Cannabis Anxiety Research

Changes in Cross-Sectional Associations Between Cannabis Use and Anxiety, Depression, and Suicidality in a Nationally Representative Sample of Canadians From 2012 to 2022: Évolution des relations transversales entre la consommation de cannabis et la dépression, l'anxiété et les idées suicidaires au sein d'un échantillon représentatif de Canadiens à l'échelle nationale, de 2012 à 2022.

Halladay, Jillian · 2026

From 2012 to 2022, the prevalence ratio for weekly+ cannabis use (vs.

Adolescent cannabis use and psychological distress from 2013 to 2023: A population-based study in Ontario, Canada.

McDonald, André J · 2026

Distress rose from 10.7% to 27.4% while cannabis use declined from 23.1% to 17.6%.

The prevalence of cannabis use pre-versus post-cannabis legalization in Canada by mental health status: findings from national repeat cross-sectional surveys.

Rundle, Samantha · 2026

Past 12-month cannabis use increased from pre-legalization among those with anxiety (AOR 1.33) in the year immediately following legalization.

Growing Concerns: A systematic review and Meta-Analysis of cannabis use and mental health risks in youth.

Sanz-Pérez, A · 2026

Unadjusted and adjusted odds ratios for youth cannabis users: Depression OR 1.51 (aOR 1.28).

Adolescent Cannabis Use and Risk of Psychotic, Bipolar, Depressive, and Anxiety Disorders.

Young-Wolff, Kelly C · 2026

This large longitudinal cohort study followed adolescents aged 13–17 who were screened for past-year cannabis use during routine pediatric care at Kaiser Permanente Northern California from 2016 to 2023, with follow-up through age 25. Adolescents who reported cannabis use had significantly higher rates of clinician-diagnosed psychiatric disorders compared to non-users.

Circuit mechanisms governing endocannabinoid modulation of affective behaviour and stress adaptation.

Loomba, Niharika · 2025

Endocannabinoid signaling modulates innate avoidance, conditioned fear, and stress responsivity through specific cortical-cortical and cortical-subcortical circuits.

The Prevalence and Predictors of Reported Prenatal Anxiety Among Primigravid Individuals in Nova Scotia.

Ramia, Jessica · 2025

In 53,852 first-time pregnancies in Nova Scotia (2004-2023), reported prenatal anxiety prevalence was 8.9% overall but rose from under 5% to over 20% over the study period.

The psychosis continuum: Systematic review on prodromal markers, symptom progression, and early intervention strategies.

Ricci, Valerio · 2025

This systematic review synthesized 60 studies spanning 25 years (2000–2025) to map the trajectory from early warning signs to full psychotic episodes.

High-Concentration Delta-9-Tetrahydrocannabinol Cannabis Products and Mental Health Outcomes : A Systematic Review.

Rittiphairoj, Thanitsara · 2025

In non-therapeutic studies, high-concentration THC showed unfavorable associations with psychosis/schizophrenia (70% of studies) and cannabis use disorder (75%).

Moderating Effect of Participation in Organized College Sports on Mental Health and Frequency of Cannabis Use in a National Cohort.

Zeiger, Joanna S · 2025

Higher cannabis use frequency was associated with greater likelihood of depression, anxiety, and PTSD diagnoses.

Associations Between Cannabis Use and Mental Distress in Young People: A Longitudinal Study.

Gripe, Isabella · 2024

Using fixed-effects models (which control for all stable individual characteristics), increasing cannabis use from none to 10+ times/year was associated in males with anxiety (RR 1.72, p=0.009), depressed mood (RR 1.49, p<0.001), and suicidal ideation (RR 3.43, p=0.012).

Development of an anxiety disorder following an emergency department visit due to cannabis use: a population-based cohort study.

Myran, Daniel T · 2024

Within 3 years of a cannabis ER visit, 12.3% were diagnosed with anxiety (ED/hospital) vs 1.2% general population (aHR 3.69).

Vaporized D-limonene selectively mitigates the acute anxiogenic effects of Δ9-tetrahydrocannabinol in healthy adults who intermittently use cannabis.

Spindle, Tory R · 2024

Co-administration of 30mg THC with 15mg d-limonene significantly reduced ratings of "anxious/nervous" and "paranoid" compared to 30mg THC alone.

Prevalence and correlates of cannabis use among individuals with DSM-5 social anxiety disorder: Findings from a nationally representative sample.

Patel, Tapan A · 2023

In both lifetime (N=1,255) and past-year (N=980) SAD samples, weekly+ cannabis use was significantly related to fear or avoidance of social situations interfering with relationships.

Directional associations between cannabis use and anxiety symptoms from late adolescence through young adulthood.

Davis, Jordan P · 2022

For the overall sample and men, greater cannabis use predicted greater subsequent increases in anxiety (substance-induced pathway).

Cannabis use among U.S. military veterans with subthreshold or threshold posttraumatic stress disorder: Psychiatric comorbidities, functioning, and strategies for coping with posttraumatic stress symptoms.

Hill, Melanie L · 2022

Veterans with PTSD who used cannabis more than weekly were significantly more likely to screen positive for depression (OR 3.4-3.8), anxiety, and suicidal ideation compared to non-users.

Cannabis containing equivalent concentrations of delta-9-tetrahydrocannabinol (THC) and cannabidiol (CBD) induces less state anxiety than THC-dominant cannabis.

Hutten, Nadia R P W · 2022

Both THC and THC/CBD increased state anxiety compared to placebo, but anxiety after THC/CBD was significantly lower than after THC alone.

Elevated social anxiety symptoms across childhood and adolescence predict adult mental disorders and cannabis use.

Krygsman, Amanda · 2022

Three social anxiety trajectories emerged: high increasing (15.5%), moderate (37.3%), and low (47.2%).

The Effectiveness and Safety of Cannabidiol in Non-seizure-related Indications: A Systematic Review of Published Randomized Clinical Trials.

Tang, Yuni · 2022

CBD appears to be anxiolytic (anxiety-reducing).

Comorbid Cannabis Use Disorder with Major Depression and Generalized Anxiety Disorder: A Systematic Review with Meta-analysis of Nationally Representative Epidemiological Surveys.

Onaemo, Vivian N · 2021

Cannabis use disorder was strongly associated with major depressive episodes (OR 3.22; 95% CI 2.31-4.49) and with generalized anxiety disorder (OR 2.99; 95% CI 2.14-4.16).

Longitudinal associations between amygdala reactivity and cannabis use in a large sample of adolescents.

Spechler, Philip A · 2020

Right amygdala reactivity to angry faces at age 14 (before cannabis use) significantly predicted cannabis use at age 19 in a dose-response fashion.

Cannabinoids for the treatment of mental disorders and symptoms of mental disorders: a systematic review and meta-analysis.

Black, Nicola · 2019

Pharmaceutical THC (with or without CBD) produced only a very small improvement in anxiety among patients with other medical conditions (SMD -0.25).

Association of Cannabis Use in Adolescence and Risk of Depression, Anxiety, and Suicidality in Young Adulthood: A Systematic Review and Meta-analysis.

Gobbi, Gabriella · 2019

Adolescent cannabis use was associated with depression in young adulthood (OR 1.37, 95% CI: 1.16-1.62), suicidal ideation (OR 1.50, 95% CI: 1.11-2.03), and suicide attempt (OR 3.46, 95% CI: 1.53-7.84).

Predicting Persistent, Limited, and Delayed Problematic Cannabis Use in Early Adulthood: Findings From a Longitudinal Study.

Hill, Sherika · 2017

Following 1,229 people from childhood through age 30, this study identified four distinct patterns of problematic cannabis use (cannabis use disorder or daily use) in early adulthood. The persistent pattern (6.7% of the sample) characterized people with problematic use in both late adolescence (19-21) and early adulthood (26-30).

The Endocannabinoid System and Anxiety.

Lisboa, S F · 2017

This comprehensive chapter reviewed how the endocannabinoid system influences anxiety across both human anxiety disorders and animal models. The system's effects on anxiety are remarkably complex.

The association between cannabis use and anxiety disorders: Results from a population-based representative sample.

Feingold, Daniel · 2016

This study followed thousands of Americans over three years to test whether cannabis use leads to anxiety disorders or vice versa.

Anxiety, depression and risk of cannabis use: Examining the internalising pathway to use among Chilean adolescents.

Stapinski, Lexine A · 2016

Researchers followed 2,508 ninth-graders from low-income schools in Santiago, Chile, for 18 months.

How cannabis causes paranoia: using the intravenous administration of ∆9-tetrahydrocannabinol (THC) to identify key cognitive mechanisms leading to paranoia.

Freeman, Daniel · 2015

This was the largest study of intravenous THC, randomizing 121 individuals with existing paranoid ideation to receive THC, placebo, or THC with prior cognitive awareness training.

