CBD shows most promise for psychosis and anxiety, but clinical evidence remains thin across all psychiatric disorders | Research

The takeaway

A scoping review found only 16 controlled studies of CBD for psychiatric disorders, with the most promising evidence for psychotic symptoms and anxiety but insufficient evidence for clinical use in any condition.

Psychiatrists, psychologists, patients considering CBD for mental health, and researchers planning clinical trials.

2,952 articles screened; only 16 controlled studies found

What the researchers found

Only 16 randomized controlled trials or within-subject studies met inclusion criteria. Studies covered psychotic disorders (6), anxiety (3), tobacco use (3), cannabis use (2), opioid use (1), and insomnia (1). No eligible studies existed for alcohol, stimulant use disorder, PTSD, ADHD, autism, or mood disorders. CBD was generally safe and well tolerated.

Why it matters

Despite enormous public and commercial interest in CBD for mental health, only 16 controlled studies exist across all psychiatric disorders. This quantifies the evidence gap clinicians face when patients ask about CBD.

The numbers in context

2,952 articles screened. 16 studies included. Distribution: psychosis (6), anxiety (3), tobacco (3), cannabis (2), opioid (1), insomnia (1). Zero studies for PTSD, ADHD, autism, mood disorders, alcohol, or stimulant use disorders.

How the study worked

Scoping review searching PubMed and PsycINFO for "cannabidiol" plus major psychiatric disorders. Of 2,952 articles screened, 16 randomized controlled trials or within-subject studies were included.

What this study cannot tell us

Scoping review, not systematic review or meta-analysis. Limited to controlled trials, which may exclude relevant observational data. Rapidly evolving field may have new studies since publication.

How to read the evidence

Scoping review with rigorous inclusion criteria that reveals the small size of the controlled evidence base.

When this study was published

Published in 2022.

The bigger picture

The mismatch between public enthusiasm for CBD as a mental health treatment and the tiny evidence base of 16 controlled studies highlights how far clinical research lags behind consumer behavior.

Questions still open

Will ongoing clinical trials change this picture? Should clinicians discourage CBD use for psychiatric conditions not yet studied, or is the safety profile sufficient to allow cautious use?

Common questions

Can CBD treat mental health conditions?

Out of 2,952 articles screened, only 16 controlled studies were found across all psychiatric disorders. The most promising preliminary findings relate to psychotic symptoms and anxiety, but there is not enough evidence to recommend clinical use.

Is CBD safe for psychiatric patients?

CBD was generally found to be safe and well tolerated across the 16 studies reviewed, though this limited evidence base means long-term safety in psychiatric populations is not fully established.

Read the original research

A scoping review of the use of cannabidiol in psychiatric disorders.

Psychiatry research, 308, 114347

View on PubMed ↗Publisher’s paper ↗

Citation

Kirkland, Anna E; Fadus, Matthew C; Gruber, Staci A; Gray, Kevin M; Wilens, Timothy E; Squeglia, Lindsay M. (2022). A scoping review of the use of cannabidiol in psychiatric disorders.. Psychiatry research, 308, 114347. https://doi.org/10.1016/j.psychres.2021.114347