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More research needed to determine effectiveness of CBD as anxiety treatment

March 5, 2019

DEAR MAYO CLINIC: Is there any harm in trying CBD for anxiety? It seems to have helped my co-worker, but I am hesitant to try it without knowing more about it.

Cannabidiol, also known as CBD, has not been approved by the Food and Drug Administration (FDA) to treat anxiety. Although some research appears to indicate that CBD might hold benefit for treating anxiety-related disorders, more study is needed. Cannabidiol may interfere with other prescriptions, and it can have side effects, so talk with your health care provider before you take any form of CBD.

Cannabidiol is a chemical found in marijuana, but it doesn’t contain tetrahydrocannabinol, or THC, the psychoactive ingredient in marijuana that produces a high. The typical formulation of CBD is a liquid that you take orally. But CBD also is sold as an extract, a vaporized liquid and an oil-based capsule. Foods, drinks and beauty products are among the many CBD-infused products available.

Epidiolex is the only CBD product authorized by the FDA. This prescription medication is approved to treat two types of epilepsy: Lennox-Gastaut syndrome and Dravet syndrome. Aside from Epidiolex, which is approved for use nationwide, U.S. state laws vary regarding other forms of CBD.

Cannabidiol has been studied as a treatment for a wide range of conditions, including Parkinson’s disease, schizophrenia, diabetes, multiple sclerosis and anxiety. But research supporting the drug’s benefits for these disorders is limited.

For example, one recent review of research looked at results from numerous studies that examined the effectiveness and safety of medical cannabis — including both CBD- and THC-based medicines — to treat mental disorders.

The review found that, when given with other medication, as well as psychotherapy, CBD and THC medications were associated with some symptom improvement. But the researchers emphasized the need for more thorough investigation before making a firm recommendation on the use of any form of medical cannabis to treat mental disorders.

Another study involving 72 participants that was published in January examined whether CBD can help improve anxiety and sleep quality. It found a decrease in anxiety symptoms in 57 of the study participants and concluded that CBD may hold benefit for anxiety-related disorders. But, again, the researchers indicated that larger, controlled clinical research studies are needed to confirm this initial finding.

There are potential risks to be aware of with CBD use, too. In some cases, it can cause side effects, such as dry mouth, diarrhea, reduced appetite, drowsiness and fatigue. Rarely, it may have an effect on liver function. CBD also can interfere with the effectiveness of other medications you’re taking, such as blood thinners.

Another cause for concern is the unreliability of the purity and dosage of CBD in nonprescription products. A recent study of 84 CBD products bought online showed that more than one-quarter of the products contained less CBD than labeled. In addition, THC was found in 18 of the products.

Before you use a product that contains CBD, talk to your health care provider. And discuss other possible treatment options for anxiety, too. In many cases, a type of psychotherapy known as cognitive behavioral therapy, along with anti-anxiety medication, can reduce anxiety symptoms significantly. — Brent Bauer, M.D., Complementary and Integrative Medicine Program, Mayo Clinic, Rochester.