Medical cannabis has been increasingly recognized as a potential treatment option for anxiety disorders, which are a group of mental health conditions characterized by excessive fear or worry. Anxiety disorders can have a significant impact on an individual's quality of life, and can be difficult to treat with traditional medications, such as benzodiazepines, which can have significant side effects and the potential for dependence.

Cannabis plants contain a number of active compounds, known as cannabinoids, which have been found to have potential therapeutic benefits, including as an anxiolytic, or anti-anxiety agent. The two most well-known cannabinoids are delta-9-tetrahydrocannabinol (THC) and cannabidiol (CBD). THC is known for its psychoactive effects, while CBD is non-psychoactive and has been found to have a range of potential therapeutic benefits, including as an anxiolytic.

Mechanism of Action

The exact mechanism by which cannabis exerts its anxiolytic effects is not fully understood, but several potential mechanisms have been proposed. One proposed mechanism is through the modulation of the endocannabinoid system, which is a complex signaling system in the body that plays a role in a range of physiological processes, including pain sensation, mood, and anxiety. The endocannabinoid system is comprised of two main receptors, CB1 and CB2, which are activated by endocannabinoids, which are naturally occurring compounds in the body, as well as by phytocannabinoids, which are compounds found in the cannabis plant. THC has been found to interact with CB1 receptors in the brain, which can lead to a reduction in anxiety.

Another proposed mechanism is through the modulation of the serotonin system in the brain. Serotonin is a neurotransmitter that plays a role in regulating mood and anxiety. CBD has been found to modulate the serotonin system in the brain, which can lead to a reduction in anxiety.

Clinical Evidence

A number of clinical trials have investigated the potential of cannabis-based treatments for the management of anxiety disorders. These studies have found that cannabis-based treatments can be effective in reducing symptoms of anxiety in some patients, although the evidence is mixed and more research is needed to fully understand the potential of cannabis-based treatments for anxiety disorders.

In a randomized, double-blind, placebo-controlled trial published in the Journal of Psychopharmacology in 2011, researchers found that a single dose of CBD was associated with a reduction in anxiety in patients with social anxiety disorder. In another randomized, double-blind, placebo-controlled trial published in the Journal of Clinical Psychopharmacology in 2014, researchers found that THC was associated with a reduction in symptoms of anxiety in patients with post-traumatic stress disorder (PTSD).

However, it is important to note that some studies have found that cannabis-based treatments can actually increase symptoms of anxiety in some patients, particularly those with a history of anxiety disorders. Additionally, the psychoactive effects of THC can be problematic for some patients, and can lead to feelings of paranoia or anxiety in some individuals.

Side Effects

While cannabis-based treatments for anxiety disorders have been found to be generally well-tolerated, they can have side effects in some patients. The most commonly reported side effects of THC include dizziness, dry mouth, and changes in mood or perception. Additionally, THC can interact with some medications, including sedatives and benzodiazepines, which can lead to increased sedation and potential adverse effects. For this reason, it is important for patients to discuss the use of cannabis-based treatments with their healthcare provider. Additionally, patients should be aware of the potential psychoactive effects of THC and should avoid driving or operating heavy machinery while under the influence.

Academic research on medical cannabis for the treatment if anxiety

1. Cannabidiol as a Potential Treatment for Anxiety Disorders

Abstract

Cannabidiol (CBD), a Cannabis sativa constituent, is a pharmacologically broad-spectrum drug that in recent years has drawn increasing interest as a treatment for a range of neuropsychiatric disorders. The purpose of the current review is to determine CBD’s potential as a treatment for anxiety-related disorders, by assessing evidence from preclinical, human experimental, clinical, and epidemiological studies. We found that existing preclinical evidence strongly supports CBD as a treatment for generalized anxiety disorder, panic disorder, social anxiety disorder, obsessive–compulsive disorder, and post-traumatic stress disorder when administered acutely; however, few studies have investigated chronic CBD dosing. Likewise, evidence from human studies supports an anxiolytic role of CBD, but is currently limited to acute dosing, also with few studies in clinical populations. Overall, current evidence indicates CBD has considerable potential as a treatment for multiple anxiety disorders, with need for further study of chronic and therapeutic effects in relevant clinical populations.

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2. Cannabidiol modulates serotonergic transmission and reverses both allodynia and anxiety-like behavior in a model of neuropathic pain

Abstract

Clinical studies indicate that cannabidiol (CBD), the primary nonaddictive component of cannabis that interacts with the serotonin (5-HT)1A receptor, may possess analgesic and anxiolytic effects. However, its effects on 5-HT neuronal activity, as well as its impact on models of neuropathic pain are unknown. First, using in vivo single-unit extracellular recordings in rats, we demonstrated that acute intravenous (i.v.) increasing doses of CBD (0.1-1.0 mg/kg) decreased the firing rate of 5-HT neurons in the dorsal raphe nucleus, which was prevented by administration of the 5-HT1A antagonist WAY 100635 (0.3 mg/kg, i.v.) and the TRPV1 antagonist capsazepine (1 mg/kg, i.v.) but not by the CB1 receptor antagonist AM 251 (1 mg/kg, i.v.). Repeated treatment with CBD (5 mg/kg/day, subcutaneously [s.c.], for 7 days) increased 5-HT firing through desensitization of 5-HT1A receptors. Rats subjected to the spared nerve injury model for 24 days showed decreased 5-HT firing activity, mechanical allodynia, and increased anxiety-like behavior in the elevated plus maze test, open-field test, and novelty-suppressed feeding test. Seven days of treatment with CBD reduced mechanical allodynia, decreased anxiety-like behavior, and normalized 5-HT activity. Antiallodynic effects of CBD were fully prevented by capsazepine (10 mg/kg/day, s.c., for 7 days) and partially prevented by WAY 100635 (2 mg/kg/day, s.c., for 7 days), whereas the anxiolytic effect was blocked only by WAY. Overall, repeated treatment with low-dose CBD induces analgesia predominantly through TRPV1 activation, reduces anxiety through 5-HT1A receptor activation, and rescues impaired 5-HT neurotransmission under neuropathic pain conditions.

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