Chemical probes of endocannabinoid metabolism.

Blankman, Jacqueline L · 2013

The review described the development and application of chemical tools that selectively block the enzymes degrading each major endocannabinoid.

A latent class analysis of illicit drug abuse/dependence: results from the National Epidemiological Survey on Alcohol and Related Conditions.

Agrawal, Arpana · 2007

Using latent class analysis of the National Epidemiological Survey on Alcohol and Related Conditions (43,093 participants), researchers identified five distinct patterns of illicit drug abuse/dependence. The largest class (92.5%) had no drug abuse/dependence.

Cannabis vaping and mental health: The association of Δ-9-tetrahydrocannabinol and cannabidiol with anxiety and depressive symptoms-Findings from the United States National Youth Tobacco Survey (2021-2023).

Chung, Jack · 2026

Adolescents who vaped THC only (aOR=1.40) or dual CBD/THC (aOR=1.51) were more likely to experience depressive symptoms.

The Prevalence of Cannabis Use Disorder in Individuals with Anxiety or Related Disorders: A Systematic Review.

Coles, Ashlee R L · 2026

Across general population samples, 3.3-21.6% of individuals with anxiety disorders had lifetime cannabis use disorder (CUD), and 4.3-20.0% had current CUD.

Therapeutic Use of Cannabis and Cannabinoids: A Review.

Hsu, Michael · 2026

Published in JAMA — the most widely read medical journal in the world — this review synthesized the therapeutic evidence for cannabis and cannabinoids across all conditions studied in randomized trials and meta-analyses. The strongest evidence supports three FDA-approved indications: HIV/AIDS-related anorexia (cannabinoids moderately increased body weight; SMD 0.57), chemotherapy-induced nausea and vomiting (small but significant reduction; SMD −0.29), and certain pediatric seizure disorders (CBD as Epidiolex). For chronic pain — the most common reason people report using medical cannabis — the review found that approximately 27% of US and Canadian adults have used cannabis medicinally, with 10.5% of the US population reporting CBD use for therapeutic purposes.

Effectiveness and clinical predictors of a virtual based combined cognitive behavioral and motivational enhancement group therapy for adults with cannabis use disorder.

Mehta, Dhvani D · 2026

Among the 79 participants who completed the program (68% retention), significant reductions were observed in cannabis use frequency, quantity, craving, depression (PHQ-9), and anxiety (GAD-7).

Tailored psychotherapy and AI-enhanced contingency management for co-occurring disorders in cannabis use disorder: a systematic review.

Mishra, Sidharth · 2026

Integrated cognitive-behavioral therapies improved psychiatric symptoms and reduced cannabis use, particularly for co-occurring depression and PTSD.

Cannabis Use in a Community-Based Sample of Adults Diagnosed With ADHD: Prevalence, Impact on Symptoms, and Stimulant Side Effects.

Ryan, Jennie E · 2026

Cannabis use was highly prevalent: 75% ever used, 41% past-30-day use.

UK Medical Cannabis Registry: a case series analysing clinical outcomes of medicinal cannabis therapy for fibromyalgia.

Varadpande, Madhur · 2026

All patient-reported outcome measures improved significantly from baseline through 18 months of follow-up.

Canadian real-world evidence: observational 24-week outcomes for health care practitioner authorized cannabis.

Yang, Brian · 2026

Over 24 weeks, patients showed improvements in pain interference (-4.6 points), numeric pain rating (-1.19), anxiety (-2.24), depression (-2.79), and quality of life (-0.56).

Cannabinoid CB1 receptor in dopaminergic circuit from ventral tegmental area to nucleus accumbens links trait anxiety with reward learning.

Cui, Chi · 2025

High trait anxiety mice exhibited increased reward learning.

The differential effects of medicinal cannabis on mental health: A systematic review.

de Bode, Nora · 2025

High doses of CBD provided some acute relief in anxiety disorders.

Endocannabinoid signaling in stress, nausea, and vomiting.

DeVuono, Marieka V · 2025

The endocannabinoid system normally regulates nausea, vomiting, and anxiety.

Examining the Role of Anxiety Sensitivity and Intolerance of Uncertainty in Terms of Cannabis Use and Coping Motives for Cannabis Use in College Students With Clinically Elevated Worry.

Goldblum, Rachel S · 2025

Greater anxiety sensitivity was significantly associated with more frequent past-month cannabis use (explaining 4.4% of variance) and stronger coping motives for use (4.9% of variance).

Role of interplay between endocannabinoids and neuropeptides in pathogenesis and therapy of depressive and anxiety disorders.

Gołyszny, Miłosz · 2025

The hypothalamus is the primary site of proven bidirectional endocannabinoid-neuropeptide interactions.

Impulsivity traits moderate the longitudinal association between mental health and hazardous cannabis use in emerging adults.

González-Roz, Alba · 2025

In a sample of 2,762 college students tracked over one year, anxiety at the midpoint predicted hazardous cannabis use at the final assessment.

Examining bidirectional associations between cannabis use and internalizing symptoms among high-risk emerging adults: A prospective cohort study.

Halladay, Jillian · 2025

Using seven assessments over two years, significant bidirectional within-person relationships were found between cannabis consequences and internalizing symptoms, but the primary direction was from cannabis consequences to increased depressive symptoms, not from depression to increased cannabis use.

Beyond the hype - who uses cannabidiol for self-medication - and why: a cross-sectional study in Germany.

Krowartz, Eva-Maria · 2025

37.9% used CBD for self-medication.

Prospective associations of COVID-related stress with vaping nicotine and cannabis among high school students: Mediated by vaping susceptibility.

Lee, Ryan · 2025

COVID-related stress during remote learning (2020-2021) predicted increased susceptibility to cannabis vaping one year later (B=0.04, p=0.02), which predicted actual cannabis vaping another year later (B=1.62, p<0.001).

Effects of Cannabinoids on Emotional States and Alcohol Use Among Underrepresented Groups: Moderation by Perceived Discrimination.

Martin-Willett, Renée · 2025

Participants using CBD showed greater decreases in DASS (Depression Anxiety Stress Scale) scores compared to THC users over 4 weeks.

Circulating endocannabinoids in children and adolescents: associations with anxiety and the impact of selective serotonin reuptake inhibitors.

Marusak, Hilary A · 2025

After adjusting for BMI, age, sex, and time of day, higher AEA and lower 2-AG were associated with more severe anxiety symptoms.

Associations Between Cannabis Use and Mental Health in Patients Accessing Treatment for Substance Use Disorders: An Exploratory Cross-Sectional Study.

Matheson, Justin · 2025

Cannabis use was significantly associated with trauma history and several psychiatric diagnoses including anxiety and depression, with the highest prevalence in current users.

Hexahydrocannabinol (HHC) use and harms in Ireland: New findings from the 2024 European Web Survey on Drugs.

Mongan, Deirdre · 2025

Hexahydrocannabinol (HHC)—a semi-synthetic cannabinoid marketed as a legal alternative to cannabis—was openly sold in Irish shops until it was banned in July 2025.

Cyberbullying, mental health, and substance use experimentation among early adolescents: a prospective cohort study.

Nagata, Jason M · 2025

Cyberbullying victimization at ages 11-12 was prospectively associated with cannabis experimentation one year later (AOR 4.65, 95% CI 2.46-8.77), along with alcohol (AOR 1.98) and nicotine experimentation (AOR 3.37).

Cannabinoids for Anxiety and Sleep Disturbances: A Scoping Review.

Perez, Juan G · 2025

Of 29 studies meeting inclusion criteria, about 45% reported positive effects on both anxiety and sleep outcomes.

Effects of Different Cannabinoid Formulations on Anxiety-Related Disorders, and Tourette Syndrome: A Systematic Review and Meta-Analysis.

Raminelli, Adrieli Oliveira · 2025

Across 21 placebo-controlled RCTs covering social anxiety, GAD, PTSD, OCD, and Tourette syndrome, pure CBD compounds showed a moderate significant effect (SMD -0.61, 95% CI -1.15 to -0.07).

Measuring the Effects of Cannabis on Anxiety and Depression Among Cancer Patients.

Reddy, Apoorva C · 2025

This longitudinal study followed 1,962 cancer patients enrolled in the Minnesota Medical Cannabis Program, measuring self-reported anxiety and depression before and after 30 days of use.

Medicinal cannabis in the management of anxiety disorders: A systematic review.

Roberts, Leah · 2025

This review examined 57 studies on medicinal cannabis for diagnosed anxiety disorders.

The Complex Relationship Between Cannabis Use and Mental Health: Considering the Influence of Cannabis Use Patterns and Individual Factors.

Sagar, Kelly A · 2025

This review highlights that seemingly contradictory findings in cannabis-mental health research are largely explained by unmeasured variables.

Anxiety sensitivity and cannabis use: A systematic review and conceptualization of research findings.

