Cannabidiol (CBD) has gained attention in recent years for its possible benefits, especially in treating anxiety. But does CBD really help with anxiety, and what do scientific studies say about the right dose? In this article, we look at the research on CBD for anxiety, how it works in the body, the results from clinical trials, and what doses appear most helpful. By focusing on the research, we move past stories and opinions to give a full and clear summary of what is known so far.
What Is CBD and How Does It Affect Anxiety?
CBD is a well-known chemical found in the Cannabis sativa plant. Unlike THC, another common compound in cannabis, CBD does not cause a “high.” Because CBD won’t make you feel intoxicated and is usually well-tolerated, it is used by both the health and wellness industry and medical field. CBD is believed to have a range of possible benefits-helping with pain, inflammation, seizures, anxiety, and more. Products made from hemp and containing CBD are marketed mainly for anxiety and pain relief, showing how popular CBD has become around the world.
How Does CBD Work in the Body?
CBD’s effects come from how it interacts with several systems in the body. It doesn’t strongly attach to cannabinoid receptors like THC does, but it acts weakly on CB1 (cannabinoid receptor 1) and as an inverse agonist on CB2 (cannabinoid receptor 2). For anxiety, its action on the serotonin 1a receptor (5-HT1A) is important since this system helps control mood and stress. CBD also affects other receptors, like GPR55, GPR18, and TRPV1. By acting in several places, CBD may have wider effects on the body than just one target. It may also help keep the body’s own system in balance by preventing the breakdown of anandamide, a natural compound involved in feeling good and relaxed.
CBD and Anxiety Disorders
Anxiety disorders are serious mental health problems affecting millions worldwide. Usual medicines for anxiety don’t always work well-they can take weeks to help, have side effects, or don’t help everyone. This is why there is interest in other treatments like CBD. Research suggests that CBD may reduce anxiety, based on both animal experiments and studies with people. Scientists learned that CBD could offset the anxiety caused by THC, which sparked more research into its calming benefits. While feeling some anxiety is normal, it’s a problem when it lasts too long or feels too strong compared to the situation. Studies are exploring if CBD can help people with ongoing anxiety issues such as generalized anxiety disorder (GAD), social anxiety disorder (SAD), and post-traumatic stress disorder (PTSD).
Clinical Evidence: What Do Studies Show About CBD for Anxiety?
There’s a growing collection of studies on CBD for anxiety. The strongest evidence for CBD comes from its use in treating severe epilepsy, but we now see more studies testing it for anxiety, with promising early results at particular doses. However, research results vary because studies use different methods, participants, and CBD products. It’s important to look at the data closely.
Types of CBD Anxiety Studies
Research into CBD and anxiety includes various types of studies:
- Double-blind, placebo-controlled trials: Neither doctors nor participants know who gets CBD or a sugar pill (placebo). This setup helps prevent bias.
- Open-label studies: Both researchers and participants know what is being given, useful for early insights.
- Case reports: Detailed stories about how one or a few people respond to CBD. These are less reliable but can show new directions for research.
While gold-standard double-blind trials matter most, open-label studies and case reports add useful information, especially for patient experiences. More and more trials are happening as interest in CBD grows, meaning more robust information will come soon.
What Have Double-Blind, Placebo-Controlled Trials Found?
These trials offer the most convincing data. Several have shown CBD can reduce anxiety. For example:
- Adults with Social Anxiety Disorder (SAD): One 600 mg oral dose lowered anxiety, cognitive problems, and discomfort during public speaking. Physical signs of anxiety also dropped.
- Healthy volunteers: 400 mg of CBD lowered self-rated anxiety during stressful tests. However, lower doses (100-200 mg) often did not outperform placebo.
This means that effective anxiety relief seems to appear at doses of around 300-400 mg. In comparison, some studies with much lower doses didn’t show a benefit over placebo.
Product type matters too. One open-label study used around 30 mg/day of a full-spectrum CBD oil and found reduced anxiety and better mood, sleep, and thinking skills over four weeks. The improvement at a lower dose than single-compound studies hints that full-spectrum products (with a mix of cannabis compounds) may work better than CBD on its own, but direct comparison studies are needed.
Results From Open-Label and Observational Studies
While not as strict as double-blind trials, open-label and long-term observation studies provide valuable information about how CBD works for anxiety in real life. For example:
- A study with 103 adults found anxiety scores dropped in 79% within the first month and stayed lower after that.
- A single case report showed a child with PTSD improved sleep and anxiety using 25 mg/day of CBD.
- Frontline healthcare workers using 300 mg/day for four weeks during COVID-19 felt less burned out and anxious than those who did not use CBD.
