What CBD Method Is Best for Anxiety?
CBD (cannabidiol) is available in the form of oils or gummies, and both have been found to be beneficial in reducing anxiety. Taking organic CBD gummies with natural ingredients is considered the best option for anxiety. CBD gummies contain melatonin, a chemical that promotes sleep and helps relieve stress and anxiety.
CBD oil is the most common form of CBD, and is another option to help reduce anxiety symptoms and soothe the nervous system. Other forms of CBD are extracts, vaporized liquids. and oil-based capsules. CBD oil drops can be taken as sublingual drops for quick relief from anxiety.
What is CBD used for?
CBD is a nonpsychoactive cannabinoid that is extracted from the plant Cannabis sativa, which is a broad-spectrum drug used to treat various neuropsychiatric disorders.
The FDA has only approved the use of CBD oil to treat two types of seizures. CBD as a treatment for anxiety-associated disorders is not regulated by the FDA.
In general, CBD is often used for the treatment of:
CBD may help relieve physical discomfort caused by:
Studies suggested that CBD contains anti-inflammatory and anti-anxiety properties, so it may be an effective treatment for anxiety. However, further studies and clinical trials are required to determine the effectiveness of the treatment.
What are the different types of CBD?
There are three types of CBD, although the extraction process similar:
- CBD isolate: Pure form of CBD without any other components of the cannabis plant. CBD is usually isolated from the cannabis plant and contains very little THC (tetrahydrocannabinol). CBD isolates are also called CBD crystals and are often crushed up and marketed as a powder. CBD isolates go through extra processing because it is to be made into a refined product.
- Full-spectrum CBD: Contains various cannabis plant extracts, such as essential oils, terpenes, and additional cannabinoids, including cannabinol. Full-spectrum CBD products may contain some THC, which causes a high. However, the amount is insufficient to produce significant psychoactive effects. Because full-spectrum CBD contains all the compounds of the cannabis plant, it is considered more effective than pure CBD, (called the entourage effect).
- Broad-spectrum CBD: Contains almost all components of the cannabis plant and very similar to full-spectrum CBD. However, broad-spectrum CBD contains less or no THC as compared to full-spectrum CBD.
What are the risks of using CBD?
Though CBD is generally regarded as safe, it may cause adverse side effects, such as:
There are various doses of CBD available in the market, but they may not be pure formulations or contain harmful substances. It is always recommended to consult a doctor before taking CBD and read labels before purchasing.
CBD FOR ANXIETY
According to W.H.O, (The World Health Organisation) 1 in 13 people around the world suffer from an anxiety disorder, making it the most common mental health disorder worldwide.
Everyone has feelings or phases of anxiety at some stage, worries about job security or relationship stress for example, are a normal part of life. But some people’s lives are more greatly impacted by anxiety and are less in control of their emotional response.
Anxiety impacts men and women of all ages, and can present in a number of forms, not limited to:
- General anxiety disorder – A wide ranging condition of general anxiety
- Social anxiety – Often extreme fear of and within social situations
- Panic disorder – Suffering with panic attacks
- Phobias – Extreme fear triggered by particular events or situations
- Post-traumatic stress disorder – Anxiety following a traumatic experience
Symptoms of anxiety differ from person to person; it is an entirely unique experience. Physical symptoms may include sleep or appetite disruption, whereas emotional symptoms may include constant worry or a feeling of a lack of control over their life.
Traditional Treatment for Anxiety
For those living with the symptoms associated with anxiety, it seems that there are limited methods of similar treatments available; powerful, prescribed anti-anxiety drugs such as Xanax or Valium, or if the symptoms are severe, perhaps anti-depressants are the best option.
All of these treatments have proven to help and relieve the symptoms of anxiety, it is the side-effects of them, such as drowsiness and fatigue, or nausea, memory problems, and addiction which drive many people to seek alternative or complementary therapies.
Why Would CBD Impact Anxiety?
It is important to note, that CBD (cannabidiol), although found in cannabis and hemp plants, is not THC. CBD does not cause feelings of high or intoxication as felt with THC and should not be considered a product to that end. What CBD is thought to do, is interact with certain receptors in the brain that help to produce Serotonin.