Short, Nicole A · 2025

Elevated anxiety sensitivity was directly associated with greater coping-oriented and potentially problematic cannabis use, but not with lifetime cannabis use or overall use frequency.

Experimental study on cannabis use and affect: Effects on reactivity to and recovery from negative stimuli.

Skrzynski, Carillon J · 2025

All three cannabis conditions (THC-dominant, CBD-dominant, 1:1 ratio) showed greater emotional reactivity to a rumination task but also stronger recovery after a breathing exercise compared to the non-use condition.

The roles of cannabis potency and gender in cannabis dependence and anxiety in recent cannabis users with trauma exposure histories.

Snooks, T · 2025

Cannabis potency measured as relative THC proportion (THC%/[THC%+CBD%]) was significantly correlated with cannabis dependence (p=0.002) and anxiety (p=0.020).

Frequency of cannabis use and symptoms of anxiety and depression: a cross-sectional analysis of the Colorado cannabis users health cohort.

Steeger, Christine M · 2025

Frequent cannabis use was associated with higher anxiety likelihood (AOR 1.06, 95% CI 1.01-1.12) but not depression on validated scales.

Acute and chronic effects of medicinal cannabis use on anxiety and depression in a prospective cohort of patients new to cannabis.

Wolinsky, David · 2025

Adults initiating medicinal cannabis for clinically significant anxiety and/or depression showed improvements on both ecological momentary assessment (real-time) and longitudinal follow-up evaluations over 6 months..

An Amygdala-hippocampus Circuit for Endocannabinoid Modulation of Anxiety Avoidance.

Xue, Bao · 2025

Endocannabinoids are released at amygdala-to-ventral hippocampus synapses during anxiety avoidance, activating CB1 receptors that reduce glutamate release and decrease anxiety — revealing a specific circuit-level mechanism for endocannabinoid anxiety regulation..

Ultra-Weak Photon Emission Demonstrates Specificity for Anxiety over Pain in Cannabis-Treated Chronic Neuropathic Pain: A Biomarker Validation Study.

Yassin, Mustafa · 2025

This study has two distinct contributions.

Acute and Extended Anxiolytic Effects of Cannabidiol in Cannabis Flower: A Quasi-Experimental ad libitum Use Study.

Bidwell, L Cinnamon · 2024

All cannabis groups reported anxiety reduction over 4 weeks, but CBD-dominant use was associated with lower DASS anxiety scores (difference=-1.03, p=0.02) and lower acute tension and paranoia compared to THC-dominant.

Marijuana use among community-dwelling older adults: A population-based study.

De Genna, Natacha M · 2024

Cannabis research in older adults has mostly relied on convenience samples — people recruited from dispensaries or cannabis clinics who are already enthusiastic users.

Use and perceptions of Cannabidiol among individuals in treatment for opioid use disorder.

Kudrich, Christopher · 2024

CBD has become wildly popular, with claims ranging from anxiety relief to pain management.

Cannabis use and its association with psychopathological symptoms in a Swiss adult population: a cross-sectional analysis.

Mosandl, Christoph Felix · 2024

After adjusting for age, gender, education, alcohol, and other substance use, only depression and ADHD remained significantly associated with both frequency (p=.006, p=.034) and quantity (p=.037, p=.019).

Cannabinoids in the Treatment of Selected Mental Illnesses: Practical Approach and Overview of the Literature.

Müller-Vahl, Kirsten R · 2024

Increasing evidence supports cannabinoids for ASD, Tourette syndrome, anxiety disorders, and PTSD.

A Cross-Sectional Survey Study of Cannabis Use for Fibromyalgia Symptom Management.

Singla, Abhinav · 2024

Of 1,336 fibromyalgia patients, 49.5% (661) reported cannabis use since diagnosis.

Cannabis use and social anxiety disorder in emerging adulthood: Results from a nationally representative sample.

Single, Alanna · 2024

The prevalence of co-occurring cannabis use and social anxiety disorder was 1.10%.

The safety and efficacy of low oral doses of cannabidiol: An evaluation of the evidence.

Arnold, Jonathon C · 2023

Therapeutic benefits became clearly evident at doses of 300 mg or higher.

Medicinal cannabis for psychiatry-related conditions: an overview of current Australian prescribing.

Cairns, Elizabeth A · 2023

Of approximately 300,000 Special Access Scheme B approvals for medical cannabis in Australia (2016-2022), 33.9% were for psychiatric conditions.

Multinational Association of Supportive Care in Cancer (MASCC) guidelines: cannabis for psychological symptoms including insomnia, anxiety, and depression.

De Feo, Giulia · 2023

From 829 articles screened, 2 systematic reviews and 15 RCTs met criteria.

The therapeutic potential of purified cannabidiol.

O'Sullivan, Saoirse Elizabeth · 2023

The areas with the most clinical evidence for purified CBD were anxiety (7 uncontrolled + 17 RCTs), psychosis/schizophrenia (1 uncontrolled + 8 RCTs), PTSD (2 uncontrolled + 4 RCTs), and substance abuse (2 uncontrolled + 3 RCTs).

Disruption of tonic endocannabinoid signalling triggers cellular, behavioural and neuroendocrine responses consistent with a stress response.

Petrie, Gavin N · 2023

CB1 receptor antagonist/inverse agonist AM251, neutral antagonist NESS243, and NAPE-PLD inhibitor LEI401 all uniformly increased PVN Fos expression, unmasked stress-linked behaviors (grooming), and increased circulating corticosterone, mimicking the effects of actual stress.

Predictors of Pain Reduction Among Fibromyalgia Patients Using Medical Cannabis: A Long-Term Prospective Cohort Study.

Sotoodeh, Romina · 2023

Reductions in pain intensity among fibromyalgia patients using medical cannabis were partially mediated by concurrent improvements in sleep quality and reductions in anxiety and depression symptoms..

Medicinal cannabis for the treatment of anxiety disorders.

Berger, Maximus · 2022

CBD demonstrated anxiolytic effects in trials with healthy volunteers and clinical populations, though evidence remains insufficient for first-line treatment.

A survey of medical cannabis use during perimenopause and postmenopause.

Dahlgren, M Kathryn · 2022

86.1% reported current cannabis use and 78.7% used it for menopause symptoms.

Co-use of Tobacco Products and Cannabis among Veterans: A Preliminary Investigation of Prevalence and Associations with Mental Health Outcomes.

Fitzke, Reagan E · 2022

Past 30-day co-users of tobacco and cannabis endorsed significantly higher levels of stress, PTSD, depression, and anxiety compared to singular product users.

Effects of cannabidiol in cannabis flower: Implications for harm reduction.

Gibson, Laurel P · 2022

Among 159 regular cannabis users randomly assigned to three chemovars, the THC+CBD chemovar (9% THC, 10% CBD) produced similar positive mood effects but significantly less paranoia and anxiety compared to the THC-dominant chemovar (24% THC, 1% CBD).

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

Kirkland, Anna E · 2022

Only 16 randomized controlled trials or within-subject studies met inclusion criteria.

Gender Differences in Dual Diagnoses Associated with Cannabis Use: A Review.

Prieto-Arenas, Laura · 2022

Studies consistently show gender differences in cannabis-associated psychiatric symptoms, but the direction varies across studies and conditions.

Developing a real-world evidence base for prescribed cannabis in the United Kingdom: preliminary findings from Project Twenty21.

Sakal, C · 2022

678 patients enrolled in 7 months.

Association between continued cannabis use during pregnancy and symptoms of anxiety and depression.

Mark, Katrina · 2021

Women who continued cannabis use had significantly higher odds of elevated GAD scores (2.55, 95% CI 1.31-4.99) and EPDS depression scores (2.75, 95% CI 1.43-5.28) compared to non-users.

Cannabidiol use and effectiveness: real-world evidence from a Canadian medical cannabis clinic.

Rapin, Lucile · 2021

All ESAS-r symptom scores improved significantly from baseline to 3 months (all p<0.003).

Maternal cannabis use is associated with suppression of immune gene networks in placenta and increased anxiety phenotypes in offspring.

Rompala, Gregory · 2021

Children exposed to maternal cannabis had increased hair cortisol levels, greater anxiety, aggression, and hyperactivity on BASC-2 assessments, and reduced vagal tone (high-frequency HRV) at baseline.

Evidence for Use of Cannabinoids in Mood Disorders, Anxiety Disorders, and PTSD: A Systematic Review.

Stanciu, Corneliu N · 2021

Of 8 identified RCTs, CBD pretreatment showed promise for social anxiety in laboratory settings, but THC showed no benefit for depression and actually worsened anxiety and psychotic symptoms in over 50% of hospitalized depression patients.

Diversity of molecular targets and signaling pathways for CBD.

de Almeida, Douglas L · 2020

CBD's effects are mediated through multiple molecular mechanisms rather than a single target.