- Parkinson’s patients with anxiety saw fewer psychotic symptoms and better functioning after using up to 400 mg/day.
These results suggest CBD may help in different settings, but the lack of placebo controls means we can’t say for sure how much of the benefit is from CBD alone.
Are Results Different for Various Anxiety Disorders?
Most of the solid evidence comes from studies on social anxiety or situations that provoke anxiety in healthy people (like public speaking). There is less research for other disorders like GAD and PTSD, but early findings are positive. A meta-analysis showed a large effect of CBD on anxiety, but better studies focused on specific disorders are needed. Differences in doses and study designs make it hard to compare across disorders, so more targeted research is needed.
Current Limitations in CBD Anxiety Research
Despite good signs, there are several problems in current CBD research:
- No standardization: Studies use different CBD types (isolate, full-spectrum, etc.), methods (capsule, oil, etc.), and doses.
- Lack of plasma level reporting: We rarely know how much CBD actually reaches the blood.
- Small study sizes: Many studies have few participants, which can affect the strength of the evidence.
- Few dose-ranging studies: We need more tests to figure out the best dose window for anxiety.
- Little data on long-term use: We don’t know much about the safety and effects of taking CBD for anxiety over many months or years.
Bigger, better studies with clear reporting are needed to understand CBD’s effects for anxiety.
Common CBD Dosages Used in Anxiety Studies
Dosing for CBD in anxiety can be confusing, as studies and use cases vary widely. Doses that show clear benefits are usually a lot higher than what you might find in store-bought products. Here is what studies have used:
| CBD Dose Per Day | Typical Study Outcomes | Safety Notes |
|---|---|---|
| Below 60 mg | Often no clear benefit for anxiety; some slight improvements in sleep. Not the main focus of these studies. | Generally safe, mild side effects like sleepiness or tiredness in some people. |
| 60-200 mg | Results are mixed. Some studies find benefits, especially at the higher end, but not all people respond. | Well-tolerated, sometimes mild drowsiness; overall safety good when used as directed. |
| Over 200 mg | Most studies find clear anxiety reductions at 300-400 mg, especially in stressful situations. Also useful in other areas (like addiction) at these doses. | Generally safe, but higher doses (especially above 300 mg/day) may affect liver enzymes in rare cases. Mild stomach or sleepiness complaints possible. |
CBD Below 60 mg: Effects and Safety
Doses lower than 60 mg per day usually don’t help much with anxiety, though some people may see slight improvements in sleep. Tests with 10-40 mg show little impact on anxiety or other main symptoms. These lower doses rarely cause side effects, but some people may feel slightly sleepy at first.
CBD 60-200 mg: What Studies Show
Doses in this middle range sometimes help anxiety, but results are mixed. For instance, one study found only doses near 600 mg made a clear difference, while another with 150 mg did not. However, taking 200 mg/day for 10 weeks was reported to reduce some mental distress in regular cannabis users. In trials up to 13 weeks with 200 mg/day, CBD was generally safe with only mild, short-lived side effects in some people.
High Dose: 300-400 mg and Above
Most reliable benefits are seen with 300-400 mg per day. In stressful situations-like simulated public speaking-these doses reduce anxiety both in healthy people and those with anxiety disorders. Some studies also show fewer cravings and less anxiety in people quitting other substances with these higher doses. Although high doses are usually safe, a few people may see mild changes in liver enzyme levels or temporary stomach problems. Liver tests are a good idea for anyone on high daily doses over many weeks.
How Should CBD Be Used for Anxiety? Dosing Advice and Tips
Trying CBD for anxiety can be confusing with so many product types and dose choices. There isn’t one perfect dose, but clinical research offers some helpful starting points.
Suggested Starting Doses from Research
Most studies with proven effects used 150-300 mg per day, and sometimes up to 400 mg for strong anxiety relief. For day-to-day management, starting within 150-300 mg/day and adjusting based on personal response is common. Some products (like full-spectrum oils) may help at lower doses, such as around 35 mg/day, but more research is needed. A good rule is to start with a low dose and raise it slowly, watching for any side effects. This helps find the right amount for each person.
What Can Affect the Right CBD Dose?
- Body size and metabolism: Bigger people or those who metabolize drugs faster may need more CBD for the same effect.
- Severity of anxiety: Very strong anxiety may require higher doses.
- CBD product type: Full-spectrum oils (with other plant compounds) may work at lower doses than CBD isolate.
- How you take it: CBD taken by mouth (capsules, food) is absorbed less efficiently and more slowly than tinctures taken under the tongue.
