Anxiety and CBD
Anxiety and CBD
Anxiety

Anxiety is an adaptive, emotional response that naturally occurs as a result of a perceived threat, without which individual survival would be impossible. However, it can become a problem when it occurs excessively or inappropriately and keeps the affected individual from leading a normal life [1],[2]. Anxiety can refer to several disorders:

 - Generalized anxiety disorder (GAD)

 - Panic disorder;

 - Social anxiety disorder (SAD);

 - Specific phobias;

 - Separation anxiety disorder;

 - Obsessive-compulsive disorder (OCD);

 - Post-traumatic stress disorder (PTSD).


OCD and PTSD make up the two most common psychiatric conditions in the U.S. [3]. 


Anxiety disorders can be treated with psychotherapy, drugs, or both. The medications used depend on the specific condition and its severity. The most common pharmacological groups are selective serotonin reuptake inhibitors (SSRIs), serotonin-norepinephrine reuptake inhibitors (SNRIs), MAO inhibitors, and tricyclic antidepressants (TCA) [1]. The limited response rates, as well as the adverse effects accompanying these therapies [4],[5], are pushing the scientific community to develop novel pharmaceutical treatments for the management of anxiety. 

CBD and Anxiety

Preclinical data suggest that CBD could be used to treat anxiety disorders. Its anti-anxiety effects are directly linked to the activation of CB1 receptors and 5-HT1A receptors in various brain regions, although further investigations may reveal a more in-depth mechanism of action. Human experimental findings support these results, suggesting that CBD lacks anxiogenic effects, has minimal sedative effects, and has an overall favorable safety profile. However, these studies only looked at the short-term effects of CBD on anxiety, and more research is needed on longer-term CBD use [6].

Dosing recommendations for anxiety

Is CBD safe? 

Yes. CBD is considered safe for anxiety treatment. 

What is the recommended daily dose? 

Start with 1 mg/kg/day and titrate to effect - as high as 7.5 mg/kg/day. Consult higher doses with your doctor. Read General recommendations

Should I take it before or after a meal? 

CBD should be taken during, or after a meal. 

How many times a day should I take CBD? 

Take your dose twice
a day. Half of it in the morning and the other half in the evening. 

Are there any known drug interactions? 

Some. Read Side effects for more information. 

Bibliography

1. Ströhle A, Gensichen J and Domschke K: The Diagnosis and Treatment of Anxiety Disorders. Dtsch Arztebl Int 155: 611-620, 2018. 

2. Tovote P, Fadok JP and Lüthi A: Neuronal circuits for fear and anxiety. Nature reviews Neuroscience 16: 317-331, 2015. 

3. Kessler RC, Berglund P, Demler O, Jin R, Merikangas KR and Walters EE: Lifetime prevalence and age-of-onset distributions of DSM-IV disorders in the National Comorbidity Survey Replication. Archives of general psychiatry 62: 593-602, 2005. 

4. Shin HJ, Greenbaum MA, Jain S and Rosen CS: Associations of psychotherapy dose and SSRI or SNRI refills with mental health outcomes among veterans with PTSD. Psychiatric services (Washington, DC) 65: 1244-1248, 2014. 

5. Otto MW, Tuby KS, Gould RA, McLean RY and Pollack MH: An effect-size analysis of the relative efficacy and tolerability of serotonin selective reuptake inhibitors for panic disorder. The American journal of psychiatry 158: 1989-1992, 2001. 

6. Blessing EM, Steenkamp MM, Manzanares J and Marmar CR: Cannabidiol as a Potential Treatment for Anxiety Disorders. Neurotherapeutics 12: 825-836, 2015.