Pretreatment with 300mg CBD significantly relieved anxiety in 57 healthy males who undertook a simulated public speaking test. However, dosages of 150mg CBD and 600mg CBD did not make any difference to the men’s anxiety levels. 7
Unfortunately, few human trials investigating the use of CBD as a single agent to relieve pain exist, with most trials using a combination of CBD and THC to relieve pain. Notably, Health Canada has approved a combination medication that contains both THC and CBD in a 1:1 ratio for the relief of central nerve-related pain in multiple sclerosis, and cancer pain that is unresponsive to optimized opioid therapy.
CBD can interact with other medications used for epilepsy and some serious side effects have been reported, notably, a decrease in liver function when given to people already taking valproate.
Medically reviewed by Carmen Fookes, BPharm. Last updated on Nov 2, 2020.
31% of people taking CBD for other conditions such as anxiety or non-cancer-related pain reported improved sleep with CBD. 8
In a large case series of 72 people, 48 patients (66.7%) reported an improvement in sleep scores within the first month, but these fluctuated over time. 9
Many other studies, both on animals and humans, have overwhelmingly concluded that CBD has immunosuppressive and anti-inflammatory properties which may make it a good choice for some autoimmune conditions or inflammation-related complaints. 16
Other trials of 300 mg of CBD in people with anxiety or depression showed that CBD appeared to preserve sleep architecture, meaning it was unlikely to have any negative effects on sleep quality. 10
CBD oil can interact with certain medications, including some drugs used to treat epilepsy. CBD inhibits an enzyme called cytochrome P450 (CYP450), which metabolizes certain drugs. By interfering with CYP450, CBD may either increase the toxicity or decrease the effectiveness of these drugs.
Scientists believe that CBD reduces nerve pain by binding to glycine receptors in the brain that regulate the speed at which nerve signals pass between nerve cells.
Remember, because CBD oils are largely unregulated, there is no guarantee that a product is either safe or effective.
Clinical research has shown that CBD oil can trigger side effects. Severity and type can vary from one person to the next.
CBD oil may also increase liver enzymes (a marker of liver inflammation). People with liver disease should use CBD oil with caution, ideally under the care of a doctor who can regularly check blood liver enzyme levels.
Meredith Bull, ND, is a licensed naturopathic doctor with a private practice in Los Angeles, California.
Outside of these two disorders, CBD’s effectiveness in treating seizures is uncertain. Even with Epidiolex, it is uncertain whether the anti-seizure effects can be attributed to CBD or some other factor.
“Our top therapies attempt to break the association between reminders of the trauma and the fear response,” said Mallory Loflin, an assistant adjunct professor at the University of California, San Diego and the study’s principal investigator. “We think that CBD, at least in animal models, can help that process happen a lot faster.” While large clinical trials are underway, psychologists say there isn’t compelling evidence yet as to whether this is a viable treatment.
Dr. Smita Das, chair of the American Psychiatric Association’s Council on Addiction Psychiatry’s cannabis work group, does not recommend CBD for anxiety, PTSD, sleep or depression. With patients turning to these to unproven products, she is worried that they may delay seeking appropriate mental health care: “I’m dually concerned with how exposure to CBD products can lead somebody into continuing to cannabis products.”
Last year, the F.D.A. approved Epidiolex, a purified CBD extract, to treat rare seizure disorders in patients 2 years or older after three randomized, double-blind and placebo-controlled clinical trials with 516 patients that showed the drug, taken along with other medications, helped to reduce seizures. These types of studies are the gold standard in medicine, in which participants are divided by chance, and neither the subject nor the investigator knows which group is taking the placebo or the medication.
Does CBD help anxiety and PTSD?
Recently, the F.D.A. sent a warning letter to Curaleaf Inc. about its “unsubstantiated claims” that the plant extract treats a variety of conditions from pet anxiety and depression to cancer and opioid withdrawal. (In a statement, the company said that some of the products in question had been discontinued and that it was working with the F.D.A.)
While there is hope for treating other conditions with the plant extract, Epidiolex remains the only CBD-derived drug approved by the F.D.A. Most of the research on cannabidiol has been in animals, and its current popularity has outpaced science. “We don’t have the 101 course on CBD quite figured out yet,” said Ryan Vandrey, an associate professor of psychiatry and behavioral sciences at Johns Hopkins University School of Medicine.
Cannabidiol, or CBD, is the lesser-known child of the cannabis sativa plant; its more famous sibling, tetrahydrocannabinol, or THC, is the active ingredient in pot that catapults users’ “high.” With roots in Central Asia, the plant is believed to have been first used medicinally — or for rituals — around 750 B.C., though there are other estimates too.
Will these trends change your life — or