CBD Oil For Anxiety

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Here’s what science says regarding CBD’s anxiolytic—or anxiety relief—properties, along with experts’ dosage guidelines and advice on how to take CBD safely. Despite some claims, there’s no scientific evidence that conclusively proves that CBD can help relieve anxiety.

How To Use CBD To Help Alleviate Anxiety

Dr. Bindiya Gandhi is an integrative medicine physician with expertise in functional and holistic medicine based in Atlanta, Georgia.

Commissions we earn from partner links on this page do not affect our opinions or evaluations. Our editorial content is based on thorough research and guidance from the Forbes Health Advisory Board.

Table of Contents

  • CBD for Anxiety
  • How to Use CBD for Anxiety
  • CBD Dosage for Anxiety
  • Potential Risks and Side Effects

While delta-9-tetrahydrocannabinol (THC) can have a bad rap for being intoxicating and anxiety-inducing, cannabidiol (CBD) can actually be used to relieve anxiety. Research supports this benefit, with several studies reinforcing the positive effects CBD can have on various anxiety conditions. In fact, 51% of U.S. adults who use CBD do so to help alleviate their anxiety, according to a recent Forbes Health survey of 2,000 U.S. adults conducted by OnePoll.

CBD isn’t yet legally cleared as an anxiolytic, or anxiety relief medication. Therefore, it’s up to you—and, ideally, a doctor who specializes in cannabis administration—to determine whether CBD is a safe treatment for your anxiety.

Here’s what the science says regarding CBD’s anxiolytic properties, along with experts’ dosage guidelines and advice on how to take CBD safely.

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CBD for Anxiety

The Food and Drug Administration (FDA) has yet to approve any CBD-based medications for anxiety. However, many studies indicate the substance can be an effective anxiolytic.

CBD for Generalized Anxiety

In 2011, a small trial-tested CBD on participants with generalized social anxiety disorder (SAD) and healthy control patients undergoing a simulated public speaking test (SPST), which is a common anxiety testing method [1] Bergamaschi MM, Queiroz RH, Chagas MH, et al. Cannabidiol reduces the anxiety induced by simulated public speaking in treatment-naïve social phobia patients. Neuropsychopharmacology. 2011;36(6):1219-1226. . Compared to a placebo, CBD significantly reduced anxiety and discomfort in the participants with SAD. In fact, their reduced anxiety levels were comparable to those of the control participants.

Eight years later, a 2019 test compared the efficacy of three CBD doses (150 milligrams, 300 milligrams and 600 milligrams) and a placebo in men taking an SPST [2] Linares IM, Zuardi AW, Pereira LC, et al. Cannabidiol presents an inverted U-shaped dose-response curve in a simulated public speaking test. Revista brasileira de psiquiatria (Sao Paulo, Brazil : 1999). 2019;41(1):9-14. . Compared to a placebo, 300 milligrams of CBD significantly reduced participants’ anxiety during the speech, but the 150-milligram and 600-milligram doses did not. These results highlight how dosage can be highly variable and that more CBD isn’t necessarily more effective.

Meanwhile, another 2019 study tested CBD in much lower doses than most other clinical studies—some participants consumed 25 milligrams a day while others consumed 50 milligrams or 75 milligrams a day [3] Shannon S, Lewis N, Lee H, Hughes S. Cannabidiol in Anxiety and Sleep: A Large Case Series. Perm J. 2019;23:18-041. . Researchers thought higher doses might be too expensive for participants to maintain in their normal lives and that low doses would still prove effective. Indeed, anxiety decreased within the first month for most participants and remained low. Sleep quality also improved, although it fluctuated more than anxiety. Only three patients reported side effects.

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CBD for Anxiety and Depression

In 2020, researchers tested the effects of CBD oil at varying doses across 397 patients with a variety of ailments [4] Gulbransen G, Xu W, Arroll B. Cannabidiol prescription in clinical practice: an audit on the first 400 patients in New Zealand. BJGP Open. 2020;4(1):bjgpopen20X101010. . Participants with non-cancer pain or mental health-related symptoms experienced significant improvement in anxiety and depression, as well as in their abilities to complete their usual activities. The use of CBD oil suggested significant pain relief in these groups as well.

CBD for PTSD and Phobia Therapy

A small 2019 study of 11 patients found that, when consumed orally and administered alongside routine psychiatric care, CBD decreased patients’ posttraumatic stress disorder (PTSD) symptom severity [5] Elms L, Shannon S, Hughes S, Lewis N. Cannabidiol in the Treatment of Post-Traumatic Stress Disorder: A Case Series. J Altern Complement Med. 2019;25(4):392-397. .

