Open-label trial finds full-spectrum CBD reduced anxiety significantly within one week, with cognitive improvements | Research

The takeaway

In 14 patients with moderate-to-severe anxiety, four weeks of a full-spectrum high-CBD sublingual solution reduced anxiety by week 1 in most patients and also improved executive function, mood, sleep, and quality of life.

Patients considering CBD for anxiety, clinicians, and clinical trial researchers.

93% responded by week 1; 100% by week 3 with no serious side effects

What the researchers found

Anxiety scores decreased significantly by week 4 (BAI: p<0.001; OASIS: p<0.001). Clinically significant treatment response (≥15% symptom reduction) was achieved by week 1 in 78.6-92.7% of patients and reached 100% by week 3. Secondary outcomes including mood, sleep, quality of life, and executive function also improved. The study drug was well-tolerated with minor side effects (sleepiness, increased energy, dry mouth).

Why it matters

This is one of the first clinical trials to examine cognitive outcomes alongside anxiety outcomes with a CBD product, and the finding that executive function improved (rather than deteriorated) addresses a key safety concern.

The numbers in context

14 patients; ~30 mg/day CBD; BAI and OASIS both p<0.001 at week 4. Response by week 1: 78.6% (BAI), 92.7% (OASIS). 100% responded by week 3. No serious adverse events. No intoxication reported.

How the study worked

Open-label stage of clinical trial NCT02548559. 14 outpatients with moderate-to-severe anxiety (BAI ≥16 or OASIS ≥11) received 1 mL t.i.d. of a full-spectrum high-CBD sublingual solution (9.97 mg/mL CBD, 0.23 mg/mL THC) for 4 weeks. Autoregressive linear modeling assessed outcomes.

What this study cannot tell us

Open-label design without placebo control. Very small sample (n=14). Short duration (4 weeks). Full-spectrum product contains trace THC and other compounds. Cannot attribute effects to CBD alone. Double-blind stage ongoing.

How to read the evidence

Open-label pilot data only. Promising but awaiting double-blind confirmation.

When this study was published

Published in 2022.

The bigger picture

The rapid onset of anxiety reduction (within one week) and improvement in cognitive function distinguish this full-spectrum CBD product from both traditional anxiolytics (which may take weeks) and THC-containing products (which may impair cognition).

Questions still open

Will the double-blind stage confirm these open-label findings? Is the trace THC contributing to the effect? Would CBD isolate produce the same rapid response? How does this compare to standard anxiolytics?

Common questions

How quickly does CBD work for anxiety?

In this open-label trial, most patients (79-93%) achieved clinically significant anxiety reduction within the first week of treatment with a full-spectrum CBD product, and 100% responded by week 3.

Does CBD affect thinking and memory?

In this study, executive function (a measure of higher-order thinking) actually improved with CBD treatment, contrasting with concerns about cognitive impairment from cannabis products.

Read the original research

Clinical and cognitive improvement following full-spectrum, high-cannabidiol treatment for anxiety: open-label data from a two-stage, phase 2 clinical trial.

Communications medicine, 2(1), 139

View on PubMed ↗Publisher’s paper ↗

Citation

Dahlgren, Mary Kathryn; Lambros, Ashley M; Smith, Rosemary T; Sagar, Kelly A; El-Abboud, Celine; Gruber, Staci A. (2022). Clinical and cognitive improvement following full-spectrum, high-cannabidiol treatment for anxiety: open-label data from a two-stage, phase 2 clinical trial.. Communications medicine, 2(1), 139. https://doi.org/10.1038/s43856-022-00202-8