Review finds weak but suggestive evidence for cannabinoids in anxiety and PTSD, with depression potentially worsened by cannabis

Recent evidence suggests CBD and CBD-enriched cannabis may have anxiolytic properties and reduce fear/stress responses in PTSD, but depression may worsen with cannabis use, and well-designed RCTs are largely absent.

Chadwick, Verity L et al.·Current opinion in psychiatry·2020·Preliminary EvidenceReview
RTHC-02461ReviewPreliminary Evidence2020RETHINKTHC RESEARCH DATABASErethinkthc.com/research

Quick Facts

Study Type
Review
Evidence
Preliminary Evidence
Sample
Not reported

What This Study Found

Some evidence suggests cannabinoids, CBD, or CBD-enriched cannabis have anxiety-reducing properties. Depression may be worsened by cannabis use, though RCTs are lacking. New evidence indicates CBD or CBD-enriched cannabis for PTSD and emotion regulation can induce reduced responses to fear and stress. The endocannabinoid system appears to be a key player in anxiety and PTSD.

Key Numbers

No pooled effect sizes; the review summarizes trends across recent publications.

How They Did This

Review of evidence published in the 18 months prior to publication on cannabis and cannabinoids in relation to anxiety, depression (unipolar and bipolar), PTSD, and emotionally unstable personality disorders. Also covers endocannabinoids as potential biomarkers.

Why This Research Matters

With increasing medicinal use and social tolerance of cannabis, understanding which psychiatric conditions might benefit or worsen from cannabinoid use is clinically urgent.

The Bigger Picture

The contrast between possible benefits for anxiety/PTSD and possible worsening of depression underscores that cannabinoids are not universally helpful for mental health and that specific conditions may require different approaches.

What This Study Doesn't Tell Us

Weak evidence overall; lack of well-designed RCTs for most conditions reviewed; heterogeneous cannabinoid preparations; most anxiety/PTSD findings are preliminary.

Questions This Raises

  • ?Could CBD be effective for anxiety and PTSD without the depression risk associated with THC-containing cannabis?
  • ?What endocannabinoid biomarkers could guide treatment selection?

Trust & Context

Key Stat:
Evidence suggests CBD may help anxiety and PTSD but cannabis may worsen depression
Evidence Grade:
Review of recent literature highlighting the absence of well-designed RCTs for most conditions.
Study Age:
Published in 2020.
Original Title:
Cannabinoids and the endocannabinoid system in anxiety, depression, and dysregulation of emotion in humans.
Published In:
Current opinion in psychiatry, 33(1), 20-42 (2020)
Database ID:
RTHC-02461

Evidence Hierarchy

Meta-Analysis / Systematic Review
Randomized Controlled Trial
Cohort / Case-Control
Cross-Sectional / ObservationalSnapshot without intervening
This study
Case Report / Animal Study

Summarizes existing research on a topic.

What do these levels mean? →

Frequently Asked Questions

Should people with anxiety use cannabis?

The review found some evidence that CBD and CBD-enriched preparations may have anxiety-reducing properties, but the evidence is weak and well-designed clinical trials are lacking. THC-containing cannabis may have different effects than CBD alone.

Does cannabis worsen depression?

The review suggests depression may be worsened by cannabis use based on recent evidence, though randomized controlled trials specifically testing this are lacking. The relationship between cannabis and depression likely depends on the type of cannabinoid, dose, and individual factors.

Read More on RethinkTHC

Cite This Study

RTHC-02461·https://rethinkthc.com/research/RTHC-02461

APA

Chadwick, Verity L; Rohleder, Cathrin; Koethe, Dagmar; Leweke, F Markus. (2020). Cannabinoids and the endocannabinoid system in anxiety, depression, and dysregulation of emotion in humans.. Current opinion in psychiatry, 33(1), 20-42. https://doi.org/10.1097/YCO.0000000000000562

MLA

Chadwick, Verity L, et al. "Cannabinoids and the endocannabinoid system in anxiety, depression, and dysregulation of emotion in humans.." Current opinion in psychiatry, 2020. https://doi.org/10.1097/YCO.0000000000000562

RethinkTHC

RethinkTHC Research Database. "Cannabinoids and the endocannabinoid system in anxiety, depr..." RTHC-02461. Retrieved from https://rethinkthc.com/research/chadwick-2020-cannabinoids-and-the-endocannabinoid

Access the Original Study

Study data sourced from PubMed, a service of the U.S. National Library of Medicine, National Institutes of Health.

This study breakdown was produced by the RethinkTHC research team. We analyze and report published research findings without making health recommendations. All interpretations are based solely on the published abstract and study data.