CBD’s potential as a treatment for anxiety disorders
Can CBD treat Anxiety disorders? The purpose of this opinion piece is to review evidence regarding risks and benefits of CBD as a treatment for anxiety disorders. The information comes from current pre-clinical, clinical, and study/analysis pertaining to CBD and the treatments. Presently, existing medications are associated with limited response rates and residual symptoms, particularly in PTSD. In addition, adverse effects may also limit tolerability and adherence to medication. Today, there are substantial burdens of anxiety related disorders and the limitations of current treatments. Therefore a high urgent priority is placed on developing novel pharmaceutical treatments that include CBD.
The anxiety disorder issue at hand…
The issue is that fear and anxiety are adaptive responses essential to coping with threats to survival. Yet excessive or persistent fear may not provide adequate tranquility, leading to disability. Symptoms arising from excessive fear and anxiety occur in a number of a broad range of medical conditions. These conditions involve both neurology and psychiatry. Included are generalized anxiety, panic, post-traumatic stress, social anxiety and obsessive–compulsive disorders. Before someone screams that PTSD and OCD are no longer in this category, for the purpose of this discussion, they are included in these studies.
Existing pre-clinical evidence supports CBD…
Most studies find that existing pre-clinical evidence strongly supports CBD as a treatment for generalized anxiety, panic and social anxiety disorders when administered acutely; Furthermore, clinical studies show CBD possesses a wide range of therapeutic properties, including anti-psychotic, analgesic, neuro-protective, anti-convulsant, anti-emetic, anti-oxidant, anti-inflammatory, anti-arthritic, and anti-neoplastic properties.
Tolerated dosages in human test…
A review of potential side effects in humans found that CBD was well tolerated across a wide dose range, up to 1500 mg/day (orally), with no reported psycho-motor slowing, negative mood effects, or vital sign (heart rate, blood pressure and body temperature).abnormalities noted. They found too that it does not affect physiological parameters such as gastrointestinal transit either. (Bergamaschi MM, Queiroz RH et.al.)
Pharmacological profile of CBD
This is difficult read but here we go. CBD has a broad pharmacological profile, including interactions with several known receptors that regulate fear and anxiety related behaviors. Specifically the cannabinoid type 1 receptor (CB1R), the serotonin 5-HT1A receptor, and the transient receptor potential (TRP) vanilloid type 1 (TRPV1) receptor. In addition, CBD may also regulate, directly or indirectly, the peroxisome proliferator activated receptor (PPARs) Y, the orphan G-protein coupled receptor 55, the equilibrative nucleoside transporter, the adenosine transporter, additional TRP channels, and glycine receptors.
Primary Anxiety Disorder Studies and Pharmacology Relevance
In the current review of primary studies, the following receptor specific actions were found to have been investigated as potential mediators of CBD’s ability to reduce anxiety: CB1R, TRPV1 receptors, and 5-HT1A receptors. First, CB1R agonists (its opposite), includes THC and AEA, which act in two different ways as the concentration increases: low doses reduces anxiety, higher doses are ineffective or causes anxiety, in both pre-clinical models and in humans.
Summary and Clinical Relevance
Overall, existing pre-clinical evidence strongly supports the potential of CBD as a treatment for anxiety disorders. CBD exhibits a broad range of actions, relevant to multiple symptom domains, including reducing anxiety, causing anxiety, and anti-compulsive actions. It also exhibits a decrease in the primary mechanism in control of the fight-or-flight response in the brain. Researchers noted a decrease in conditioned fear expression, and enhancement of fear extinction. Included too is reconsolidation blockade, and prevention of the long-term increase of anxiety effects from stress.
Conclusion
Pre-clinical evidence conclusively demonstrates CBD’s efficacy in reducing anxiety behaviors relevant to multiple disorders. These include PTSD, GAD, PD, OCD, and SAD with a notable lack of increased anxiety effects. CBD’s decrease in anxiety actions appear to depend upon CB1Rs and 5-HT1ARs in several brain regions; however, investigation of additional receptor actions may reveal further mechanisms. Human experimental findings support pre-clinical findings, and also suggest a lack of increased anxiety effects, minimal sedative effects, and an excellent safety profile.
