A comprehensive review identified cannabidiol-enriched cannabis among 21 plant-based medicines with clinical trial evidence for anxiety, alongside established herbs like kava, chamomile, and passionflower.
Read this if you have anxiety and are interested in plant-based treatment options including CBD.
21 plants with clinical trial evidence for anxiety, CBD among the emerging options
What the researchers found
The review examined 1,525 papers and identified 53 plants with anxiolytic evidence, of which 21 had human clinical trials. Among those with the strongest evidence for chronic anxiety treatment were kava, chamomile, ginkgo, skullcap, milk thistle, passionflower, ashwagandha, and several others.
Cannabidiol-enriched (low-THC) cannabis was discussed among psychotropic plant-based treatments with emerging anxiolytic evidence. The review noted that CBD reduces anxiety without the psychoactive effects of THC and showed promise in social anxiety disorder. However, the evidence was still considered emerging compared to more established herbal anxiolytics.
Why it matters
Placing CBD in the context of other plant-based anxiolytics provides perspective. While CBD has received enormous popular attention, it is one of many plant medicines with anxiety evidence, and several herbs have stronger clinical trial support. This context helps patients make informed choices.
The numbers in context
1,525 papers reviewed. 53 plants with anxiolytic evidence. 21 with clinical trials. Chronic efficacy: kava, chamomile, ginkgo, skullcap, milk thistle, passionflower, ashwagandha, others. Emerging: CBD-enriched cannabis, psilocybin, ayahuasca.
How the study worked
Comprehensive narrative review searching MEDLINE, CINAHL, Scopus, and Cochrane Library through October 2012. Included studies using whole plant extracts. Part 2 of a two-part review covering plants with both preclinical and clinical evidence.
What this study cannot tell us
Narrative review with subjective evidence grading. Many included studies had methodological issues (small samples, brief interventions). Clinical trial quality varied enormously across plants. The CBD evidence was still emerging at the time. Standardization of plant preparations is a persistent challenge.
How to read the evidence
Comprehensive review of variable-quality clinical trials; moderate evidence base overall, with CBD still emerging.
When this study was published
Published in 2013. Clinical evidence for CBD in anxiety has grown substantially since.
The bigger picture
This review positioned CBD within the broader tradition of plant-based medicine for anxiety, rather than treating it as an isolated novelty. The comprehensive approach helps clinicians and patients understand the full range of evidence-based botanical options.
Questions still open
- How does CBD compare head-to-head with kava or passionflower for anxiety? Would combining CBD with other anxiolytic herbs produce additive effects? Which anxiety disorders respond best to plant-based treatments?
Common questions
Is CBD the best plant-based treatment for anxiety?
What plant-based treatments have the most evidence for anxiety?
Read the original research
Plant-based medicines for anxiety disorders, part 2: a review of clinical studies with supporting preclinical evidence.
CNS drugs, 27(4), 301-19
Citation
Sarris, Jerome; McIntyre, Erica; Camfield, David A. (2013). Plant-based medicines for anxiety disorders, part 2: a review of clinical studies with supporting preclinical evidence.. CNS drugs, 27(4), 301-19. https://doi.org/10.1007/s40263-013-0059-9
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