It is widely accepted that serotonin plays an important role in wellbeing and mental health, and is the function of many prescribed anti-anxiety drugs – This is what is leading people to CBD as a good suitable alternative option, to help with anxiety symptoms.
How Can CBD Improve Anxiety Symptoms?
The Endocannabinoid system impacts several major processes in the human body, such as sleep, mood and memory. CBD is believed to interact with these processes, stimulating your body to produce vital Endocannabinoids, that promote homeostasis. More information on the endocannabinoid system can be found here.
How to get started with CBD for Anxiety
The dosage of CBD depends on the person, and on the method chosen. Our CBD products include.
– to be administered under the tongue – to be administered topically
- CBD Capsules – to be administered orally
All our products outline recommended minimum and maximum daily dosages, after a few days of adjustment, customers usually find the right balance for them.
Clinical Research Around CBD and Anxiety
An ever-growing body of clinical research indicates CBD may help relieve anxiety, with mounting evidence pointing towards all its therapeutic benefits.
In a double-blind study from 2019, 37 Japanese teenagers with social anxiety disorders received 300 milligrams or 3%CBD Oil, or a placebo daily for four weeks. The results showed the anti-anxiety properties of CBD, reduced the symptoms aligned with the disorder.
A 2019 retrospective case study, reviewed outpatients at mental health clinic in Fort Collins, Colorado USA. 47 patients expressing concerns about anxiety, were given 25 milligram daily doses of CBD over the course of three months. At the end of the first month, 79.2% of the patients experienced an improvement in anxiety, and after two months, 78.1% of patients reported a further improvement compared to the previous month.
Despite these successful isolated tests, there is insufficient scientific evidence to support the claim that CBD is an effective treatment for depression or anxiety. We believe however, that it will not be long before a breakthrough is made, as there are many positive CBD user experiences with anxiety and depression and current clinical trials that are evaluating the potential benefits of CBD body creams, oils and other CBD products for combatting anxiety and depression.
Highs and Lows: CBD Oil for Anxiety Disorders
Almost half of all CBD users in the US use CBD to help relieve anxiety and stress. This new medication offers a potential alternative for Australian patients who experience side effects or lack of efficacy from traditional medicines prescribed for anxiety.
Quick Summary: The Highlights
- Current evidence indicates that cannabidiol (CBD) oil has considerable potential as a treatment option for multiple anxiety disorders.
- Studies show CBD oil is safe and well tolerated for short-term use, even at high doses.
- CBD oil does not cause a high that is generally associated with recreational cannabis use.
- If your regular doctor is unwilling to prescribe, you can do our quick eligibility test and book in directly with one of our doctors.
The ABCs of CBD: What Is It?
Cannabidiol (CBD) belongs to a class of molecules called cannabinoids. These are chemicals found in cannabis (marijuana and hemp) plants. 1 CBD oil contains CBD dissolved in a carrier oil. 2
How Does It Work?
The endocannabinoid system (ECS) is a complex cell-signalling system, identified in the early 1990s by researchers investigating THC (delta-9-tetrahydrocannabinol), a common cannabinoid. The system is active in your body, even if you don’t use cannabis. The ECS consists of cannabinoid receptors found throughout your body.
Our brain contains the highest number of cannabinoid receptors in the human body. CBD modulates how our brain cells behave by controlling the release of neurotransmitters (the body’s chemical messengers).
CBD can also activate non-cannabinoid receptors, such as serotonin receptors. Low levels of brain serotonin, a neurotransmitter, is associated with depression and anxiety. CBD may help the brain use serotonin more effectively in some people, although this is not yet fully understood. 3
How Is CBD Different to THC?
More than 100 different types of cannabinoids have been found in the leaves and flowers of the cannabis plant. The two most common cannabinoids used in medicinal cannabis products are CBD and THC.
While from the same class of molecules, CBD and THC work differently to one another. 4
THC may be used to reduce symptoms of nausea, vomiting, pain and muscle spasticity as well as improve sleep and appetite. In some people who take too much, THC may cause a high that is generally associated with recreational cannabis use. 5
CBD does not cause a high and may reduce the unwanted side effects of THC. 5
Evidence Snapshot: What Does the Research Say?