Cannabis Use and Internalizing/Externalizing Symptoms in Youth: A Canadian Population-Based Study.

Girgis, Joseph · 2020

Frequent cannabis use was associated with elevated externalizing symptoms (OR 2.17 in males, 5.13 in females) and internalizing symptoms (OR 2.07 in males, 3.40 in females).

Cannabinoid CB2 receptors mediate the anxiolytic-like effects of monoacylglycerol lipase inhibition in a rat model of predator-induced fear.

Ivy, Devon · 2020

JZL184 (MGL inhibitor) dose-dependently suppressed predator-induced fear (ED50 = 4 mg/kg).

The therapeutic role of Cannabidiol in mental health: a systematic review.

Khan, Rabia · 2020

Across 23 included studies, CBD showed the most consistent positive signals for anxiety disorders and as an adjunct treatment for schizophrenia.

Dosage, Efficacy and Safety of Cannabidiol Administration in Adults: A Systematic Review of Human Trials.

Larsen, Christian · 2020

Across 25 studies (927 patients), CBD showed anxiolytic effects with acute administration and therapeutic effects for social anxiety disorder, psychotic disorder, and substance use disorders.

Altered Effective Connectivity of Central Autonomic Network in Response to Negative Facial Expression in Adults With Cannabis Use Disorder.

Ma, Liangsuo · 2020

Compared to 23 controls, 23 people with cannabis use disorder showed stronger amygdala-to-hypothalamus connectivity and amygdala-to-fusiform gyri connectivity when viewing fearful/angry faces.

Is there a relationship between cannabis use problems, emotion dysregulation, and mental health problems among adults with chronic pain?

Orr, Michael F · 2020

In 431 opioid-using adults with moderate to severe chronic pain (176 current cannabis users, 30% with cannabis use problems), emotion dysregulation significantly mediated the relationship between cannabis use problems and anxiety, depression, and suicidal ideation.

A time-dependent contribution of hippocampal CB1 , CB2 and PPARγ receptors to cannabidiol-induced disruption of fear memory consolidation.

Raymundi, Ana Maria · 2020

CBD (10-30 pmol) injected into the dorsal hippocampus impaired fear memory consolidation when given immediately or 1 hour after conditioning, but not at 3 hours.

The effects of Cannabidiol (CBD) and Delta-9-Tetrahydrocannabinol (THC) on the recognition of emotions in facial expressions: A systematic review of randomized controlled trials.

Rossi, Giordano Novak · 2020

Across 7 experiments (170 total participants), THC (7.5-15 mg) had no effect in 3 experiments and reduced facial emotion recognition in 3 others.

Medicinal cannabis for psychiatric disorders: a clinically-focused systematic review.

Sarris, Jerome · 2020

CBD showed tentative support for reducing social anxiety.

Impact of Medical Cannabis on Patient-Reported Symptoms for Patients With Cancer Enrolled in Minnesota's Medical Cannabis Program.

Anderson, Susan P · 2019

Significant reductions were found across all 8 symptoms (anxiety, appetite loss, depression, sleep disturbance, fatigue, nausea, pain, and vomiting) within 4 months of starting medical cannabis.

Cannabis and Neuropsychiatric Disorders: An Updated Review.

Chayasirisobhon, Sirichai · 2019

CBD has demonstrated therapeutic benefit across multiple neuropsychiatric conditions including autism spectrum disorder, anxiety, psychosis, neuropathic pain, cancer pain, migraine, MS, Alzheimer disease, Parkinson disease, Huntington disease, hypoxic-ischemic injury, and epilepsy.

The Mental Health of Young Canadians Who Are Not Working or in School.

Gariépy, Geneviève · 2019

Being NEET was associated with depression (OR 1.67), generalized anxiety disorder (OR 2.65), and other drug use disorder (OR 3.22), but was not associated with cannabis use disorder (OR 0.97) or alcohol use disorder (OR 1.03)..

Is there a role for cannabidiol in psychiatry?

Khoury, Julia Machado · 2019

Evidence levels varied: B-level for cannabis withdrawal, C2 for cannabis addiction, C1 for positive symptoms in schizophrenia and anxiety in social anxiety disorder.

Cannabis and mental illness: a review.

Lowe, Darby J E · 2019

The review found increasing documentation of potential harms from cannabis use in patients with psychotic and mood disorders, while data supporting beneficial effects in psychiatric populations remains limited.

Single and combined effects of plant-derived and synthetic cannabinoids on cognition and cannabinoid-associated withdrawal signs in mice.

Myers, Alyssa M · 2019

THC caused significant motor and cognitive impairment in Barnes maze; adding CBD did not attenuate these effects.

Use of medicinal cannabis and synthetic cannabinoids in post-traumatic stress disorder (PTSD): A systematic review

Orsolini, Laura · 2019

This systematic review gathered everything published through May 2019 on cannabis and synthetic cannabinoids for PTSD.

Translational Investigation of the Therapeutic Potential of Cannabidiol (CBD): Toward a New Age.

Crippa, José A · 2018

Brazilian researchers who have been at the forefront of CBD research reviewed the translational evidence, from basic science to clinical application, for CBD across multiple neuropsychiatric conditions. The most established properties of CBD include anxiolytic (anxiety-reducing), antipsychotic, and neuroprotective effects.

The Psychiatric Consequences of Cannabinoids.

De Aquino, Joao P · 2018

This overview examined the psychiatric effects of both plant-based and synthetic cannabinoids across different timeframes. Acutely, cannabinoids produce multiphasic, dose-dependent effects on anxiety, mood, and perception while impairing cognition and psychomotor function.

Clinical and functional outcomes of cannabis use among individuals with anxiety disorders: A 3-year population-based longitudinal study.

Feingold, Daniel · 2018

Researchers analyzed data from 3,723 individuals with diagnosed anxiety disorders (social anxiety, panic disorder, generalized anxiety disorder, specific phobias) from the National Epidemiologic Survey on Alcohol and Related Conditions. In unadjusted analysis, remission rates from anxiety disorders decreased with increasing levels of cannabis use, suggesting cannabis worsened outcomes. However, after adjusting for baseline confounders, the association between cannabis use and lower remission rates was no longer statistically significant.

Pharmacological properties of cannabidiol in the treatment of psychiatric disorders: a critical overview.

Mandolini, G M · 2018

Researchers reviewed all clinical studies investigating CBD as treatment for psychiatric symptoms and linked findings to pharmacological mechanisms. For schizophrenia: CBD may exert antipsychotic effects primarily through facilitation of endocannabinoid signaling and CB1 receptor antagonism.

Negative affectivity as a mechanism underlying perceived distress tolerance and cannabis use problems, barriers to cessation, and self-efficacy for quitting among urban cannabis users.

Manning, Kara · 2018

Researchers studied 203 urban adult daily cannabis users (29.2% female, mean age 37.7, 63% African American) to understand why low distress tolerance is linked to cannabis problems. Negative affectivity (the general tendency to experience negative emotions) significantly mediated the relationship between distress tolerance and multiple cannabis outcomes: - Cannabis use problems (b=-0.58, 95% CI [-1.14, -0.21]) - Cannabis withdrawal (b=-0.65, 95% CI [-1.36, -0.21]) - Self-efficacy for quitting (b=-0.83, 95% CI [-1.85, -0.22]) - Perceived barriers to cessation (b=-0.71, 95% CI [-1.51, -0.24]) In other words, people who perceive they cannot tolerate distress tend to experience more negative emotions generally, which in turn drives cannabis problems, withdrawal severity, low confidence in quitting, and perception of more barriers to stopping..

Deficient endocannabinoid signaling in the central amygdala contributes to alcohol dependence-related anxiety-like behavior and excessive alcohol intake.

Serrano, Antonia · 2018

Alcohol dependence decreased baseline 2-AG levels and increased glutamate and GABA in the central amygdala.

Acute induction of anxiety in humans by delta-9-tetrahydrocannabinol related to amygdalar cannabinoid-1 (CB1) receptors.

Bhattacharyya, Sagnik · 2017

In 14 healthy males studied with both fMRI and PET imaging, a 10mg oral dose of THC induced anxiety and changed how the right amygdala responded while processing fearful faces.

Cannabis as a substitute for prescription drugs - a cross-sectional study.

Corroon, James M · 2017

Of 2,774 cannabis users surveyed, 1,248 (46%) reported using cannabis as a substitute for prescription drugs.

Cannabis and development of dual diagnoses: A literature review.

Hanna, Rebecca C · 2017

This narrative review examined the relationship between cannabis use and psychiatric disorders across multiple categories.

Reductions in cannabis use are associated with improvements in anxiety, depression, and sleep quality, but not quality of life.

