Learn how cannabidiol (CBD) helps treat anxiety and how growing studies in the medical community are proving it's legitimacy as a treatment option. with anxiety, CBD oil is touted as an all-natural way to find relief. use it to treat more serious conditions like generalized anxiety disorder. Notably, PTSD and OCD are no longer classified as anxiety disorders in the recent .. By contrast, CBD potently reduces experimentally induced anxiety or fear.
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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.
Further studies are also required to establish whether chronic, in addition to acute CBD dosing is anxiolytic in human. Human experimental findings support preclinical findings, and also suggest a lack of anxiogenic effects, minimal sedative effects, and an excellent safety profile. Overall, this review emphasizes the potential value and need for further study of CBD in the treatment of anxiety disorders. Disclosure forms provided by the authors are available with the online version of this article.
National Center for Biotechnology Information , U. Journal List Neurotherapeutics v. Published online Sep 4. Blessing , 1 Maria M. Steenkamp , 1 Jorge Manzanares , 1, 2 and Charles R. Author information Copyright and License information Disclaimer. This article has been cited by other articles in PMC. Abstract Cannabidiol CBD , a Cannabis sativa constituent, is a pharmacologically broad-spectrum drug that in recent years has drawn increasing interest as a treatment for a range of neuropsychiatric disorders.
Electronic supplementary material The online version of this article doi: Cannabidiol, Endocannabinoids, Anxiety, Generalized anxiety disorder, Post-traumatic stress disorder. Introduction Fear and anxiety are adaptive responses essential to coping with threats to survival.
CBD Pharmacology Relevant to Anxiety General Pharmacology and Therapeutic Profile Cannabis sativa , a species of the Cannabis genus of flowering plants, is one of the most frequently used illicit recreational substances in Western culture. Table 1 Preclinical studies. Open in a separate window. Effective doses are in bold Receptor specific agents: Stress-induced Anxiety Models Stress is an important contributor to anxiety disorders, and traumatic stress exposure is essential to the development of PTSD.
Summary and Clinical Relevance Overall, existing preclinical evidence strongly supports the potential of CBD as a treatment for anxiety disorders.
Table 2 Human psychological studies. Table 3 Neuroimaging studies. Evidence from Epidemiological and Chronic Studies 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 [ ].
Summary and Clinical Relevance Evidence from human studies strongly supports the potential for CBD as a treatment for anxiety disorders: Electronic supplementary material Below is the link to the electronic supplementary material.
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Leafly operates in compliance with state laws regarding access to cannabis. If you keep seeing this age prompt whenever you visit Leafly. These responses help us recognize and avert potential threats; they can also help motivate us to take action to better our situation work harder, pay bills, improve relationships, etc. This can lead to clinically diagnosable anxiety-related disorders. In response, Big Pharma has developed numerous drugs to treat anxiety-related disorders, from selective serotonin reuptake inhibitors SSRIs like Prozac and Zoloft to tranquilizers the most popular class being benzodiazepines such as Valium and Xanax.
Moreover, tranquilizers like Valium and Xanax can be highly addictive. Clearly, alternative treatments are warranted.
Could cannabidiol CBD , the most prominent non-intoxicating constituent in cannabis, provide a viable alternative for currently available anxiety medications? In recent years, CBD has generated a tremendous amount of interest among consumers, clinicians, and scientists. CBD exerts several actions in the brain that explain why it could be effective in treating anxiety. However, preclinical studies provide insights that move us in the right direction:. SSRIs work by blocking reabsorption of serotonin in the brain, which increases availability of serotonin in the synaptic space.
This helps brain cells transmit more serotonin signals, which can reduce anxiety and boost mood in certain cases although the full biological basis for this is more complicated and not fully understood. The hippocampus is a major brain area, and plays a critical role in a variety of brain functions. Brain scans of patients suffering from depression or anxiety often show a smaller hippocampus, and successful treatment of depression is associated with the birth of new neurons neurogenesis in the hippocampus.
An animal study using mice found repeated administration of CBD may help the hippocampus regenerate neurons, which could be useful for treating anxiety or depression. This is significant, because evidence suggests that severely impaired neuronal plasticity may influence suicidal behavior. Future research comparing CBD and SSRIs effect on neurogenesis could open up promising new avenues in how we understand depression and how to most effectively treat it. Building on the foundation of animal studies, human studies are starting to provide evidence to demonstrate that CBD can improve many commonly reported anxiety-disorder symptoms, including acute stress and anxiety.
Brazilian researchers conducted a small double-blind study of patients afflicted with generalized social anxiety. After consuming CBD, participants reported a significant decrease in anxiety.
In another small study , researchers had patients suffering from Social Anxiety Disorder perform a simulated public speaking test. Participants reported significantly less anxiety, findings supported by objective anxiety indicators like heart rate and blood pressure. Given the huge social and financial costs of anxiety disorders in the U. We are here to help, offering discounts on products to students, students, members of the armed services and more.
Why get high when all you want to do is get healthy! Truly on the planet as a gift from God! More research info videos and to order HempHealthNews. Just wanted to thank whomever it was that recommended Medical Cannabis. Thanks to Dr Megan. You can reach her via dr. Good delivery service too. Can you tell me what specific product you use for your migraines? These products have worked wonders for my anxiety and i would recommend http: I sell CBD oil with Kannaway https: Yes Zoloft helped me with anxiety related to PTSD but CBD helped with that and got me healthy and less foggy and more energy and able to sleep… the list goes on and on.
Everyone needs CBD oils. Has anyone done any comparisons of CBD oil products so that we can know which are highest quality? WOW mg a day? How much CBD are you getting in that?
How Cannabidiol (CBD) Works for Treating Anxiety
These may bind to receptors in the brain to help relieve symptoms of Because CBD oil is not regulated as a medical treatment for anxiety, it is. CBD is a great, natural way to reduce the anxiety symptoms that have destroyed the lives of so CBD relieves physical symptoms of anxiety. There is already good evidence of CBD's usefulness for treating generalized anxiety disorder, panic disorder, social anxiety disorder.