While more research is needed to better understand how and why CBD works in the treatment of anxiety disorders, it is relatively safe. 6 CBD could be an option for those patients who have not experienced benefits from traditional medication or have experienced side effects from these medications.
Current evidence indicates CBD has considerable potential as a short-term treatment for multiple anxiety disorders. Further studies are needed for to determine its use for long-term treatment. 7
Table 1 (below) summarises the evidence from short-term psychological studies of CBD oil for anxiety disorders. CBD was initially found to reverse the anxiety effects of THC when used together.
However, it had no effect on anxiety when used alone at the dosages given in these studies. 8,9 At higher dosages, CBD reduced anxiety associated with a simulated public speaking test in healthy adults, as well as in adults with social anxiety disorder.
It showed a comparable effectiveness to ipsapirone (a 5-HT1A agonist) or diazepam (a benzodiazepine). 10,11
CBD also reduced anxiety in patients undergoing a single-photon emission computed tomography (SPECT) imaging procedure, in both healthy adults and adults with social anxiety disorder. 12
Table 1: Evidence from short-term psychological studies of CBD oil for anxiety disorders
|Study||Measure of anxiety||Results|
|Karniol et al. 8||Anxiety and pulse rate after taking THC||Decrease subjective anxiety and pulse rate|
|Zuardi et al. 9||STAI after taking THC||Decrease in STAI scores|
|Zuardi et al. 10||VAMS, STAI and blood pressure following simulated public speaking test||Decrease in STAI scores, VAMS scores and blood pressure|
|Crippa et al. 12||VAMS||Decrease in VAMS scores|
|Bhattacharyya et al. 13||STAI and VAMS||Decrease in STAI scores and VAMS scores|
|Bergamaschi et al. 11||VAMS, SSPS-N, cognitive impairment, SCR and heart rate||Decrease in VAMS scores, SSPS-N scores and cognitive impairment; no effect on SCR or heart rate|
|Hindocha et al. 14||Baseline VAS anxiety||No significant effect|
SCR = skin conductance response; SSPS-N = negative self-evaluation subscale; STAI = Spielberger’s state trait anxiety inventory; THC = delta-9-tetrahydrocannabinol; VAMS = visual analogue mood scale
Neuroimaging studies have demonstrated modified blood flow in specific areas of the brain associated with anxiety. 12,15
CBD was also found to be effective in reducing anxiety symptoms in patients with anxiety disorders and post-traumatic stress disorder when used in combination with other pharmacological treatment and psychotherapies. 16,17
Anxiety and Depression
A study shows that CBD improve patients’ overall quality of life after 3 weeks of treatment for various conditions. Patients who received CBD for anxiety or depression specifically experienced improvements in their ability to perform daily tasks as well as a reduction in pain and anxiety or depression symptoms. 18
Post-traumatic Stress Disorder and Phobia Therapy
Studies suggest CBD decreased the severity of patients’ post-traumatic stress disorder symptoms when given alongside routine psychiatric care 16 or when given with THC. 19 When taken together with THC, an “entourage effect” occurs. This is where THC enhances the effects of CBD, while CBD counters the adverse effects of THC. 20
A study has demonstrated CBD can enhance the effects of exposure therapy. This is a kind of phobia therapy that helps patients separate certain cues with a fear response. 21
Which Anxiety Disorders Can CBD Oil Help Treat?
Existing pre-clinical evidence strongly supports CBD oil as short-term treatment for the following anxiety disorders: 7
- generalised anxiety disorder
- panic disorder
- social anxiety disorder
- obsessive compulsive disorder
- post-traumatic stress disorder.
What Is CBD Oil’s Place in Anxiety Treatment Pathways?
Anxiety is the most common mental health condition in Australia, with 1 in 4 people (1 in 3 women and 1 in 5 men) experiencing anxiety at some stage in their life. 22 There are many ways to manage anxiety. The sooner people with anxiety get support, the sooner they are likely to recover.
