The cannabis-derived compound cannabidiol (CBD) may reduce the severity of treatment-resistant anxiety by around 50 percent in young people, the results of a new pilot study indicate. Appearing in the Journal of Clinical Psychiatry, the research involved patients between the ages of 12 and 25, none of whom experienced any major side effects when using the non-psychoactive cannabinoid.
The 31 participants had been diagnosed with various forms of anxiety such as social anxiety disorder, generalized anxiety disorder, panic disorder, and phobias. All did not respond to cognitive behavioral therapy (CBT), with the average length of time spent in treatment being just over two years.
Twenty-one subjects had also been prescribed selective serotonin reuptake inhibitors (SSRIs) to combat depression, changing medications twice on average due to a lack of efficacy or intolerable side effects.
However, following a 12-week course of CBD in combination with CBT, roughly 40 percent of patients experienced a 50 percent reduction in symptoms, as measured by the Overall Anxiety Severity and Impairment Scale (OASIS). Around two-thirds saw an improvement of at least 33 percent, while the average reduction in anxiety scores was 42.6 percent.
A separate scale known as the Hamilton Anxiety Rating indicated an average improvement of 50.7 percent following the 12-week intervention.
“The young people had fewer panic attacks and could do things which they were previously unable to do like leave the house, go to school, participate in social situations, eat at restaurants, take public transport or attend appointments by themselves,” explained study author Paul Amminger in a statement. “That's an amazing change in the group which has had treatment-resistant, long-standing severe to very severe anxiety.”
Importantly, these improvements were not sustained after CBD treatment was halted, and anxiety scores had largely returned to baseline when participants were assessed again three months after their last dose. This indicates that the observed reduction in symptoms was likely to have been caused directly by the cannabinoid rather than the CBT or other factors.
While the exact mechanism by which CBD alleviates anxiety is not fully understood, the study authors stress that the drug activates separate pathways to SSRIs, and does not, therefore, provoke the side effects associated with conventional antidepressants.
“Cannabidiol is non-intoxicating and doesn’t contain tetrahydrocannabinol (THC) so it doesn’t cause alterations in thinking and perception, it doesn’t make you ‘high’ and it’s not addictive,” said Amminger.
“We did not see side-effects like suicidal thoughts, irritability or sleep problems, which are not uncommon in people taking SSRIs.”
As encouraging as these findings may seem, the authors point out that this small-scale pilot study was not placebo-controlled and that more research is needed to determine the efficacy of CBD as a treatment for anxiety.
“The next step is a randomised controlled trial, which is the gold standard to test a new intervention,” said Amminger. “Such a trial needs to be done in a much larger group – around 200 to 250 young people – to enable us to say with some certainty that there is, or is not, real treatment benefits and effects.”