hippocampal neurogenesis, as demonstrated by genetic ablation techniques [ 81 ].
Finally, CBD, partially via CB 1 Rs, decreased defensive immobility and explosive escape caused by bicuculline-induced neuronal activation in the superior colliculus [ 89 ]. Several studies assessed CBD using contextual fear conditioning.
Briefly, this paradigm involves pairing a neutral context, the conditioned stimulus CS , with an aversive unconditioned stimulus US , a mild foot shock. After repeated pairings, the subject learns that the CS predicts the US, and subsequent CS presentation elicits freezing and other physiological responses.
By contrast, CBD microinjection in the infralimbic cortex enhanced conditioned freezing [ 70 ]. Finally, El Batsh et al. In this study, CBD was administered prior to conditioning rather than prior to re-exposure as in acute studies, thus further directly comparable studies are required. CBD has also been shown to enhance extinction of contextually conditioned fear responses. Extinction training involves repeated CS exposure in the absence of the US, leading to the formation of a new memory that inhibits fear responses and a decline in freezing over subsequent training sessions.
Further studies showed CB 1 Rs in the infralimbic cortex may be involved in this effect [ 82 ]. CBD also blocked reconsolidation of aversive memories in rat [ 76 ]. Briefly, fear memories, when reactivated by re-exposure retrieval , enter into a labile state in which the memory trace may either be reconsolidated or extinguished [ 97 ], and this process may be pharmacologically modulated to achieve reconsolidation blockade or extinction.
Overall, existing preclinical evidence strongly supports the potential of CBD as a treatment for anxiety disorders. Activation of 5-HT 1A Rs appears to mediate anxiolytic and panicolytic effects, in addition to reducing conditioned fear expression, although CB 1 R activation may play a limited role. While CBD predominantly has acute anxiolytic effects, some species discrepancies are apparent. In addition, effects may be contingent on prior stress and vary according to brain region.
Further receptor-specific studies may elucidate the receptor specific basis of this distinct dose response profile. Further studies are also required to establish the efficacy of CBD when administered in chronic dosing, as relatively few relevant studies exist, with mixed results, including both anxiolytic and anxiogenic outcomes.
In particular, results show potential for the treatment of multiple PTSD symptom domains, including reducing arousal and avoidance, preventing the long-term adverse effects of stress, as well as enhancing the extinction and blocking the reconsolidation of persistent fear memories. The anxiolytic effects of CBD in humans were first demonstrated in the context of reversing the anxiogenic effects of THC.
CBD reduced THC-induced anxiety when administered simultaneously with this agent, but had no effect on baseline anxiety when administered alone [ 99 , ]. Further studies using higher doses supported a lack of anxiolytic effects at baseline [ , ]. By contrast, CBD potently reduces experimentally induced anxiety or fear. CBD reduced anxiety associated with a simulated public speaking test in healthy subjects, and in subjects with SAD, showing a comparable efficacy to ipsapirone a 5-HT 1A R agonist or diazepam [ 98 , ].
CBD also reduced the presumed anticipatory anxiety associated with undergoing a single-photon emission computed tomography SPECT imaging procedure, in both healthy and SAD subjects [ , ]. Finally, CBD enhanced extinction of fear memories in healthy volunteers: These rCBF changes were not correlated with anxiolytic effects [ ]. In a series of placebo-controlled studies involving 15 healthy volunteers, Fusar-Poli et al. Response activation is diminished in PTSD and other anxiety disorders, and increased activation predicts response to treatment [ ].
CBD produced no changes in predicted areas relative to placebo but reduced activation in the left insula, superior temporal gyrus, and transverse temporal gyrus.
The fearful faces task activates the amygdala, and other medial temporal areas involved in emotion processing, and heightened amygdala response activation has been reported in anxiety disorders, including GAD and PTSD [ , ]. CBD attenuated blood-oxygen-level dependent activation in the left amygdala, and the anterior and posterior cingulate cortex in response to intensely fearful faces, and also reduced amplitude in skin conductance fluctuation, which was highly correlated with amygdala activation [ ].
Dynamic causal modeling analysis in this data set further showed CBD reduced forward functional connectivity between the amygdala and anterior cingulate cortex [ ]. Epidemiological studies of various neuropsychiatric disorders indicate that a higher CBD content in chronically consumed cannabis may protect against adverse effects of THC, including psychotic symptoms, drug cravings, memory loss, and hippocampal gray matter loss [ — ] reviewed in [ ].
As THC acutely induces anxiety, this pattern may also be evident for chronic anxiety symptoms. Two studies were identified, including an uncontrolled retrospective study in civilian patients with PTSD patients [ ], and a case study in a patient with severe sexual abuse-related PTSD [ ], which showed that chronic cannabis use significantly reduces PTSD symptoms; however, these studies did not include data on the THC: Thus, overall, no outcome data are currently available regarding the chronic effects of CBD in the treatment of anxiety symptoms, nor do any data exist regarding the potential protective effects of CBD on anxiety potentially induced by chronic THC use.
