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Review of medicinal cannabis for anxiety finds CBD has anxiolytic evidence while THC effects are mixed

ReviewModerate evidence
The takeaway

Clinical trials show CBD has anxiolytic effects, but evidence is not yet strong enough for first-line treatment, while THC-containing products show mixed results and may worsen anxiety in some people.

Patients considering cannabis for anxiety, healthcare providers, and researchers studying cannabinoid therapeutics.

Anxiety is #2 reason for medicinal cannabis Rx in Australia

What the researchers found

CBD demonstrated anxiolytic effects in trials with healthy volunteers and clinical populations, though evidence remains insufficient for first-line treatment. THC-dominant products showed ambiguous results, with some individuals experiencing relief and others worsening anxiety. About 17% of anxiety prescriptions were for CBD-dominant products while 50% were for herbal cannabis for vaporization.

Why it matters

Anxiety is the second most common reason for medicinal cannabis prescriptions in Australia, yet the evidence base is still developing, creating a gap between prescribing practice and scientific certainty.

The numbers in context

17% of anxiety prescriptions for CBD-dominant products (oils, wafers, capsules); 33% for THC-containing liquids; 50% for herbal cannabis for vaporization. Anxiety is the second most common reason for medicinal cannabis prescription in Australia.

How the study worked

Review article summarizing clinical trials, laboratory studies, and prescribing data on medicinal cannabis for anxiety disorders in Australia.

What this study cannot tell us

Review article, not a systematic review. Australian prescribing data may not reflect patterns elsewhere. The evidence base for CBD in anxiety is still mostly from small trials. No long-term outcome data reviewed.

How to read the evidence

Review synthesizes existing clinical trial evidence, which includes RCTs for CBD but remains limited overall.

When this study was published

Published in 2022.

The bigger picture

The disconnect between rapidly increasing prescriptions and limited clinical evidence highlights a broader tension in medicinal cannabis: patient demand and practitioner willingness are outpacing the evidence from controlled trials.

Questions still open

  • Why are THC-containing products prescribed more often than CBD for anxiety, given the stronger anxiolytic evidence for CBD? What outcomes are patients experiencing with these prescriptions?

Common questions

Is CBD or THC better for anxiety?
Based on current evidence, CBD has more consistent anxiolytic effects across trials. THC results are mixed, with some people reporting relief and others experiencing worsened anxiety. CBD also lacks the intoxicating effects and driving impairment associated with THC.
What types of cannabis products are most commonly prescribed for anxiety in Australia?
Herbal cannabis for vaporization accounts for 50% of anxiety prescriptions, THC-containing liquid products 33%, and CBD-dominant products (oils, wafers, capsules) only 17%.

Read the original research

Medicinal cannabis for the treatment of anxiety disorders.

Australian journal of general practice, 51(8), 586-592

Citation

Berger, Maximus; Amminger, G Paul; McGregor, Iain S. (2022). Medicinal cannabis for the treatment of anxiety disorders.. Australian journal of general practice, 51(8), 586-592. https://doi.org/10.31128/AJGP-04-21-5936

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