Currently, the main pharmacological treatments for anxiety disorders include selective serotonin reuptake inhibitors, serotonin-norepinephrine reuptake inhibitors, monoamine oxidase inhibitors, tricyclics, partial 5-hydroxytryptamine 1A (5-HT1A) receptor agonists, and benzodiazepines. 23 These medicines tend to have adverse effects and a low rate of effectiveness (in about 40 to 60% of patients). 24
Anxiety disorders may also be treated using psychological approaches, such as cognitive behavioural therapy. 24 However, these therapies can be costly and limited to specific situations. 25
CBD oil is not considered first line treatment for anxiety disorders, but may be a suitable alternative when other treatments have been unsuccessful. Evidence supports the use of CBD oil as an effective monotherapy or complementary therapy for treating anxiety disorders. 26
The therapeutic effects of CBD oil for the treatment of anxiety include the reduction of: 27
- muscular tension
- problems in concentration
- social anxiety.
Benefits vs. Risk
CBD oil can be a good alternative when other medicines aren’t working. It is well tolerated, has minimal side effects and has lots of research data strongly supporting its anxiolytic effects. 10,11
Currently, CBD oil is only available on the Pharmaceutical Benefits Scheme (PBS) for treatment of Dravet syndrome, also known as severe myoclonic epilepsy in infancy (SMEI). 28
Out of pocket costs may be high for indications not covered on the PBS. On average, patients who are using CBD oil for anxiety disorders will need to pay between $4–10 per day for their medicine.
How Do I Take CBD for Anxiety?
You can take CBD products in several ways: 29
- by using a spray into your mouth or under your tongue (orally or sublingually)
- by swallowing oils, liquid capsules or tablets (orally)
- by vaporising CBD flower – heating the flower and inhaling the vapour using a flower vaporizer device
- by vaporising CBD extract cartridges through a metered dosage device
Smoking CBD oil or flower is not recommended as it increases the risk of cancer, stroke, heart disease and other serious health conditions. 29
Taking CBD oil orally allows you to easily measure the exact dose. When taken orally, the effects of CBD begin working within 30 minutes to 2 hours. Vaping CBD results in more immediate effects. 30
You may choose to take CBD oil in the morning to relieve anxiety throughout the day, or just before a stressful event, such as giving a speech.
CBD for Anxiety Dosing
A recent review found that different studies don’t have a consensus on a single universal dosage of CBD oil that everyone should take for treatment of anxiety disorders. Rather, it highlighted that different people respond to different dosages of CBD oil. Most studies used dosages between 20 to 1,500mg per day. 6
A 2018 study found that 300mg of CBD, given 90 minutes before a simulated public speaking test, significantly reduced speakers’ anxiety. Those who received a lower dose (150mg) and higher dose (600mg) saw little benefit. 31 These results highlight how dosages can be variable and a higher dosage does not necessarily mean it is more effective.
A 2019 study tested CBD oil in lower doses (25 to 75mg/day) and found that anxiety decreased within the first month and remained low for most patients. 17
The dosage of CBD oil you should take depends on a range of factors, including:
- your weight
- the condition being treated
- the concentration of CBD in the product.
However, few commercially available CBD products contain enough CBD to replicate the therapeutic effects seen in clinical trials. 32
It is important that you speak with your doctor about the appropriate dosage and any potential risks before starting CBD oil. Generally, it Is best to start with a smaller dosage and gradually increase until the desired effect is reached (known as titrating the dosage).
Unless your doctor recommends a specific dose, start by taking 10 to 20mg a day for a week to ensure you can tolerate it and that you don’t experience any unwanted adverse effects. If the desired effect is not achieved, try increasing in increments of 5mg each week until the desired effect is reached. 33 Table 2 (below) summarises the successful dosages that studies have evaluated for anxiety relief specifically.
Table 2: Successful dosages of CBD oil evaluated for anxiety relief
|Dosage||Condition being treated|
|600mg 11||Social anxiety disorder before a simulated public speaking test|
|300mg 31||Anxiety before a simulated public speaking test|
|25 to 75mg 17||Generalised anxiety and/or sleep problems|
|33 to 49mg per day 16||Post-traumatic stress disorder, in addition to routine psychiatric treatment|
Figure 1: Successful dosages of CBD oil evaluated for anxiety relief
CBD Oil Dosing Research
More studies with standardised approaches to dosing are needed to determine the appropriate dosing strategy for CBD oil and its place in therapy. 26
Calculating CBD Oil Dosage for Anxiety
CBD oil usually comes in a dropper bottle. The packaging may specify how much CBD is in a single drop. This will allow you to determine how many drops you need.