Hser, Yih-Ing · 2017

This study tracked 302 adults with cannabis use disorder over 12 weeks of a medication trial, splitting them into those whose cannabis use decreased and those whose use increased. The cannabis reduction group (152 people) showed statistically significant improvements in anxiety, depression, and sleep quality compared to the cannabis increase group (150 people), even after controlling for demographics, treatment condition, and concurrent tobacco and alcohol use. However, reductions in cannabis use did not translate into improved overall quality of life.

Substitution of medical cannabis for pharmaceutical agents for pain, anxiety, and sleep.

Piper, Brian J · 2017

Among 1,513 New England dispensary members surveyed, the rates of medication reduction after starting medical cannabis varied significantly by drug class.

Attitudes to cannabis and patterns of use among Canadians with multiple sclerosis.

Banwell, Emma · 2016

Researchers surveyed 225 people with multiple sclerosis (MS) attending neurology and neuropsychiatry clinics in Canada about their cannabis use and attitudes. Overall attitudes were favorable: 54.3% approved of cannabis and 43.7% endorsed full legalization, while another 43.7% supported legalization for medical use only.

The impact of cannabis use on clinical outcomes in recent onset psychosis.

Barrowclough, Christine · 2015

This study followed 110 people with early psychosis who also had cannabis abuse or dependence, measuring their substance use and symptoms at four time points over 18 months.

Cannabidiol: pharmacology and potential therapeutic role in epilepsy and other neuropsychiatric disorders.

Devinsky, Orrin · 2014

This landmark review by leading researchers summarized the evidence for CBD across multiple neuropsychiatric conditions.

Functional connectivity alterations in brain networks relevant to self-awareness in chronic cannabis users.

Pujol, Jesus · 2014

Compared to 29 controls, 28 heavy cannabis users showed increased functional connectivity within the core of the Default Mode Network and Insula Network, and enhanced anticorrelation between these two networks.

Treatment of cannabis dependence using escitalopram in combination with cognitive-behavior therapy: a double-blind placebo-controlled study.

Weinstein, A M · 2014

Cannabis-dependent users received 9 weeks of weekly CBT and motivational enhancement therapy along with either escitalopram (10 mg/day) or placebo.

Changes in cannabis use among young people: impact on mental health.

Copeland, Jan · 2013

The review examined current trends in youth cannabis use and their mental health implications.

Plant-based medicines for anxiety disorders, part 2: a review of clinical studies with supporting preclinical evidence.

Sarris, Jerome · 2013

The review examined 1,525 papers and identified 53 plants with anxiolytic evidence, of which 21 had human clinical trials.

Acute effects of a single, oral dose of d9-tetrahydrocannabinol (THC) and cannabidiol (CBD) administration in healthy volunteers.

Martin-Santos, R · 2012

Sixteen healthy male volunteers received oral THC (10 mg), CBD (600 mg), or placebo in a double-blind crossover design with one-month intervals between sessions.

Cannabidiol in humans-the quest for therapeutic targets.

Zhornitsky, Simon · 2012

The review identified 34 studies: 16 in healthy subjects and 18 in clinical populations covering MS, schizophrenia, bipolar mania, social anxiety, pain, cancer, Huntington's disease, insomnia, and epilepsy. Key findings included: high inhaled/IV doses of CBD were needed to block THC effects.

Cannabidiol reduces the anxiety induced by simulated public speaking in treatment-naïve social phobia patients.

Bergamaschi, Mateus M · 2011

Twenty-four treatment-naive SAD patients were randomized to CBD 600 mg (n=12) or placebo (n=12), with 12 healthy controls.

Associations of social phobia and general anxiety with alcohol and drug use in a community sample of adolescents.

Fröjd, Sari · 2011

Researchers followed Finnish adolescents aged 15-16 at baseline over two years to examine how anxiety related to substance use. Anxiety preceded substance use, but no reciprocal effect was found (substance use did not predict anxiety).

Cannabis and anxiety: a critical review of the evidence

Crippa, Jose Alexandre S. · 2009

Acute anxiety reactions and panic attacks were commonly reported during cannabis intoxication.

Does occasional cannabis use impact anxiety and depression treatment outcomes?: Results from a randomized effectiveness trial.

Bricker, Jonathan B · 2007

In a randomized trial of 232 adults with anxiety and panic disorders, researchers examined whether occasional cannabis use affected treatment outcomes. Participants receiving a combined cognitive-behavioral therapy (CBT) and medication intervention showed similar improvements in anxiety regardless of cannabis use frequency.

Nicotine and cannabinoids: parallels, contrasts and interactions.

Viveros, Maria-Paz · 2006

This review examined the pharmacological interactions between nicotine and cannabis, two drugs increasingly used in combination, especially by adolescents and young adults. Animal studies suggested that the reinforcing effects of both drugs may be enhanced by joint consumption.

Comorbidity: cannabis and complexity.

Raphael, Beverley · 2005

This review covered multiple dimensions of cannabis health effects and comorbidity.

Self-reported psychopathological symptoms in recreational ecstasy (MDMA) users are mainly associated with regular cannabis use: further evidence from a combined cross-sectional/longitudinal investigation.

Daumann, Jörg · 2004

At baseline, ecstasy users reported significantly more psychological complaints than controls.

Randomised Controlled Trial Evidence on Medicinal Cannabis for Treatment of Mental Health and Substance Use Disorders: A Scoping Review.

Cooling, Sophie · 2026

This scoping review mapped all available randomized controlled trial evidence on medicinal cannabis for mental health conditions classified by the DSM-5.

Impact of prenatal delta-9-tetrahydrocannabinol exposure on mouse brain development: a fetal-to-adulthood magnetic resonance imaging study.

Cupo, Lani · 2026

Using MRI brain scans at nine timepoints from gestation through adulthood, researchers tracked what happened to mouse brains after prenatal THC exposure.

The effects of cannabidiol on sleep disturbances within a sample of high trait worriers: A double-blind, randomized placebo controlled trial.

Gournay, L Riley · 2026

300 mg CBD decreased sleep disturbances significantly more than 50 mg CBD (B=-0.39, t=-2.59, p<0.05, d=0.08) but not significantly more than placebo (B=-0.32, t=-2.09, p=0.10, d=0.07), with no effects on sedation or cognitive impairment..

Chronic cannabidiol treatment effects on contextual fear and neuropathic pain in Carioca rats high and low conditioned freezing.

Macêdo-Souza, Carolina · 2026

CBD (5 mg/kg daily for 10 days) reduced allodynia across all rat lineages bred for different anxiety levels, though anxiety-prone (CHF) rats showed less benefit.

Cannabinoids and drug-drug pharmacokinetic interactions: Deciphering the risks.

Papakyriakopoulou, Paraskevi · 2026

This review mapped the pharmacokinetic drug-drug interactions involving cannabinoids across the full ADME framework (absorption, distribution, metabolism, excretion). The metabolism interactions are the most clinically significant.

A qualitative study on cannabis use for harm reduction and pain among veterans enrolled in an SUD treatment program.

Pleasant, Traben · 2026

Through interviews with 33 veterans receiving care in a VA substance use disorder treatment program, researchers documented how veterans with chronic pain viewed and used cannabis alongside their addiction treatment. Most participants had a primary diagnosis of alcohol use disorder (70%), followed by opioid use disorder (18%) and stimulant use disorder (12%).

Anxiety Sensitivity and Coping-Oriented Cannabis Use: The Moderating Role of Positive Cannabis Expectancies.

Reyes, Lauren D · 2026

The interaction between anxiety sensitivity and positive cannabis expectancies was significant: the link between anxiety sensitivity and coping-oriented use was stronger when positive expectancies were high.

Involvement of Adenosine A2A Receptors in Anxiety-Like Behaviors in Tetrahydrocannabinol-Treated Mice.

Ün, Burçin · 2026

THC induced anxiety-like behavior in mice.

Effects of Medical Cannabis Treatment for Autistic Children on Anxiety and Restricted and Repetitive Behaviors and Interests: An Open-Label Study.

David, Ayelet · 2025

Significant reductions in overall anxiety and specific subtypes (general, social, panic, separation) after 6 months.

Unravelling a potential therapeutic effect of polymeric lipid-core nanoencapsulated cannabidiol on anxiety- and panic-like behaviours elicited by Bothrops jararaca lancehead pit vipers.

de Paula Rodrigues, Bruno Mangili · 2025

Polymeric lipid-core nanoencapsulated CBD at low doses significantly reduced defensive attention, flat-back approach, and escape behaviors in mice facing a pit viper.

Stress reactivity is modulated by cannabinoid type-1 receptors in norepinephrine and epinephrine neurons in a context-dependent manner.

Engborg, Christopher B · 2025

Mice lacking CB1 receptors in NE/E neurons showed reduced avoidance after restraint stress, increased escape behavior to visual threats, and reduced immobility in forced swim, but normal baseline anxiety and unchanged heart rate responses to foot shock..

