Anxiety and CBD Oil: Research, Dosing and Warnings

What does the research say?

In a 15-week study in India of 178 people with mild to moderate anxiety disorder, anxiety scores fell clearly in those taking CBD; sleep and depression symptoms also improved. However, this effect was much larger than what other studies have seen, the dose used was not reported in the published abstract, and the result has not been repeated by other researchers. 6 of the study's 7 authors are executives or employees of pharmaceutical companies. In 2024, the expert committee of India's drug regulator asked for an explanation of why no placebo response at all was seen in the placebo group of a phase 3 application whose features match this study; because the minutes do not give a trial identifier, it is not certain that this is the same study.

In a study of 63 people with high levels of worry, taking CBD for two weeks did not reduce worry; anxiety symptoms, however, decreased somewhat. Positive results were also reported in studies where everyone knew what they were taking and there was no placebo group; but in such studies, expectation itself can change anxiety, so the results are hard to interpret. In a later small double-blind part of one of these studies (31 people), self-reported anxiety also fell clearly in those taking placebo; the drop in interviewer-rated anxiety was larger in the CBD arms. The groups were not compared statistically; the results are only in the trial registry, with no peer-reviewed publication.

In anxiety situations created in the lab in healthy volunteers, the results of a single dose of CBD were inconsistent: no effect was seen on exam anxiety, in emotional face tasks or in a virtual reality setting. Analyses pooling the studies judge the evidence to be limited and of low quality. THC, on the other hand, can increase anxiety in the lab: vaporized THC increased state anxiety in healthy volunteers; CBD given together with THC reduced anxiety compared with THC alone, but did not prevent it in those with high baseline anxiety. In a stress test, a low dose of THC slightly reduced distress after stress, while a higher dose increased anxiety; in regular cannabis users, the stress-reducing effect of vaporized THC was similar to placebo. These lab findings do not give direct information about treating anxiety disorders.

Other placebo-controlled studies measuring anxiety also saw no clear benefit: in 50 women with advanced breast cancer who had anxiety before a scan, a single 400 mg dose of CBD did not make the change in anxiety different from placebo; before root canal treatment, a CBD-rich extract did not reduce dental anxiety; in 180 stressed students, a low-dose full-spectrum oil for 30 days was no different from a placebo oil for anxiety. In a study that gave people seeking medical cannabis for anxiety or depression early access by lottery, anxiety did not improve either, while cannabis use disorder increased. Because these studies are small or short, the evidence is still weak.

In studies of cannabis products used in real life, the results go both ways. In a study where anxious people were randomly assigned to different cannabis flowers, anxiety decreased in all groups (including people not using cannabis); CBD-dominant flower was linked to a slightly larger drop than THC-dominant flower, but there was no placebo. In a UK patient registry, patients with generalized anxiety disorder who were mostly prescribed THC-rich flower reported that their anxiety decreased (no control group; most of the authors are linked to the clinic chain that runs the registry); in a 5,075-person registry in Canada, however, the average change was clinically meaningless.

Small studies done in 1978–1981 with nabilone, a synthetic THC-like cannabinoid, were inconsistent: a 4-week study of 25 anxious patients reported a clear benefit, while single-dose studies with anxious volunteers found a weak effect or none at the group level; the evidence based on these old, small studies is very weak. The most recent analysis pooling RCTs in people whose primary diagnosis is a mental disorder found no difference from placebo for anxiety; an analysis that also included anxiety measured as a secondary outcome in other diseases found a small reduction, but the certainty of the evidence was very low.

Strength of evidence: ●●○○ Weak evidence. Finding: Mixed results. What does this mean?

Ongoing research on this topic

Trials testing CBD for this topic on ClinicalTrials.gov: 16 under way (10 recruiting); results are awaited from 2 that ended in the last two years. A trial being under way does not show that CBD works.

NCT05324449: Phase 4, completed, results awaited, 20 participants
NCT07123467: Phase 3, recruiting, target 90 participants
NCT06290063: Phase 2, recruiting, target 385 participants

Registries in other countries also list 1 recruiting trial on this topic: other registries.

All trials on this topic and their history

Possible side effects and drug interactions

Studies reported sleepiness, tiredness and a mild decrease in attention. In a study with young people aged 12–25, side effects such as tiredness and low mood were seen in 80.6% of participants. In a study with healthcare workers, 4 people in the CBD group had raised liver enzymes and 1 person had a severe drug rash.

CBD can slow down how some medicines are broken down in the body. For example, blood levels of citalopram and escitalopram, used for anxiety and depression, rose with CBD. THC-containing products can increase state anxiety and suspiciousness, and CBD does not always reduce THC's effects. In people given early access to medical cannabis for anxiety or depression, cannabis use disorder rose clearly over 12 weeks.

Interactions with medicines used for this condition

Interactions reported for these medicines in peer-reviewed publications and official prescribing information. A medicine that is not listed can still interact with CBD; tell your doctor about every medicine you take.