Other studies suggest CBD can reduce PTSD symptoms when consumed with THC [6] Bitencourt RM, Takahashi RN. Cannabidiol as a Therapeutic Alternative for Post-traumatic Stress Disorder: From Bench Research to Confirmation in Human Trials. Front Neurosci. 2018;12:502. . When taken together, the two compounds create what’s known as the “entourage effect,” where THC enhances the effects of CBD as CBD tempers the effects of THC, resulting in a more well-rounded experience [7] Ferber SG, Namdar D, Hen-Shoval D, et al. The “Entourage Effect”. Terpenes Coupled with Cannabinoids for the Treatment of Mood Disorders and Anxiety Disorders. Curr Neuropharmacol. 2020;18(2):87-96. .

Some studies also suggest CBD can enhance the effects of exposure therapy—which assists patients in dissociating certain cues with a fear response—and cognitive behavioral therapy [8] Das RK, Kamboj SK, Ramadas M, et al. Cannabidiol enhances consolidation of explicit fear extinction in humans. Psychopharmacology (Berl). 2013;226(4):781-792. [9] Blessing EM, Steenkamp MM, Manzanares J, Marmar CR. Cannabidiol as a Potential Treatment for Anxiety Disorders. Neurotherapeutics. 2015;12(4):825-836. .

How to Use CBD for Anxiety

Without clear FDA guidance, optimal CBD use for anxiety varies from person to person. You may find one method works better for you over another. You can consume CBD in the following forms:

  • Oils and tinctures, which come in dropper bottles and are consumed by mouth
  • Gummies, which are chewable, sweet and often fruit-flavored
  • Sprays, which come in bottles with a nozzle to be sprayed in the mouth
  • Capsules, softgels or tablets, which are taken individually by mouth like a pill
  • Vapes, which heat CBD oil without igniting it, resulting in an inhalable vapor
  • Flowers, which are dried hemp plants that are typically ignited and smoked
  • Creams and gels, which introduce CBD topically (through the skin) as a more localized treatment

You may have to try different forms to determine what works best in addressing your anxiety. For instance, when it comes to the absorption of CBD in your bloodstream, vaping and smoking are more effective than edibles like gummies.

CBD Dosage for Anxiety

You also have to find the right CBD dosage for your anxiety. Experts suggest starting small and working your way up depending on how your body reacts.

Many clinical trials jump right to testing high doses. Successful doses evaluated for anxiety relief specifically include:

  • 600 milligrams in patients with SAD in a speech simulation [10] Bergamaschi MM, Queiroz RH, Chagas MH, et al. Cannabidiol reduces the anxiety induced by simulated public speaking in treatment-naïve social phobia patients. Neuropsychopharmacology. 2011;36(6):1219-1226.
  • 300 milligrams in male patients in a speech simulation [11] Linares IM, Zuardi AW, Pereira LC, et al. Cannabidiol presents an inverted U-shaped dose-response curve in a simulated public speaking test. Revista brasileira de psiquiatria (Sao Paulo, Brazil : 1999). 2019;41(1):9-14.
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However, other trials suggest much lower doses are also quite effective in treating anxiety.

  • 25 to 75 milligrams for generalized anxiety and/or sleep problems [12] Shannon S, Lewis N, Lee H, Hughes S. Cannabidiol in Anxiety and Sleep: A Large Case Series. Perm J. 2019;23:18-041.
  • 33 to 49 milligrams a day for PTSD, in addition to routine psychiatric treatment [13] Elms L, Shannon S, Hughes S, Lewis N. Cannabidiol in the Treatment of Post-Traumatic Stress Disorder: A Case Series. J Altern Complement Med. 2019;25(4):392-397.

Another study involving hundreds of patients noted success with doses from 40 milligrams to 300 milligrams a day, further supporting the idea that CBD dosage varies significantly, depending on a person’s symptoms and physiology.

Potential Risks and Side Effects

The World Health Organization deems CBD a safe and generally well-tolerated substance. Studies report very few adverse effects, if any.

However, taking CBD while on other medications may pose a risk, as these substances may interact and cause unwanted effects, such as weight gain, drowsiness, upset stomach and change in appetite.

Cheryl Bugailiskis, M.D., a cannabis specialist at Heally, a telehealth platform for alternative medicine, also warns people with preexisting liver injuries and people taking medications that can cause liver injuries should practice caution when using CBD.

Does CBD Help With Anxiety?