Monthly simultaneous cannabis and alcohol use: effects on depression, anxiety, and stress in male and female college students.

Hetelekides, Eleftherios M · 2025

Among 367 college students, monthly simultaneous cannabis and alcohol (SCA) use significantly predicted depression in both males (beta=0.322) and females (beta=0.296).

The Effects of Indirect and Direct Modulation of Endocannabinoid System Function on Anxiety-Related Behavior in Mice Assessed in the Elevated Plus Maze Test.

Kruk-Slomka, Marta · 2025

CB1 antagonist AM 251 was anxiogenic.

Inflammatory state moderates response to cannabis on negative affect and sleep quality in individuals with anxiety.

Lisano, Jonathon K · 2025

While cannabis use did not change cytokine concentrations over four weeks, baseline inflammation moderated outcomes.

Personality-based intergenerational effects of prenatal THC exposure in an inherited mouse model of social dominance and submissiveness.

Mari, Mohamed · 2025

In selectively bred dominant mice, prenatal THC exposure reduced body weight and increased anxiety-like behaviors.

Possible Anxiolytic Effects of Cannabidiol (CBD) Administration on Feline Responses to a Fear Response Test.

Masataka, Nobuo · 2025

After two weeks of CBD administration (4.0 mg/kg/day), cats exposed to a simulated thunderstorm showed significantly reduced fear-related urination compared to their initial test.

Effects of Cannabidiol on Social Relating, Anxiety, and Parental Stress in Autistic Children: A Randomized Controlled Crossover Trial.

Parrella, Nina-Francesca · 2025

CBD oil (10 mg/kg/day for 12 weeks) did not significantly improve the primary outcome of social responsiveness (SRS-2).

A cannabidiol (CBD) lipid-based nanoemulsion induces anxiolytic- and panicolytic-like effects and increases FosB/deltaFosB immunoreactivity in serotonergic cells of the dorsal raphe.

Rosário, Bárbara A · 2025

Chronic oral CBD nanoemulsion (2.5 mg/kg for 21 days) produced anxiolytic and panicolytic effects in rats tested on the elevated T-maze.

Cannabis-enriched oral Actinomyces induces anxiety-like behavior via impairing mitochondria and GABA signaling.

Salman, Tabinda · 2025

Actinomyces species, previously found to be enriched in chronic cannabis smokers' oral microbiome, induced anxiety-like behaviors in mice when inoculated orally.

Negative urgency increases risk for coping-motivated cannabis outcomes in socially anxious male emerging adult cannabis users.

Single, Alanna · 2025

Higher social anxiety predicted elevated cannabis use and problems via coping motives, but only for males higher in negative urgency.

Clinical and Cognitive Improvement Following Treatment with a Hemp-Derived, Full-Spectrum, High-Cannabidiol Product in Patients with Anxiety: An Open-Label Pilot Study.

Smith, Rosemary T · 2025

Patients reported significant reductions in anxiety symptoms over 6 weeks.

Development and Implementation of a Medical Cannabis Clinic Within a Geriatrics Primary Care Clinic: Preliminary Data.

Weaver, Ryan · 2025

Cannabis use among older adults is rising, but most use it without medical supervision—a gap this clinic aimed to fill.

Unraveling Cannabidiol's Dual Modulatory Role in Schizophrenia: Network Pharmacology and In Vivo Validation of Neuroinflammatory and Behavioral Modulation.

Wei, Ying · 2025

RTHC-00193 reviewed clinical evidence that CBD may have therapeutic potential for schizophrenia.

The Impacts of Adolescent Cannabinoid Exposure on Striatal Anxiety- and Depressive-Like Pathophysiology Are Prevented by the Antioxidant N-Acetylcysteine.

De Felice, Marta · 2024

Adolescent THC exposure caused lasting anxiety- and depressive-like behaviors in rats, along with molecular and neuronal abnormalities in the nucleus accumbens.

Long-Term Treatment for Unspecified Anxiety Disorders with Cannabidiol: A Retrospective Case Series from Real-World Evidence in Colombia.

Galvez-Florez, Juan F · 2024

After 6 months at median 100 mg CBD daily, 54% still had significant anxiety.

Fetal Cannabinoid Syndrome: Behavioral and Brain Alterations of the Offspring Exposed to Dronabinol during Gestation and Lactation.

Navarro, Daniela · 2024

Offspring exposed to dronabinol (10 mg/kg twice daily) from gestational day 5 through postnatal day 21 displayed increased anxiogenic and depressive-like behaviors, cognitive impairment, disrupted reward system function, and increased alcohol consumption motivation at postnatal day 60.

Sex Differences in the Anxiolytic Properties of Common Cannabis Terpenes, Linalool and β-Myrcene, in Mice.

Wagner, Jasmin K · 2024

Both terpenes had anxiolytic effects in female mice with repeated vapor pulls over 30 minutes, while in males only a single vapor hit was effective.

Ecological Momentary Assessment of Cannabis Use and Affect Among Adolescents Following Psychiatric Discharge.

Brick, Leslie A · 2023

Using ecological momentary assessment over 21 days following psychiatric discharge, cannabis use among adolescents was associated with higher positive affect and lower anger/irritability but not with negative affect.

Perceived Effectiveness of Medical Cannabis Among Adults with Chronic Pain: Findings from Interview Data in a Three-Month Pilot Study.

McMahon, Alexandra N · 2023

Patient experience data is often overlooked in cannabis research, where the focus tends to be on controlled trials.

The Place of Cannabinoids in the Treatment of Gynecological Pain.

Sinclair, Justin · 2023

Cannabis has a long history of use for menstrual and reproductive pain, predating modern medicine by centuries.

Trends in Illicit Cannabis Potency based on the Analysis of Law Enforcement Seizures in the Southern Area of Rome.

Vernich, Francesca · 2023

The potency escalation in cannabis isn't just a North American phenomenon.

Cannabidiol for Treatment-Resistant Anxiety Disorders in Young People: An Open-Label Trial.

Berger, Maximus · 2022

Mean OASIS anxiety scores decreased from 10.8 at baseline to 6.3 at week 12, a 42.6% reduction (p<0.001).

Anti-aversive effect of 2-arachidonoylglycerol in the dorsolateral periaqueductal gray of male rats in contextual fear conditioning and Vogel tests.

Brianis, Rayssa C · 2022

2-AG injected into the dorsolateral PAG reduced contextual fear expression and produced anxiolytic effects in the Vogel conflict test, both dependent on CB1 and CB2 receptor activation.

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

Dahlgren, Mary Kathryn · 2022

Anxiety scores decreased significantly by week 4 (BAI: p<0.001; OASIS: p<0.001).

Clinical outcome analysis of patients with autism spectrum disorder: analysis from the UK Medical Cannabis Registry.

Erridge, Simon · 2022

Among 74 ASD patients (mean age 32.7), significant improvements were seen in general quality of life (EQ-5D-5L), sleep quality (SQS), and anxiety (GAD-7) at 1 and 3 months.

Broad-spectrum cannabis oil ameliorates reserpine-induced fibromyalgia model in mice.

Ferrarini, Eduarda Gomes · 2022

Oral broad-spectrum cannabis oil (0.1-3 mg/kg) inhibited both mechanical hyperalgesia and thermal allodynia in a single dose.

Assessing cognitive behavioral therapy for insomnia in individuals with cannabis use disorder utilizing actigraphy and serum biomarkers: A pilot study.

Geagea, Luna · 2022

After four CBT for insomnia sessions, mean ISI scores dropped from moderately severe to not clinically significant, sustained at 3 and 6 months.

Examining the Use of Antidepressants for Adolescents with Depression/Anxiety Who Regularly Use Cannabis: A Narrative Review.

Hen-Shoval, Danielle · 2022

Almost all randomized clinical trials of antidepressants excluded participants using cannabis or other drugs, so the expected course of therapy in cannabis users is unknown.

An Observational Cross-Sectional Survey Exploring the Indications for and Responses to Medical Marijuana Use in Certified Patients in Pennsylvania.

Kimless, Debra · 2022

Anxiety disorder was the most common qualifying condition (50.1%) and comorbid condition (69.3%).

Insomnia treatment: a new multitasking natural compound based on melatonin and cannabis extracts.

Palmieri, G · 2022

PSQI (sleep quality) and HAM-A (anxiety) scores showed significant improvements.

Survey of Patients Employing Cannabigerol-Predominant Cannabis Preparations: Perceived Medical Effects, Adverse Events, and Withdrawal Symptoms.

Russo, Ethan B · 2022

Most common conditions treated: anxiety (51.2%), chronic pain (40.9%), depression (33.1%), insomnia (30.7%).

Cannabidiol Modulates the Motivational and Anxiety-Like Effects of 3,4-Methylenedioxypyrovalerone (MDPV) in Mice.