Anxiety: medicines used and their interactions with CBD
Medicine	Importance	Warning	Source
Citalopram (SSRI) (Cipram, Citol, Relaxol), Escitalopram (SSRI) (Cipralex, Citoles, Eslorex)	Caution	Citalopram, escitalopram: CBD raised citalopram blood levels: a significant rise in a series of 6 patients; in healthy volunteers, citalopram exposure (AUC) rose by 43% after 12 days of approved CBD (2.5 mg/kg twice a day). If you take these medicines, talk to your doctor.	PMID 34121064, PMID 41622700
Sertraline (SSRI) (Lustral, Selectra, Serdep)	Caution	Sertraline: In a 78-year-old patient who had taken sertraline for 20 years, blood sodium dropped and forgetfulness developed in the months after over-the-counter CBD was added; it resolved after CBD and then sertraline were stopped (a single case; CBD's role was rated "possible"). In two adverse event reports from Poland, people taking CBD oil together with sertraline had diarrhea, vomiting, fever and severe fatigue. Tell your doctor or pharmacist.	PMID 36627907, PMID 39502532, PMID 34121064
Fluoxetine (SSRI) (Prozac, Depreks, Fulsac)	Caution	SSRIs (fluoxetine, paroxetine): In a young person taking fluoxetine, worsening insomnia, restlessness and obsessive symptoms were reported after CBD oil was added (a single case). The reported case of a child taking paroxetine involved smoked marijuana, not CBD. Tell your doctor or pharmacist.	PMID 35652796, PMID 39719830
Alprazolam (Xanax, Ansiox, Stabina), Clonazepam (Rivotril, Rivoclon), Other benzodiazepines (lorazepam, etc.), Pregabalin (Lyrica), Hydroxyzine (Atarax)	Caution	Benzodiazepines, sleep medicines and sedatives: Drowsiness and sedation may increase together with CBD. Talk to your doctor before using them together.	DailyMed Epidiolex label 7.4, EMA Epidyolex SmPC 4.4
SNRIs (venlafaxine, duloxetine, etc.) (Efexor XR, Cymbalta)	Information	SNRIs and tricyclic antidepressants: There are no clinical data on interactions between CBD and SNRIs or tricyclics other than amitriptyline (see the separate warning for amitriptyline). Still tell your doctor about all the medicines you take.	PMID 38868665
Alprazolam (Xanax, Ansiox, Stabina), Buspirone (Buspon)	Information	Alprazolam, trazodone, buspirone: No study has looked at these medicines and CBD together. The data on the enzyme that breaks them all down (CYP3A4) conflict: approved CBD (750 mg twice a day) did not affect this enzyme, while a single dose of a CBD-dominant extract raised the blood level of midazolam, which is broken down the same way, by 56%. Drowsiness and sedation may increase when they are taken together. Tell your doctor.	FDA Epidiolex label §7.4 and §12.3 (05/2026), PMID 37313955, Alprazolam prescribing information §12.3, dailymed.nlm.nih.gov, Trazodone prescribing information §12.3, dailymed.nlm.nih.gov, Buspirone prescribing information (Drug Interactions), dailymed.nlm.nih.gov
Mirtazapine (Remeron, Zestat)	Information	Mirtazapine: In the lab, CBD had very little effect on the breakdown of mirtazapine; this has not been measured in patients. Still tell your doctor about the medicines you take.	PMID 34121064
Clonazepam (Rivotril, Rivoclon)	Information	Clonazepam: In 45 people with epilepsy taking approved CBD, clonazepam blood levels did not change as the CBD dose went up. Still, drowsiness may increase when they are taken together; tell your doctor.	PMID 37593907

To check interactions with the medicines you take: CBD drug interaction checker.

How was CBD used in studies?

Controlled studies used 50 or 300 mg a day for two weeks, 30 mg a day for 4 weeks, 300 mg a day for 28 days and, in stressed students, a low dose increased step by step according to body weight over 30 days (at most 1 mg per kilogram; 85 mg a day for someone weighing 85 kg) (study doses; not a personal recommendation); a single 400 mg dose (study dose; not a personal recommendation) was tried before a scan in anxious cancer patients. Lab studies tried single doses of, for example, 150, 300 and 600 mg (study dose; not a personal recommendation). Studies without a comparison group used doses between about 30 mg and 800 mg a day (study dose; not a personal recommendation). No dose has shown a clear benefit for anxiety disorders.

Study details (for health professionals)