Sometimes, it might be difficult to calculate how much CBD is in one drop because the packaging specifies the total amount of CBD in the entire bottle, not how much is in a single drop. As a rule of thumb, one drop (not the full dropper) is about 0.05mL.
For example, a 15mL bottle of CBD oil contains 300 drops. If the strength of the formulation is 30mg/mL, each drop contains 1.5mg of CBD.
When Should CBD Oil Be Taken?
You can take CBD oil with or without food. However, taking it with food (particularly a high fat, high calorie meal) can increase the level of CBD in your blood 34 and make it more effective. Because of this, you need to be consistent when you take CBD oil. Consistent dosing will minimise variability in the way the medicine works.
Is It Possible to Take Too Much CBD?
Studies have shown that dosages of up to 5,000mg a day are safe and well-tolerated. 35 However, it is important to remember that more research is needed to understand the potential long-term effects of CBD oil at these dosages.
Is CBD Oil for Anxiety Safe to Take?
Like all medicines, CBD oil can have side effects. The extent of these effects vary with the type of product and between individuals. In general, the side effects of CBD products are less than those for THC products. 5 A recent review shows that extensive research has found CBD oil to be relatively safe. 6
Known side effects of CBD include: 5
- fatigue and sedation
- dizziness (vertigo)
- nausea and vomiting
- decreased or increased appetite
- dry mouth
Continuous use of CBD oil is safe and well tolerated. 6,11 Studies show that CBD oil is well tolerated even at high doses (up to 5,000mg). 35
Contact your doctor if you experience any medicine-related side effect or adverse event.
Withdrawal and Dependence
Withdrawal symptoms from CBD oil is not associated with discontinuation and it may be stopped without gradually reducing. 35
CBD oil demonstrates no potential for abuse or dependence. 36,37
CBD oil blocks CYP3A4, an enzyme responsible for breaking down many medicines. This can increase the level of medicines in your system, resulting in unwanted or harmful side effects. There is potential for CBD oil to be associated with drug interactions through blocking this enzyme, but it is not yet clear whether these effects occur at CBD oil’s usual dosage ranges. 27
High dosages of CBD oil may increase plasma concentrations of certain epilepsy medicines such as clobazam and topiramate, while abnormal liver function test results were noted in patients taking CBD oil together with valproate. Although the observed level changes of the epilepsy medicines remained within the accepted therapeutic dosages, the study emphasises on the importance of monitoring serum antiepileptic drug levels and liver function tests during treatment with CBD oil. 38
A recent comprehensive review found that there have been reports of CBD oil interacting with epilepsy medicines, antidepressants, opioid analgesics and THC, as well as several other common medicines such as paracetamol, and substances including alcohol. 39
It is important that you speak with your doctor about any vitamins, supplements, prescription and over-the-counter medicines you are taking before starting or stopping CBD oil.
What should patients and caregivers know?
- CBD oil does not cause a high as it does not contain THC.
- Assess your sensitivity to CBD oil. Your individual ability to tolerate CBD oil can play a role in determining how much you need. Unless your doctor recommends a specific dose, start with a low dose and gradually increase until you achieve the desired effect.
- Although CBD oil may help with your anxiety, do not stop any medicines you are already using without talking to your doctor first. Suddenly stopping your prescription medicines may cause you to experience withdrawal symptoms.
- As CBD oil is not intoxicating, there are no restrictions around driving when taking products that contain only CBD. However, take care when taking products containing both CBD and THC as it is illegal to drive while you are taking THC products. 29
What Are the Next Steps?
In most states in Australia, most GPs and specialists can prescribe CBD oil. However, they will need to apply under the special access scheme.
If your doctor is unwilling to apply on your behalf or uncomfortable prescribing medical cannabis, they can refer you to our clinic. We do virtual consultations nationwide and in-person at our flagship clinic in Sydney.