Epidemiological studies of various neuropsychiatric disorders indicate that a higher CBD content in chronically consumed cannabis may protect against adverse effects of THC, including psychotic symptoms, drug cravings, memory loss, and hippocampal gray matter loss [115–118] (reviewed in ). As THC acutely induces anxiety, this pattern may also be evident for chronic anxiety symptoms. Two studies were identified, including an uncontrolled retrospective study in civilian patients with PTSD patients , and a case study in a patient with severe sexual abuse-related PTSD , which showed that chronic cannabis use significantly reduces PTSD symptoms; however, these studies did not include data on the THC:CBD ratio. Thus, overall, no outcome data are currently available regarding the chronic effects of CBD in the treatment of anxiety symptoms, nor do any data exist regarding the potential protective effects of CBD on anxiety potentially induced by chronic THC use.
Let's start with the most officially proven medical use of CBD. Earlier this year, the FDA approved the first-ever drug containing CBD, Epidiolex, to treat two rare forms of pediatric epilepsy. To get to that point, the drug's manufacturers had to do a whole lot of randomized, placebo-controlled trials on humans. They had to study how much children could take, what would happen in case of overdose, and any possible side effects that would occur.
Hey Linda. Thanks for your comment. I understand your frustration. Since you say you are taking Seroquel, I recommend checking with a doctor if you are mixing CBD with this and other medications. As far as dosage goes, always best to start low (0.5 mg to 20 mg of CBD) and then only add more if you need it and slowly increase your dose. A good guidebook I have been recommending lately which provides helpful information is called CBD: A Patient’s Guide to Medicinal Cannabis–Healing without the High Check it out and let me know what you think and if you have more questions 🙂
Several complexities of the eCB system may impact upon the potential of CBD and other CB1R-activating agents to serve as anxiolytic drugs. First, CB1R agonists, including THC and AEA, have a biphasic effect: low doses are anxiolytic, but higher doses are ineffective or anxiogenic, in both preclinical models in and humans (reviewed in [33, 45]). This biphasic profile may stem from the capacity of CB1R agonists to also activate TRPV1 receptors when administered at a high, but not low dose, as demonstrated for AEA . Activation of TRPV1 receptors is predominantly anxiogenic, and thus a critical balance of eCB levels, determining CB1 versus TRPV1 activation, is proposed to govern emotional behavior [27, 47]. CBD acts as a TRPV1 agonist at high concentrations, potentially by interfering with AEA inactivation . In addition to dose-dependent activation of TRPV1 channels, the anxiogenic versus anxiolytic balance of CB1R agonists also depends on dynamic factors, including environmental stressors [33, 49].
Similarly, though CBD oil is technically illegal on the federal level, it is sold freely online and in stores even here in New Jersey. Erica McBride, executive director of the National Hemp Association in Washington, said there have been instances in states where pot hasn't been legalized where CBD oil was confiscated at the post office or people possessing it were arrested, but it's “very rare.”
Research has shown that administration of cannabidiol actually inhibits agonist effects at the CB1/CB2 receptor sites. Although the effects of CB1 inverse agonism aren’t fully elucidated, many speculate that CB2 inverse agonism may contribute to cannabidiol’s anti-inflammatory effects. Due to the fact that neuroinflammation is associated with anxiety disorders, we could hypothesize that a decrease in inflammation may yield anxiolytic responses in a subset of CBD users.
The nervous system’s endocannabinoid system is not well understood. But it’s thought to play a role in regulating pain, sleep, mood, memory, appetite, and other cognitive and physical processes. Because CBD is able to mimic the actions of some natural brain chemicals, its potential therapeutic benefits are wide-ranging but—at this point—nebulous. “We know that cannabidiol modulates the endocannabinoid system, but we don’t know how it works,” Szaflarski says. That said, there are theories.
In a series of placebo-controlled studies involving 15 healthy volunteers, Fusar-Poli et al. investigated the effects of CBD and THC on task-related blood-oxygen-level dependent functional magnetic resonance imaging activation, specifically the go/no-go and fearful faces tasks [109, 110]. The go/no-go task measures response inhibition, and is associated with activation of medial prefrontal, dorsolateral prefrontal, and parietal areas . Response activation is diminished in PTSD and other anxiety disorders, and increased activation predicts response to treatment . CBD produced no changes in predicted areas (relative to placebo) but reduced activation in the left insula, superior temporal gyrus, and transverse temporal gyrus. The fearful faces task activates the amygdala, and other medial temporal areas involved in emotion processing, and heightened amygdala response activation has been reported in anxiety disorders, including GAD and PTSD [113, 114]. CBD attenuated blood-oxygen-level dependent activation in the left amygdala, and the anterior and posterior cingulate cortex in response to intensely fearful faces, and also reduced amplitude in skin conductance fluctuation, which was highly correlated with amygdala activation . Dynamic causal modeling analysis in this data set further showed CBD reduced forward functional connectivity between the amygdala and anterior cingulate cortex .
From our personal experience, we can also confirm that CBD can have a very calming effect. We can as well imagine that it can help with anxiety, although we do not suffer from anxiety. When I was stressed out by pressure, it always helped a lot. This may not exactly be anxiety in the real sense of it, but the potential could already be guessed well.
Szaflarski explains that cannabis contains about 500 different compounds, some of which—including CBD and THC—interact with certain chemical receptors in the human nervous system. But unlike THC, CBD isn’t psychoactive—meaning it doesn’t cause any kind of a high. Despite that, the US Drug Enforcement Agency classifies CBD (and other cannabis compounds) as schedule I substances, making their sale illegal in many states.
The truth is that no one knows precisely what any of these molecules are doing to us. It is a case of finding the effects first and working backwards to understand the mechanisms. “There are a number of possible transmitter systems that CBD could act on,” says McGuire. “And it’s not 100% clear which ones are critical for anxiety, or psychosis or schizophrenia. But [the antipsychotic effect] is a different mechanism from existing treatments, which is a big deal because existing treatments aren’t working.”
Both Bonn-Miller and Ward stress that it's up to the consumer to be well-educated about the material they're purchasing and the research that's out there. "The companies that are creating [cannabis oils] are offering lots of claims about its use that are not necessarily substantiated by any research," Bonn-Miller said. So "I think there needs to be, from a consumer standpoint, a lot of vigilance," he added.
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