Open-label trial finds CBD reduced anxiety by 43% in young people who did not respond to standard treatment | Research

The takeaway

In 31 young people aged 12-25 with anxiety disorders that had not responded to therapy or medication, 12 weeks of add-on CBD (up to 800 mg/day) reduced anxiety severity by 42.6%.

Clinicians treating youth anxiety, parents, and researchers interested in CBD as a therapeutic option.

42.6% reduction in anxiety severity over 12 weeks

What the researchers found

Mean OASIS anxiety scores decreased from 10.8 at baseline to 6.3 at week 12, a 42.6% reduction (p<0.001). Depression, clinical global impressions, and functioning also improved significantly. 80.6% of participants reported adverse events, most commonly fatigue and low mood, but no serious or unexpected events occurred.

Why it matters

Treatment resistance in youth anxiety is common (affecting nearly half of patients), and this trial provides initial evidence that CBD could be a viable add-on option for this underserved group.

The numbers in context

31 participants; ages 12-25; CBD titrated up to 800 mg/day; 42.6% reduction in anxiety severity (OASIS scores 10.8 to 6.3); 80.6% reported adverse events; no serious adverse events.

How the study worked

Open-label trial of 31 young people aged 12-25 with DSM-5 anxiety disorders who had not improved with CBT and/or antidepressants. All received add-on CBD on a fixed-flexible schedule titrated up to 800 mg/day for 12 weeks.

What this study cannot tell us

Open-label design with no placebo control, so expectancy effects cannot be ruled out. Small sample size (n=31). High rate of mild adverse events. No long-term follow-up. Add-on design makes it difficult to isolate CBD's specific contribution.

How to read the evidence

Open-label pilot study without placebo control. Promising but needs RCT confirmation.

When this study was published

Published in 2022 with enrollment from 2018-2019.

The bigger picture

With nearly half of young people with anxiety not responding to standard treatments, finding safe add-on options is a clinical priority. This pilot provides initial support for CBD, but the lack of a placebo control means the results need confirmation.

Questions still open

Would the effects hold up in a placebo-controlled trial? Is 800 mg/day the optimal dose, or could lower doses work? What happens after CBD is discontinued?

Common questions

What dose of CBD was used?

CBD was titrated on a fixed-flexible schedule up to 800 mg per day, which is significantly higher than doses found in most consumer CBD products.

Were there any safety concerns?

80.6% of participants reported at least one adverse event, most commonly fatigue, low mood, and hot flushes or cold chills. However, there were no serious or unexpected adverse events during the 12-week trial.

Read the original research

Cannabidiol for Treatment-Resistant Anxiety Disorders in Young People: An Open-Label Trial.

The Journal of clinical psychiatry, 83(5)

View on PubMed ↗Publisher’s paper ↗

Citation

Berger, Maximus; Li, Emily; Rice, Simon; Davey, Christopher G; Ratheesh, Aswin; Adams, Sophie; Jackson, Henry; Hetrick, Sarah; Parker, Alexandra; Spelman, Tim; Kevin, Richard; McGregor, Iain S; McGorry, Patrick; Amminger, G Paul. (2022). Cannabidiol for Treatment-Resistant Anxiety Disorders in Young People: An Open-Label Trial.. The Journal of clinical psychiatry, 83(5). https://doi.org/10.4088/JCP.21m14130