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Cannabidiol, or CBD – the non-psychoactive component in cannabis – could be a promising therapy for treatment-resistant anxiety in adolescents and young adults, a new Australian study shows.
After 12 weeks of CBD treatment, study participants ages 12 to 25 reported an average 42.6% reduction in anxiety severity and impairment compared to pre-treatment, the research led by Australian youth mental health service provider and research institute Orygen found. Study participants took between 200 and 800mg of CBD per day, depending on observed effectiveness.
The study was published today in the Journal of Clinical Psychiatry.
The researchers used two rating scales to assess treatment effectiveness: self-ratings which found a 42.6% reduction in anxiety symptoms, and the standardized Hamilton Anxiety Rating, which recorded a 50.7% reduction in anxiety severity.
The study was small, including just 31 participants, but importantly focused on those who did not show progress with other anxiety treatments, including at least five cognitive behavioral therapy (CBT) sessions. Participants did continue to receive CBT treatments throughout the 12-week study, however.
The study was funded in part by the Lambert Initiative for Cannabinoid Therapeutics at the University of Sydney, a philanthropically-funded research program specializing in the development of cannabis-based therapies.
This is a hopeful but still early study,” said Steven C. Hayes, Ph.D., a clinical psychologist, and professor at the University of Nevada at Reno, who was not involved in the research. “Any open trial is just a beginning, but you have to start somewhere, and this is a start.”
“A handful of studies, some controlled, has shown benefits of CBD on anxiety-related problems, so the results fit with what we know so far about cannabidiol,” he added.
One benefit to CBD is that it appears to have few side effects at low to moderate doses, such as those used in the study.
“Our pilot study found that cannabidiol not only helped to reduce anxiety symptoms but it was also very well tolerated – the most common side-effects were mild sedation and mild fatigue, but that was at the time when doses were increased and usually went away after a couple of days,” lead study author Dr. Paul Amminger, PhD, said in a press release.
“We did not see side-effects like suicidal thoughts, irritability or sleep problems, which are not uncommon in people taking SSRIs.”
Experts praised the research for trying to assess the use of novel therapies for mental health treatment in a pediatric and young adult setting. Still, they had some criticisms regarding aspects of the study.
For instance, the study may not have been rigorous in its definition of “treatment-resistant anxiety.”
“Stating that a child has ‘treatment resistant’ anxiety after having anxiety symptoms that persisted beyond five CBT sessions is an overreach,” said Dr. program director of the Cannabis Medicine, Science and Business Master’s Program at the Sidney Kimmel Medical College in Philadelphia. “SSRIs have a meaningful role in the treatment of anxiety in children, and none of them were exposed to that treatment it would seem, and thus can’t claim the population has ‘treatment-resistant anxiety.’”
Dr. Hayes agreed.
“Especially if exposure was involved, as might be expected with anxiety problems, five sessions is a rather limited course of psychotherapy and may not have been adequate to see a therapeutic effect,” he said. “CBT has virtually no known adverse side effects, so it would have been better to give it a more thorough try.”
Despite those limitations, these findings are a promising direction for further study.
“We know that the endocannabinoid system has a high proportion of receptors in the brain, interacting with many other neurotransmitters where anxiety and depression manifest,” Worster told Healthline. “Time and time again, in animal models, CBD causes increased relaxation in various stress settings – so we know that there is a pathophysiologic reason that CBD is a promising therapy for anxiety.”
That said, she urged caution.
“These findings do not mean that CBD is a panacea and everyone with anxiety will be cured by using it,” she said. “This study moves us toward more understanding, but many more important questions remain.”
Amminger, the study lead, seemed to acknowledge this.
“An open-label pilot study is limited by its design. To see a treatment effect in the treatment-resistant group is encouraging, but it could still be a placebo effect,” he said in the press release. Following these initial findings, he called for a larger, gold-standard, randomized, controlled study.