Evidence from human studies strongly supports the potential for CBD as a treatment for anxiety disorders: Limited results in healthy subjects also support the efficacy of CBD in acutely enhancing fear extinction, suggesting potential for the treatment of PTSD, or for enhancing cognitive behavioral therapy.
Also, I love how seemingly long-lasting the effects are. Whatever the case, if you suffer from anxiety, panic attacks, depression, or insomnia, I would absolutely recommend you give a quality CBD oil a shot. I was certainly not quick to buy into the whole hype machine I know that the cannabis industry is pretty crazy right now , but I can say as a first time user that it legitimately did work, and it caused absolutely no high or side effects whatsoever.
Wow much of this story really resonated with my own experiences… thank you for sharing this. Thank you for this article and for sharing. Anxiety is such a broadly used term these days. But truthfully speaking, I feel from my own personal experience that CBD can really help, and has already helped thousands and thousands of people. This is my first time using CBD. I suffer from social anxiety. Which would be a good brand to start with?
I tried a local brand and it caused Nausea. I stopped after 2 days and switched to a more trusted brand and it seems to be working. They are pretty good but I think it also depends on what you are trying to treat. I have been suffereing with anxiety for most of my life. Leave a Reply Cancel reply. Your email address will not be published. Remember me Lost your password?
Debbie R on February 5, Daniella on January 23, DJ Samuels on January 15, Patricia on January 4, They also deliver to all 50 states which is a major bonus. They actually custom the oil to help treat your medical condition. Green Roads World employees a team of physicians, chemists and other health care professionals to provide affordable and reliable medications that are dosed to perfection for each patient. This year a new brand caught our attention and while Premium Jane may be classed as the new kid on the block, they have definitely made an impact in the CBD industry.
After receiving some of their high-quality CBD for review, it was no question that we had to add them to this list as one of the top CBD brands. This brand is simply a rising star! One of our team members here at Marijuanabreak actually takes CBD oil every single day for anxiety and stress relief she usually uses PureKana , and she said that the effects of Premium Jane mg were just as potent.
They currently offer their tinctures in three different potencies , , mg and three flavors Natural Hemp, Citrus, Mint. Visit their official online store at www. Hemp Bombs is a U. S based company with their main offices located in Tampa, Florida. They have gained an amazing reputation due to their customer service and CBD formula that is extremely effective for helping to treat a wide range of medical conditions such as anxiety and pain.
Their mg bottle is an ideal solution for treating long-term pain. They avoid CBD isolates, and they always disclose lab test results to ensure there are no heavy metals or contaminants in the oil. Want to learn more about CBD Essence? The team over at Herbal Renewals, which is the company behind CBD Pure, are cannabidiol experts, and apart from providing an outstanding customer service they actually seem to care.
They specialize specifically in CBD-based products, and know their stuff inside and out. Want to learn more about CBD Pure? These guys have been around for a while. CBD Oil is currently thought of by some as the next big thing in regards to anxiety treatment. Furthermore, their reviews are outstanding. Want to view some of their top products? All CBD tinctures are not mamade equally. They come from hemp strains that have varying amounts of terpenes…some beneficial to anxiety, others not as much.
Depending on how the oil was processed and what phytochemical profile it had to begin with, will impact its affect on you. I have been using Purekana for 13 months to help with my chronic anxiety. Before discovering this brand I had smoked cannabis but found it made my symptoms much worse and I had several panic attacks. I have also been using this brand for a while. I prefer their capsules over the oils. A tincture under your tongue is the best method. I feel so relaxed lately. I was willing to try whatever to get a hold of my anxiety.
CBD has helped so much and has given me an overall sense of calm. Not to mention I am sleeping better. I have been using a CBD mg for the last 2 months. I have just started.
Honestly I thought it was all hocus pocus. So honestly at first I thought this was all hocus pocus, but I must say that I am surprised by the results. Excellent if you are looking for an alternative way to treat your condition. Wow, really helpful FAQ video there above the comments section. Must agree with Hank. Based on this article I ordered purekana.
Will keep you all posted. Hope it stays this way. Just got my order today. I deal with dizziness and anxiety on a daily basis. I was a bit scared since this is new to me and get nervous when trying something new.
Can CBD oil help anxiety?
Feb 24, I am curious to know if anyone has had success with CBD or Hemp oil helping with depression/anxiety? I've been reading a lot about it and am. CBD oil reviews for the top-selling CBD oil brands for Including best for pain, anxiety, depression, weight loss, arthritis, cancer, vaping, sleep. Looking for a CBD oil that can ease anxiety? Take a look at our step-by-step guide on hemp-derived CBD oils can help you and 3, CBD Pure Review.