Alegre-Zurano, Laia · 2021

CBD (20 mg/kg) reduced MDPV-induced conditioned place preference.

Citalopram and Cannabidiol: In Vitro and In Vivo Evidence of Pharmacokinetic Interactions Relevant to the Treatment of Anxiety Disorders in Young People.

Anderson, Lyndsey L · 2021

This study combined lab work and real patient data to examine whether CBD interacts with common antidepressants.

URB597 abrogates anxiogenic and depressive behaviors in the methamphetamine-withdrawal mice: Role of the cannabinoid receptor type 1, cannabinoid receptor type 2, and transient receptor potential vanilloid 1 channels.

Ebrahimi-Ghiri, Mohaddeseh · 2021

Methamphetamine (30 mg/kg) caused anxiety and depression behaviors 3 days after withdrawal.

An initial analysis of the UK Medical Cannabis Registry: Outcomes analysis of first 129 patients.

Erridge, Simon · 2021

Among 129 patients (most common indication: chronic pain, 37.2%), statistically significant improvements were seen at 1 and 3 months in GAD-7 (anxiety), sleep quality, EQ-5D-5L pain and discomfort, anxiety and depression subscales, and overall quality of life indices.

Evaluating the Suitability and Potential Efficiency of Cannabis sativa Oil for Patients with Primary Burning Mouth Syndrome: A Prospective, Open-Label, Single-Arm Pilot Study.

Gambino, Alessio · 2021

All 17 patients showed statistically significant improvement in oral pain intensity over time (assessed by VAS, Present Pain Intensity, McGill Pain Questionnaire, and OHIP).

CB1 and CB2 receptors in the bed nucleus of the stria terminalis differently modulate anxiety-like behaviors in rats.

Gomes-de-Souza, Lucas · 2021

Both CB1 and CB2 receptor gene expression were confirmed in the anterior and posterior BNST.

Cannabidiol treatment in an adolescent with multiple substance abuse, social anxiety and depression.

Laczkovics, Clarissa · 2021

After unsuccessful antidepressant treatment, the patient received escalating CBD doses (100-600mg over 8 weeks).

Differential contribution of CB1, CB2, 5-HT1A, and PPAR-γ receptors to cannabidiol effects on ischemia-induced emotional and cognitive impairments.

Mori, Marco Aurélio · 2021

CBD prevented anxiety-like behavior, memory impairments, and despair-like behaviors after cerebral ischemia.

Demographics, Perceptions, and Use of Medical Marijuana among Patients in Florida.

Rosenthal, Martha S · 2021

Patients most commonly used medical marijuana for anxiety, pain, and stress symptoms.

Female but not male rats show biphasic effects of low doses of Δ9-tetrahydrocannabinol on anxiety: can cannabidiol interfere with these effects?

Salviato, Beatriz Zanutto · 2021

This study revealed a striking sex difference that most cannabis research has missed by testing only males.

Developmental cannabidiol exposure increases anxiety and modifies genome-wide brain DNA methylation in adult female mice.

Wanner, Nicole M · 2021

F1 offspring exposed to CBD during development exhibited increased anxiety and improved memory in a sex-specific manner.

Cannabidiol disrupts conditioned fear expression and cannabidiolic acid reduces trauma-induced anxiety-related behaviour in mice.

Assareh, Neda · 2020

CBD disrupted cued fear memory expression (conditioned fear response) but did not affect generalized anxiety.

Cannabinoids and the endocannabinoid system in anxiety, depression, and dysregulation of emotion in humans.

Chadwick, Verity L · 2020

Some evidence suggests cannabinoids, CBD, or CBD-enriched cannabis have anxiety-reducing properties.

Acute neuroradiological, behavioral, and physiological effects of nose-only exposure to vaporized cannabis in C57BL/6 mice.

Farra, Yasmeen M · 2020

Cannabis inhalation decreased heart rate and blood pressure but promoted anxiety-like behavior in the open field test.

The "Entourage Effect": Terpenes Coupled with Cannabinoids for the Treatment of Mood Disorders and Anxiety Disorders.

Ferber, Sari Goldstein · 2020

The endocannabinoid system is involved in depression, anxiety, and bipolar disorders, and the review proposes that terpenes found in cannabis (such as those also in lavender oil) may enhance cannabinoid therapeutic effects through complementary receptor mechanisms..

Acute effects of cannabinoids on symptoms of obsessive-compulsive disorder: A human laboratory study.

Kayser, Reilly R · 2020

Fourteen adults with OCD underwent symptom provocation after smoking cannabis with high THC, high CBD, or placebo in a crossover design.

Cannabis Improves Obsessive-Compulsive Disorder-Case Report and Review of the Literature.

Szejko, Natalia · 2020

A 22-year-old male with severe OCD since childhood, previously resistant to standard treatments, showed marked improvement in OCD symptoms and depression with medicinal cannabis, resulting in considerable quality of life improvement.

Endocannabinoid modulating drugs improve anxiety but not the expression of conditioned fear in a rodent model of post-traumatic stress disorder.

Vimalanathan, Akshayan · 2020

Acute WIN55,212-2 (CB1 agonist) reduced anxiety in "weak extinction" rats but did not affect fear recall.

Cannabidiol (CBD) use in psychiatric disorders: A systematic review.

Bonaccorso, Stefania · 2019

From 1,301 screened papers, 27 met inclusion criteria (RCTs of CBD for psychiatric disorders).

Effects in rats of adolescent exposure to cannabis smoke or THC on emotional behavior and cognitive function in adulthood.

Bruijnzeel, Adriaan W · 2019

Despite testing both cannabis smoke and THC at multiple doses during the adolescent period (P29-49 or P35-45), adult rats showed no significant effects on anxiety (open field, elevated plus maze), depression (sucrose preference, forced swim), or cognition (novel object recognition) after abstinence until P70.

Role of the endocannabinoid system in the dorsal hippocampus in the cardiovascular changes and delayed anxiety-like effect induced by acute restraint stress in rats.

Hartmann, Alice · 2019

The FAAH inhibitor URB597 injected into the dorsal hippocampus prevented stress-induced cardiovascular responses (heart rate increase, blood pressure rise, temperature drop) and delayed anxiety.

Effects of the synthetic cannabinoid 5F-AMB on anxiety and recognition memory in mice.

Ito, Shiho · 2019

Central 5F-AMB produced anxiolytic effects and impaired recognition memory acquisition via CB1 receptors (blocked by AM251).

Concomitant THC and stress adolescent exposure induces impaired fear extinction and related neurobiological changes in adulthood.

Saravia, Rocio · 2019

Adolescent mice given both THC and stress showed impaired cued fear extinction in adulthood, with decreased neuronal activity in the basolateral amygdala and infralimbic prefrontal cortex.

Cross-domain correlates of cannabis use disorder severity among young adults.

Schuster, Randi Melissa · 2019

Of 71 candidate variables, five predicted CUD severity: more frequent cannabis use in the past 90 days, greater expectations that cannabis causes cognitive/behavioral impairment, greater self-reported metacognitive deficits, greater anxiety, and lower reaction time variability on sustained attention (though this last variable was less robust)..

The Consumption of Cannabis by Fibromyalgia Patients in Israel.

Habib, George · 2018

Researchers surveyed 383 fibromyalgia patients through Israeli Facebook support groups. Of respondents, 84% reported consuming cannabis, but only 44% had a medical cannabis license.

Cannabis Use in Individuals With Spinal Cord Injury or Moderate to Severe Traumatic Brain Injury in Colorado.

Hawley, Lenore A · 2018

Researchers surveyed 116 Colorado adults who had sustained spinal cord injury (SCI) or moderate to severe traumatic brain injury (TBI), combining focus group data with a telephone survey. 70% reported cannabis use before their injury (67% SCI, 74% TBI) and 48% reported use after their injury (53% SCI, 45% TBI). Reasons for use differed between groups.

Cannabis and the Anxiety of Fragmentation-A Systems Approach for Finding an Anxiolytic Cannabis Chemotype.

Kamal, Brishna S · 2018

Medical cannabis patients receiving organically grown cannabis from a single source rated cannabis as highly effective for anxiety (average 8.03 out of 10 on a Likert scale). Patients identified which strains they found most and least effective for anxiety.

Distress intolerance moderation of neurophysiological markers of response inhibition after induced stress: Relations with cannabis use disorder.

Macatee, Richard J · 2018

Researchers tested whether high distress intolerance (difficulty tolerating negative emotions) would lead to stress-induced impairment of response inhibition in frequent cannabis users. Cannabis users with high and low distress intolerance completed a Go/No-Go task during EEG recording before and after a laboratory stressor. Contrary to the hypothesis, cannabis users with high distress intolerance showed enhanced conflict-monitoring neural activity (N2 amplitude) after stress rather than impairment.