- Other medications: CBD can interact with many prescriptions, especially those using the CYP450 system in the liver.
- Sensitivity or tolerance: Some people feel effects at low doses, others need more, especially over time.
Because of these differences, finding the best dose is personal. Checking with a doctor makes sense, especially if you take other medications.
Timing and Best Ways to Take CBD
The way you take CBD and when you take it affects how well it works:
- Oral (capsules, food): Effects start slowly (30 minutes to 2 hours) and last longer. Good for daily, steady relief.
- Sublingual (oils/tinctures under the tongue): Faster start (15-45 minutes), higher absorption, good for quick relief when needed.
Pick your method based on how fast you need relief and how long you want it to last. Consistency matters-for steady results, use CBD the same way each day. Be aware that taking CBD with food can increase how much reaches your bloodstream.
Should CBD Be Used Alone or With Other Anxiety Treatments?
Some studies look at CBD by itself, but many use it as an extra to regular medicines. In some cases, adding CBD (as in Epidiolex for seizures) improves results without more side effects. For anxiety, there’s some early evidence that CBD may help when added to usual care, such as in healthcare workers during the pandemic. Since CBD can interact with other medicines (by raising their levels in the blood), it’s important to involve your doctor if you plan to use CBD with prescription drugs.
Is CBD Safe for Anxiety? Side Effects and Drug Interactions
CBD is usually safe, even at the high doses used in clinical research. Still, like any medicine or supplement, it can cause side effects and interact with other drugs.
Common Side Effects
Most people tolerate CBD well. If there are side effects, they are generally minor and may include:
- Drowsiness or sleepiness
- Fatigue
- Upset stomach or diarrhea
- Loss of appetite
- Occasionally dry mouth, nausea, or vomiting
These side effects happen about as often as with placebo in many studies. Rarely, higher doses can affect liver enzymes. Starting with a low dose and moving up slowly helps limit problems.
Interactions With Prescription Drugs
CBD can slow down how some medicines are processed in the liver (by blocking the CYP450 system). This can cause higher levels of drugs such as:
- Benzodiazepines (like alprazolam, diazepam)
- Some antidepressants (SSRIs, tricyclics)
This may cause extra sleepiness, dizziness, or-very rarely-serotonin syndrome. Higher doses of CBD increase this risk. If you take these types of medication, talk to your healthcare provider before using CBD so they can help keep watch for any problems and adjust your prescription if needed.
Groups That Should Use Caution With CBD
- Pregnant or breastfeeding: There isn’t enough research to say if CBD is safe; best to avoid unless your doctor says otherwise.
- Liver disease or problems: CBD is handled by the liver, and high doses may increase liver enzymes. You may need smaller doses or closer checks by your doctor.
- Children and teens: Only prescription CBD (Epidiolex) is approved for certain conditions. Over-the-counter CBD for anxiety is not well studied in youth.
- People on multiple medications: More drugs mean more chances for interactions, especially with blood thinners or heart medications.
- History of substance abuse: CBD itself is not addicting, but people with a history of addiction should check with their provider before using any cannabis-related product.
For anyone in these groups, it’s best to check with a doctor before starting CBD.
Frequently Asked Questions About CBD for Anxiety
Can Store-Bought CBD Products Help With Anxiety?
Many over-the-counter (OTC) CBD products are sold as “relief” for anxiety, but their doses are often lower than those shown to work in research. Most store brands contain 10-100 mg per day, while studies that find clear anxiety relief use 300-600 mg or more. Also, the labeling of CBD content in products is not always accurate, and quality varies. Mild anxiety may improve with lower doses, but people with diagnosed anxiety disorders should talk to a healthcare provider before trying CBD and not rely only on OTC products.
How Long Does It Take CBD to Work for Anxiety?
- Sublingual tinctures/oils: Work in 15-45 minutes.
- Capsules/edibles: Take longer, about 30 minutes to 2 hours, but effects last longer.
For steady improvement with ongoing anxiety, use it daily and expect effects to build up over a few days to weeks, based on clinical trial timelines.
Are There Long-Term Risks of Using CBD for Anxiety?
There isn’t much research yet on long-term CBD use for anxiety. Most studies last only weeks or a few months and find CBD safe during that time. The main concern with long-term use is possible liver strain at higher doses, as shown by rare increases in liver enzyme levels. Also, CBD may interact with medications over time. Extended use in children or teens should only be with a doctor’s care. While CBD is not seen as addictive or likely to cause dependence, regular doctor visits are important to monitor for any new or unexpected effects over longer periods.