How Starting Medical Cannabis Affects Anxiety and Depression Over Six Months | Research

The takeaway

New medical cannabis patients with anxiety and depression showed both acute and sustained improvements over six months, measured through real-time ecological momentary assessment.

People considering medical cannabis for anxiety or depression, healthcare providers, and researchers studying cannabinoid therapeutics for mental health.

What the researchers found

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.

Why it matters

Patients increasingly use cannabis for mental health despite mixed evidence. This prospective study with real-time symptom tracking provides more nuanced data than typical retrospective surveys on whether cannabis helps anxiety and depression.

The numbers in context

6-month prospective follow-up using ecological momentary assessment and Hospital Anxiety and Depression Scale measures in Maryland medical cannabis patients.

How the study worked

Prospective observational cohort of adults with clinically significant anxiety and/or depression initiating medicinal cannabis in Maryland, using ecological momentary assessment (EMA) plus standard longitudinal follow-up over 6 months.

What this study cannot tell us

Observational design without controls — improvements could reflect placebo effects, natural course, or concurrent treatments. Maryland-specific population may limit generalizability.

How to read the evidence

Prospective cohort with innovative EMA methodology, but lacks control group — cannot rule out placebo or natural improvement.

When this study was published

Recent prospective study using modern real-time assessment methods to track cannabis effects on mental health.

The bigger picture

Mental health is the fastest-growing reason for medical cannabis use. Prospective data with real-time monitoring helps move beyond patients' retrospective recall, which can be biased by expectations.

Questions still open

Would these improvements hold up against placebo in an RCT? Which specific cannabis products and dosing patterns were associated with the best outcomes?

Common questions

Does medical cannabis help with anxiety and depression?

This study found improvements over 6 months in new users, but without a control group, it's unclear how much is due to cannabis vs. placebo effect or natural symptom fluctuation.

What is ecological momentary assessment?

EMA captures symptoms in real-time through repeated brief surveys during daily life, reducing recall bias compared to asking patients to remember how they felt weeks or months ago.

Read the original research

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

Journal of affective disorders, 390, 119829

View on PubMed ↗Publisher’s paper ↗

Citation

Wolinsky, David; Mayhugh, Rhiannon E; Surujnarain, Renuka; Thrul, Johannes; Vandrey, Ryan; Strickland, Justin C. (2025). Acute and chronic effects of medicinal cannabis use on anxiety and depression in a prospective cohort of patients new to cannabis.. Journal of affective disorders, 390, 119829. https://doi.org/10.1016/j.jad.2025.119829