Medicinal Cannabis for the Treatment of Anxiety Disorders: a Narrative Review

Summary & key facts

This paper is a review of research about using medicinal cannabis for anxiety disorders. The authors looked at studies about the cannabis ingredients THC, CBD and aromatic compounds called terpenes. They explain how these chemicals work on the brain’s endocannabinoid system and how CBD often shows calming effects while THC can either calm or worsen anxiety depending on dose, how it’s taken, and individual differences. The main takeaway is that we still do not have reliable, standardized evidence about the right doses or CBD-to-THC mixes to treat anxiety, so more careful human trials and patient data are needed.

Key facts:

• Anxiety disorders are common and have complex causes, and current medicines (like antidepressants and benzodiazepines) can have limits in how well they work and in safety for some people.
• Cannabis contains different active parts: THC, CBD, and terpenes. These act on the body’s endocannabinoid system, which affects mood and other brain functions.
• CBD has been suggested to reduce anxiety in some studies, meaning it may have calming effects for some people.
• THC can have two opposite effects: at some doses or in some people it may reduce anxiety, while in others or at other doses it may increase anxiety. How it’s taken and a person’s genes or environment can change the effect.
• There is some evidence that terpenes (aromatic chemicals in cannabis) could help with anxiety, but the research is not strong or consistent yet.
• Right now, there is a gap in the evidence. We do not have clear, standardized human trial results that tell us the exact doses or the best CBD-to-THC ratios to use for anxiety disorders.

Abstract

Abstract Purpose of review Anxiety is a prevalent mental health condition which manifests as a disproportionate response of fear to a perceived threat. Different types of anxiety disorders vary in their pathophysiology, symptoms and treatments. The causes of anxiety disorders are complex and largely unknown; however, it has been suggested that a number of brain mechanisms and neurotransmitters are involved in the development of these conditions. While there are non-pharmacological treatments for anxiety, many patients are prescribed medications such as selective serotonin reuptake inhibitors, serotonin and noradrenaline reuptake inhibitors and/or benzodiazepines. Unfortunately, these medications have issues with efficacy and safety, and therefore, there is a continuing need for newer medicines. The cannabis constituents of tetrahydrocannabinol (THC), cannabidiol (CBD) and terpenes have been proposed as a potential treatment for anxiety conditions. Recent findings Medicinal cannabis constituents act on the endocannabinoid system (ECS) and other targets. The ECS affects several physiological functions through modulation of the central nervous system and inflammatory pathways. In particular, CBD has been suggested to exhibit anxiolytic properties, whereas THC can either have an anxiogenic or anxiolytic effect, depending on the dose, route of administration and individual genetic and environmental factors. There is also evidence that terpenes could be effective in anxiety management. Summary Currently, there is a gap in the literature as to whether standardised CBD and/or THC preparations can be used for anxiety disorders. Further information is required to know the precise doses and CBD-THC ratios from human clinical trials and real-world patient use.

Topics

Cannabis and Cannabinoid Research Neurotransmitter Receptor Influence on Behavior Sleep and Wakefulness Research

Categories

Health Sciences Medicine Pharmacology

Tags

Anti-Anxiety Agents Anxiety Anxiogenic Anxiolytic Cannabidiol Cannabis Endocannabinoid system Internal medicine Medicine Pharmacology Psychiatry Psychology Receptor

Substances

Cannabis

Conditions & symptoms

Anxiety Anxiety or worry Panic