Decreased anxiety in juvenile rats following exposure to low levels of chlorpyrifos during development.

Carr, Russell L · 2017

Rat pups exposed to chlorpyrifos (CPF) daily from postnatal day 10 to 16 at doses of 0.5, 0.75, and 1.0 mg/kg showed inhibition of FAAH (the enzyme that breaks down anandamide) at all doses, leading to elevated anandamide levels.

Enhanced anandamide signaling reduces flight behavior elicited by an approaching robo-beetle.

Heinz, Daniel E · 2017

Using a novel behavioral task that confronted mice with an erratically moving robo-beetle, researchers found that the two main endocannabinoids in the brain have opposite effects on fear and panic responses. Blocking the enzyme FAAH (which breaks down anandamide) with the drug URB597 reduced flight behavior and increased tolerance to the approaching beetle.

Sex- and hormone-dependent alterations in alcohol withdrawal-induced anxiety and corticolimbic endocannabinoid signaling.

Henricks, Angela M · 2017

This study revealed striking sex differences in how the endocannabinoid system responds to alcohol withdrawal. Male rats exposed to chronic alcohol vapor showed increased anxiety-like behavior during withdrawal, along with reduced anandamide in the amygdala and reduced 2-AG in the prefrontal cortex.

Emotional disorders induced by Hemopressin and RVD-hemopressin(α) administration in rats.

Leone, Sheila · 2017

This study tested two naturally occurring peptides that modulate the endocannabinoid system and found they produce opposite emotional effects in rats. Hemopressin, which blocks CB1 receptors (acting as an antagonist/inverse agonist), induced anxiogenic (anxiety-promoting) and depressive behavior when injected.

Marijuana and other cannabinoids as a treatment for posttraumatic stress disorder: A literature review

Steenkamp, Maria M. · 2017

The biological case for cannabis helping PTSD was compelling.

Cannabinoids reverse the effects of early stress on neurocognitive performance in adulthood.

Alteba, Shirley · 2016

Researchers tested whether cannabinoid treatment during late adolescence could reverse the long-term cognitive damage caused by early life stress in rats. Male and female rats were stressed during their first two weeks of life, then treated with the cannabinoid agonist WIN55,212-2 for two weeks during late adolescence.

Gender Dysphoria and Social Anxiety: An Exploratory Study in Spain.

Bergero-Miguel, Trinidad · 2016

Researchers studied social anxiety among 210 individuals attending a public gender identity unit in Spain.

Cannabidiol as a potential treatment for anxiety disorders

Blessing, Esther M. · 2015

Across animal models, CBD showed consistent anxiolytic-like effects spanning generalized anxiety, panic, social anxiety, obsessive-compulsive disorder, and post-traumatic stress.

Endocannabinoid signaling in hypothalamic-pituitary-adrenocortical axis recovery following stress: effects of indirect agonists and comparison of male and female mice.

Roberts, Christopher J · 2014

After restraint stress, mice lacking CB1 receptors or treated with a CB1 antagonist showed prolonged elevation of corticosterone (the stress hormone), confirming endocannabinoid signaling helps the stress response return to baseline. The MAGL inhibitor JZL184 (which increases 2-AG levels) accelerated corticosterone recovery in both male and female mice, though the timing differed: at stress offset in males and at 30 minutes recovery in females.

An Internet survey of marijuana and hot shower use in adults with cyclic vomiting syndrome (CVS).

Venkatesan, Thangam · 2014

Of 437 CVS patients who completed questions about marijuana use, 81% reported use and only 19% had never used.

Pregabalin and topiramate regulate behavioural and brain gene transcription changes induced by spontaneous cannabinoid withdrawal in mice.

Aracil-Fernández, Auxiliadora · 2013

Mice made tolerant to the synthetic cannabinoid CP-55,940 showed increased motor activity, rearing, and anxiety-like behavior on days 1 and 3 after cessation.

Withdrawal from THC during adolescence: sex differences in locomotor activity and anxiety.

Harte-Hargrove, Lauren C · 2012

Male and female rats received THC (2, 7.5, or 15 mg/kg) or vehicle during mid-adolescence (postnatal days 35-41).

Antagonism of cannabinoid 1 receptors reverses the anxiety-like behavior induced by central injections of corticotropin-releasing factor and cocaine withdrawal.

Kupferschmidt, D A · 2012

Researchers tested whether blocking CB1 receptors could reduce anxiety caused by two different triggers: direct brain injection of corticotropin-releasing factor (CRF, the brain's primary stress peptide) and withdrawal from 14 days of cocaine. AM251 reversed anxiety from both CRF and cocaine withdrawal in a dose-dependent manner when injected directly into the brain.

Cannabis use and schizotypy: the role of social anxiety and other negative affective states.

Najolia, Gina M · 2012

Researchers studied over 650 college undergraduates, comparing those with elevated schizotypy traits to controls.

O-hydroxyacetamide carbamates as a highly potent and selective class of endocannabinoid hydrolase inhibitors.

Niphakis, Micah J · 2012

The researchers investigated O-hydroxyacetamide carbamate compounds and found they could be tuned to selectively inhibit FAAH (the enzyme that breaks down anandamide) or to simultaneously inhibit both FAAH and MAGL (which breaks down 2-AG).

Two Sides of the Same Coin: Cannabis Dependence and Mental Health Problems in Help-Seeking Adolescent and Young Adult Outpatients.

Norberg, Melissa M · 2012

Among 36 young people seeking help for both cannabis dependence and mental health issues, the psychiatric picture was complex.

Inhibition of endocannabinoid catabolic enzymes elicits anxiolytic-like effects in the marble burying assay.

Kinsey, Steven G · 2011

Researchers tested whether boosting either of the two main endocannabinoids could reduce anxiety-like behavior in a marble-burying test, a model relevant to compulsive behaviors in disorders like OCD. The FAAH inhibitor PF-3845 (which boosts anandamide) and the MAGL inhibitor JZL184 (which boosts 2-AG) both reduced marble burying at doses that did not impair locomotor activity.

Modulation of effective connectivity during emotional processing by Delta 9-tetrahydrocannabinol and cannabidiol.

Fusar-Poli, Paolo · 2010

Fifteen healthy men received CBD (600 mg), THC (10 mg), or placebo before viewing fearful faces during fMRI.

Anxiety-like effects of SR141716-precipitated delta9-tetrahydrocannabinol withdrawal in mice in the elevated plus-maze.

Huang, Peng · 2010

Male mice received THC (10 mg/kg) daily for 10 days.

Distinct effects of {delta}9-tetrahydrocannabinol and cannabidiol on neural activation during emotional processing.

Fusar-Poli, Paolo · 2009

Fifteen healthy men received THC (10 mg), CBD (600 mg), or placebo before viewing faces expressing different levels of fear during fMRI scanning. THC increased anxiety, intoxication, sedation, and psychotic symptoms.

A placebo-controlled trial of buspirone for the treatment of marijuana dependence.

McRae-Clark, Aimee L · 2009

Fifty participants with marijuana dependence received either buspirone (up to 60 mg/day) or placebo for 12 weeks alongside motivational interviewing. In the full intent-to-treat analysis, the buspirone group had 18 percentage points more negative urine drug screens than placebo, though this did not reach statistical significance (p=0.071). Self-reported marijuana-free days did not differ between groups (45.2% vs 51.4%). However, among participants who completed all 12 weeks, buspirone produced a significantly higher percentage of negative drug tests (p=0.014) and a trend toward reaching the first negative test sooner (p=0.054). Retention in the study was a major challenge, limiting statistical power..

New insights into endocannabinoid degradation and its therapeutic potential.

Bari, M · 2006

This review focused on the enzymes responsible for endocannabinoid synthesis and degradation.

The time course and significance of cannabis withdrawal

Budney, Alan J. · 2003

After heavy users stopped, a consistent withdrawal pattern emerged across mood, sleep, and physical symptoms.

Cannabidiol attenuates diet-induced metabolic endotoxemia, neuroinflammation, and anxiety-like behaviors in male aged rats.

Jantsch, Jeferson · 2025

Cafeteria diet increased anxiety-like behaviors, circulating LPS (endotoxemia), and prefrontal cortex IL-6 in 18-month-old rats.

Cannabidiol Treatment in a Predator-Based Animal Model of PTSD: Assessing Oxidative Stress and Memory Performance.

Jîtcă, George · 2025

In a predator-odor PTSD model, CBD (10 mg/kg) did not significantly alter anxiety in the elevated plus maze, though a trend toward increased exploration was observed.

Identification of a novel fatty acid binding protein-5-CB2 receptor-dependent mechanism regulating anxiety behaviors in the prefrontal cortex.

Uzuneser, Taygun C · 2023

The FABP-5 inhibitor SBFI-103 reduced anxiety-like behaviors when administered to the rat prefrontal cortex.