The proven effects of CBD continued:

We still have a lot to learn about what the best way is to use CBD to reduce anxiety, but what data we do have is very promising!

Anxiety disorders are the most common type of psychiatric disorders, with a lifetime prevalence of up to 33.7%, and double the prevalence in women compared to men.

Generalized anxiety disorder is characterized by excessive and difficult-to-control anxiety and worry. The condition is associated with at least 3 of the following 6 symptoms occurring more days than not for at least 6 months: restlessness, fatigue, difficulty concentrating, irritability, muscle tension, and sleep disturbance.

Social anxiety disorder is characterized by impaired function due to excessive fear of social or performance situations and includes avoidance behavior, anticipation, and distress.

While there is some evidence that CBD can relieve anxiety, we still have a lot to learn about which patients will benefit and how much CBD is optimal.

First of all, we know for sure that CBD can reduce the anxiety caused by high doses of THC. (I know this from personal experience because I have a very high sensitivity to THC). This is likely because of CBD's ability to decrease CB1 receptor signaling, but may not apply to other types of non-THC-induced anxiety.

Many studies have examined a single, high dose of CBD given before a stressful experience, typically a public speaking test. These small studies have shown that high doses of CBD can decrease anxiety during or shortly after the speech in healthy subjects and those with anxiety disorders. However, this data may not be the same to people trying to deal with daily, ongoing symptoms of anxiety. Interestingly, in two of the trials, 300mg of CBD seemed to work better than 100mg, 150mg, 600mg, or 900mg single doses.

Several other studies have tested the effectiveness of high-dose CBD before other stressors, like cannula insertion, electric shocks, and anxiety-provoking visual and auditory stimulation. These studies had mixed results, but in general did not show a strong benefit.

A recent large case series from Colorado found that taking 25-175mg of CBD per day reduced anxiety scores in 57 of 72 patients. Despite the absence of a control group, It’s believed this data is more relevant than some of the others because it measured daily anxiety scores, not just those related to a stressful siuation, and the dosing was more realistic (and affordable). Most patients used only 25mg, and more than half reported benefit.

Another recent case study from Colorado showed improvements in PTSD symptoms in 10 out of 11 patients who were followed for 8 weeks. The average dose of CBD was approximately 50mg daily, and the average decrease in symptom severity was 28%.

All in all, CBD may benefit some people with anxiety disorders, and it may help people decrease anxiety associated with episodic, stressful situations. It’s recommended that a dosing range of 20-300mg per day in these cases. CBD is certainly safer than benzodiazepine drugs like Ativan or Valium, and if it works, it will likely work faster than SSRI antidepressants. It’s also believed that many patients who don't respond well to CBD-dominant treatments could find more relief with combination CBD + THC.

So keep in mind:

CBD has biphasic dose-response effects related to anxiety;( higher doses may be less effective than moderate doses).

CBD-dominant cannabis can likely help some patients with both chronic and episodic anxiety symptoms. One case series showed that nearly 80% of patients experienced some benefit.

CBD is safer and acts faster than other drugs typically used to reduce anxiety. 

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