It’s likely that in the last few years, you’ve come across a lot of discussion and anecdotes about cannabidiol, also known as CBD. Availability and sales of CBD have exploded across the U.S. since it became legalized on the federal level and is now legal in most states.

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You can find CBD on shelves in many stores, with various brands promoting benefits that range from alleviating pain to aiding sleep. It also comes in many forms like CBD gummies, CBD oils, CBD lotions and even CBD-infused sodas. And one big claim CBD supporters tout is its ability to relieve anxiety, a feeling many of us have experienced over the last few years thanks in part to the COVID-19 pandemic.

But not all CBD is created equally, and the truth about the benefits is kind of, well, complicated. To dig deeper into whether or not CBD actually curbs anxiety and what else you should know before trying it, we spoke to psychiatrist David Streem, MD.

What is CBD?

“CBD is one of the chemicals present in cannabis-containing plants,” explains Dr. Streem. CBD mostly comes from hemp and, notably, contains very small traces of tetrahydrocannabinol (THC), the psychoactive ingredient that causes the “high” in marijuana. In fact, the U.S. government limits hemp-derived products from having a THC content of more than 0.3%.

As far as proven health benefits, there has been some evidence that CBD might serve as a treatment for chronic pain, but data is still mixed. More substantially, though, Dr. Streem says, “CBD has particular health benefits that have been demonstrated in scientific studies and it’s the active ingredient in an FDA-approved medication for the treatment of particular childhood seizure disorders.”

Specifically, he notes that CBD has shown benefits for children experiencing Lennox-Gastaut and Dravet syndromes, both rare conditions. “In these cases, the more common seizure medications don’t work very well.” CBD is part of a treatment package that includes other medications and even brain surgery.

Does CBD really help curb anxiety?

In short, no. CBD probably doesn’t help curb anxiety the way advertisements or anecdotal evidence claim. “The science isn’t there yet,” says Dr. Streem, adding that while there are scientific studies backing the use of CBD for the previously mentioned seizure conditions, no such high-quality data exists for CBD and anxiety yet.

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And if you’re waiting on those studies to turn out evidence, get comfortable. As Dr. Streem notes, studies that yield the necessary data are difficult for researchers to conduct for two reasons.

A lack of oversight

The first is government oversight and federal laws that make research into cannabinoids, including marijuana, difficult. While the number of states that have legalized some form of marijuana — whether for medical or recreational use — has dramatically increased in recent years, cannabis containing THC remains illegal on a federal level.

The U.S. Food and Drug Administration (FDA) also has its hands full trying to regulate it. Many states allow selling CBD over-the-counter as a dietary supplement even though that’s, technically, against FDA regulations. The FDA has warned dozens of companies about this practice but, so far, little has been done to change these practices. Dr. Streem says, “The FDA has to have evidence that there’s a safety risk before they can intervene.”

That overlaps with the second issue with CBD, which is a troubling lack of quality control. You can buy CBD just about anywhere now, from boutiques that specialize in CBD to your corner convenience store. But not all CBD is created equally, and neither is the labeling.

A 2017 study published in the Journal of the American Medical Association (JAMA) tested 84 CBD products from 31 different companies and found that 26% had less CBD than claimed on their respective labels, while 43% had more CBD than claimed on their labels.

Just as troubling, Dr. Streem points out that a number of the tested products had what he calls “relevant amounts of THC.” In other words, enough THC to trigger a positive on a drug test even if the label said there wasn’t any THC in their oil. And if you ingest CBD with a certain amount of THC, you’re also subject to the side effects, including delusions and hallucinations. Plus, there’s a chance these effects won’t go away when the effects of the drug wear off.

Risks of taking CBD

If you’re thinking of trying CBD without consulting with your healthcare provider, Dr. Streem has a simple response: Don’t. It’s about the unknowns, including the unregulated nature of most products and the possible inclusion of enough THC to flag a drug test.

“Trying a CBD product with consultation from your doctor is less risky,” advises Dr. Streem, “but you should still be aware of how the product makes you feel. If it makes you feel strange at all, stop using that product immediately.”

He continues, “If you could confirm that a product had no THC and had a CBD percentage close to what the label claims, there’s little concern it would do any harm regardless of the benefits. But that’s not what we’re dealing with right now.”

The bottom line

While data shows there are some benefits of using CBD in certain medically approved settings, for now, the scientific evidence just isn’t there for using CBD to help with anxiety, concludes Dr. Streem. Trying over-the-counter products without more stringent regulation carries more risk than reward.

Cleveland Clinic is a non-profit academic medical center. Advertising on our site helps support our mission. We do not endorse non-Cleveland Clinic products or services. Policy

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