Table 2.
Recent Studies Assessing the Effects of CBD on Anxiety in Humans
| Citation | Participants | CBD Dose/Route | Drug Admin-Anxiety Rating Interval | Stress Induction | Anxiety Outcome Measures | Anxiety Effects | Main Findings | Sex Differences |
|---|---|---|---|---|---|---|---|---|
| Spindle et al. 2020 [36] | Healthy adults (n=18) | 100mg CBD vs placebo; oral and vaporized. CBD-dominant cannabis (100mg CBD, 3.7mg THC) vs placebo; vaporized | 0, 0.5, 1, 1.5, 2, 3, 4, 5, 6, and 8h after oral dosing (vapor dosing occurred 1 hour after oral dosing) | N/A | VAS anxious/nervous, heart racing, relaxed, paranoid, restless | ↑ | CBD-dominant cannabis produced higher peak ratings for heart racing relative to placebo and vaporized CBD | ns |
| Bloomfield et al. 2022 [37] | Healthy adults (n=24) | 600mg CBD vs placebo; oral | 6 hours | Mental arithmetic task | VAS anxious, HR, BP | - | No significant drug effects found for ratings of anxiety, HR or BP | Not assessed |
| Linares et al. 2019 [38] | Healthy adult men (n=57) | 150mg, 300mg, 600mg CBD vs placebo; oral | 90, 104, 117, 125 and 155 mins | Simulated public speaking test (SPST) | VAMS anxiety factor, HR, BP | ↓ | 300mg CBD was associated with significantly lower anxiety during stress induction relative to placebo | N/A |
| Crippa et al. 2022 [39] | Healthy adult men (n=45) | 150mg CBD (Powder and dissolved in corn oil) vs placebo; oral |
30, 60, 90, 120, 150, 180, and 240 mins | Simulated public speaking test (SPST) | VAMS anxiety factor, HR, BP | - | No significant differences observed across groups | N/A |
| Stanely et al. 2022 [40] | Healthy college students (n=32) | 150mg, 300mg, 600mg CBD vs placebo; oral | 66, 84, and 104 mins | Statistics exam | VAS state test anxiety, VAMS, STAI-state, somatic anxiety symptom scale | - | No significant effects of CBD on anxiety measures | Not assessed |
| CBD for Anxiety Disorders | ||||||||
| Masataka et al. 2019 [41] | Japanese teenagers with social anxiety disorder and avoidant personality disorder (n=37) | 300mg CBD vs placebo; daily oral admin for 4 weeks | 4 weeks | N/A | Fear of Negative Evaluation Questionnaire, Liebowitz Social Anxiety Scale | ↓ | Individuals in the CBD group reported significantly lower anxiety on both scales | Not assessed |
| Bolsoni et al. 2022 [42] | Adults with PTSD (n=33) | 300mg CBD vs placebo; oral | 90 mins | Trauma recall paradigm | VAMS, BP, HR, cortisol | ↓/- | Among individuals with nonsexual trauma (n=19), differences in VAMS anxiety before and after trauma recall were significantly smaller following CBD vs placebo; this difference was not significant among individuals with sexual trauma (n=16) | ns |
| Kwee et al. 2022 [43] | Adults with SAD or PD with agoraphobia (n=80) | 300mg CBD vs placebo 2 hours prior to 8 90-min therapist-assisted augmented exposure in vivo sessions; oral | Change from baseline to post-treatment | N/A | FQ, BAI | - | No difference in treatment outcome between individuals receiving CBD vs placebo | Not assessed |
| Berger et al. 2022 [44] | Young people (aged 12–25) with an anxiety disorder and no clinical improvement from CBT and/or antidepressant (n=31) | Fixed-flexible dosing schedule from 200–800mg/d CBD as add-on treatment for 12 weeks; oral | Change from baseline to post-treatment | N/A | OASIS | ↓ | OASIS scores decreased significantly across 12-week treatment period; no placebo control | Not assessed |
| CBD for Substance Use Disorders | ||||||||
| Hurd et al. 2019 [45] | Adults with heroin use disorder (n=42) | 400mg, 800mg CBD vs placebo for 3 days; oral | 118 mins, ~24 hours, 7 days after 3rd daily dose | Drug-cue exposure paradigm on day 1, 2 and 7 | VAS anxiety, BP, HR, cortisol | ↓ | CBD associated with significant reduction in drug-cue induced anxiety | Not assessed |
| Freeman et al. 2020 [46] | Adolescents and adults with cannabis use disorder (n=82) | 200mg, 400mg, 800mg CBD vs placebo daily for 4 weeks; oral | 4 weeks (post-treatment), 24 weeks (end of follow-up) | N/A | BAI | ↓ | 800mg CBD associated with significant reduction in anxiety during treatment and follow-up | Not assessed |
| Mongeau-Perusse et al. 2022 [47] | Adults with current cocaine use disorder (n=78) | 800mg CBD vs placebo for 92 days; oral | Every 2 days for 10 days, every 2 weeks for another 12 weeks | N/A | VAS anxiety, BAI | - | No group differences in anxiety | Not assessed |
| Meneses-Gaya et al. 2021 [48] | Adult men with crack-cocaine dependence (n=31) | 300mg CBD vs placebo for 10 days; oral | 10 days (post-treatment) | N/A | BAI | - | No group differences in anxiety | N/A |
| CBD for Other Clinical Populations | ||||||||
| de Faria et al. 2020 [49] | Adults with Parkinson’s disease (n=24) | 300mg CBD vs placebo; oral | 90 mins | Simulated public speaking test (SPST) | VAMS, BP, HR, Self-Statements During Public Speaking Scale | ↓ | CBD associated with significantly lower task-induced anxiety | Not assessed |
| Appiah-Kusi et al. 2020 [50] | Individuals at clinical high risk for psychosis (n=32) | 600mg CBD vs placebo for 1 week; oral | 8 days | Trier Social Stress Test (TSST) | STAI (state), cortisol | - | No significant difference in anxiety between CHR groups following CBD vs placebo treatment | Not assessed |
| Hundal et al. 2018 [51] | Individuals with high paranoid traits (n=32) | 600mg CBD vs placebo; oral | 130 mins | 3D virtual-reality paradigm that simulates being on London Underground train | BAI, University of Wales Mood Adjective Checklist, cortisol, HR, BP | - | No group differences in anxiety | Not assessed |
| Shannon et al. 2019 [52] | Diverse psychiatric patients presenting with primary anxiety and/or sleep concerns (n=72) | 25–175mg CBD daily (majority on 25mg dose) as adjunct to treatment as usual; oral | Monthly | N/A | Hamilton Anxiety Rating Scale | ↓ | Anxiety scored decreased within first month and remained decreased for duration of study for majority of patients; no control condition | Not assessed |
Abbreviations: ↑=anxiogenic; ↓=anxiolytic; -=no effect; AUC=area under the curve; BAI=Beck Anxiety Inventory; BP=blood pressure; CBD=cannabidiol; CBT=cognitive behavioral therapy; DEQ=drug effects questionnaire; FQ=fear questionnaire; HR=heart rate; IV=intravenous; mg=milligrams; ns=not significant; N/A=not applicable; OASIS=Overall Anxiety Severity and Impairment Scale; PD=panic disorder; POMS=Profile of Mood States; PTSD=post-traumatic stress disorder; SAD=social anxiety disorder; STAI=state-trait anxiety inventory; THC= Delta-9-tetrahydrocannabinol; VAMS=visual analogue mood scale; VAS=visual analogue scale