A 15-week, 178-person RCT in India reported a very large effect (6 of the 7 authors are executives or employees of pharmaceutical companies; the reported spread is unusually small for a psychiatry study); its dose is unknown, the result has not been independently repeated, and in November 2024 the drug regulator's expert committee questioned the absence of a placebo response in the placebo group of a phase 3 application whose features match this study (178 people, 150 mg/mL CBD solution, mild to moderate anxiety disorder; no trial identifier in the minutes). In May 2026, the same committee recommended approving the product on condition that a phase 4 study comparing it with an active medicine be done and that it be sold only with a psychiatrist's prescription; this recommendation is not the result of an independent repeat, and the approval document itself could not be found. In people with high levels of worry, 300 mg/day for 2 weeks did not reduce worry, and anxiety symptoms decreased somewhat. Other placebo-controlled studies measuring anxiety found no difference: a single 400 mg dose for pre-scan anxiety in advanced breast cancer (n=50; Nayak 2024), a CBD-rich extract before root canal treatment (de Andrade Silva 2024) and a low-dose full-spectrum oil for 30 days in stressed students (n=180; Winkler 2025); anxiety also did not improve with early access to medical cannabis by lottery for anxiety or depression (n=83; Gilman 2022). In a small double-blind part comparing full-spectrum and pure CBD with placebo (31 people; NCT02548559, no peer-reviewed publication), self-reported anxiety fell clearly in all groups, including placebo, and interviewer-rated anxiety fell more in the CBD arms; in the registry, the groups were not compared statistically. Positive results in open-label studies therefore cannot be separated from the expectation effect. The small nabilone (a synthetic THC-like cannabinoid) studies from 1978–1981 are inconsistent (Fabre 1981 positive; Glass 1980 and Nakano 1978 weak or ineffective). In artificially created anxiety in the lab, single-dose results are inconsistent: no effect was seen on exam anxiety, in emotional face tasks or in a virtual reality paranoia setting; results in lab anxiety do not substitute for treatment of anxiety disorders. THC can increase anxiety in the lab (Hutten 2022; at a high dose in Childs 2017); a low dose of THC slightly reduced distress after a stress test (n=42; Childs 2017); in regular users, the stress-reducing effect of vaporized THC was similar to placebo (n=120; Cuttler 2026). Meta-analyses find the evidence of low or very low certainty: in RCTs in people whose primary diagnosis is a mental disorder, no significant difference from placebo for anxiety (Wilson 2026); in the analysis that also included anxiety measured as a secondary outcome in other diseases, a small to moderate reduction, but very low certainty (Bharat 2026); in the analysis split by drug type, no cannabinoid alone is significant (Bilbao 2022). Real-world data go both ways: in a UK patient registry, patients mostly prescribed THC-rich flower reported reduced anxiety (no control; most of the authors are linked to the clinic chain that runs the registry; Rifkin-Zybutz 2023), while in a 5,075-person registry in Canada the average change was clinically meaningless (Lee 2022). The pooled association between cannabis use and later development of generalized anxiety disorder is not significant (OR 1.44; 95% CI 0.94–2.22; observational; Xue 2021). The anxiety disorder guidelines that could be read (Germany 2022, Brazil 2024) do not mention cannabinoids. Studies in social anxiety, panic disorder and PTSD are on their own pages. October 2026 search (PubMed, Cochrane, ClinicalTrials.gov): 21 controlled studies with cannabinoids on this topic were found; 11 in patients or people experiencing anxiety or stress (8 placebo-controlled; only 1 placebo-controlled study with more than 100 people was done in patients diagnosed with an anxiety disorder; the follow-up publication of one is also in the table), 10 in volunteers in a lab or experimental setting (THC was also tested in 3). Alongside these, the table has 4 studies with no control group, 7 systematic reviews (5 of them meta-analyses) and 5 observational studies (one a meta-analysis of observational studies). Older lab experiments and meta-analyses whose question is answered by a newer or larger study or review in the table were not added separately. No Cochrane review and no treatment study from Turkey were found.

Evidence assessment: Weak: the only positive large RCT has not been independently repeated; the other controlled studies are small and most found no difference from placebo

CBD alone

The results of controlled anxiety studies with pure CBD are mixed; the only large positive RCT has not been repeated and its dose was not reported in the abstract. In anxious cancer patients, a single 400 mg dose was no different from placebo on the primary outcome; of the two meta-analyses that looked at CBD separately, one found an effect in the pure CBD subgroup (wide confidence interval) and the other did not; in both, the certainty of the evidence is low.

Products containing THC

There are no controlled studies showing a benefit of THC-containing products in anxiety disorders. In a small double-blind part with a low-THC full-spectrum product, self-reported anxiety decreased in all groups, including placebo, and interviewer-rated anxiety decreased more in those taking the full-spectrum product; but nearly half of this arm came from the open-label first phase and the groups were not compared statistically (registry only). In an RCT giving access to medical cannabis by lottery, anxiety did not improve; in a study without placebo comparing cannabis flowers, THC-dominant flower was linked to a smaller drop in anxiety than CBD-dominant flower. In the lab, THC and THC+CBD increased state anxiety (THC+CBD less than THC alone); a low dose of THC slightly reduced distress after stress, and a higher dose increased anxiety.

Evidence: Very weak: there are no controlled studies showing a benefit of THC-containing products in anxiety disorders; there is a small double-blind part whose groups were not compared statistically (registry only), a negative RCT that assigned access to medical cannabis by lottery, and data without placebo and observational data. Lab findings go both ways: increased anxiety at high doses, a slight reduction in distress after stress at low doses

Dose range in studies

In controlled studies, 30–300 mg/day (2–4 weeks) and, in one study, a low dose increased step by step according to body weight (at most 1 mg/kg/day); single doses 32–600 mg; in open-label studies about 30–800 mg/day; in an uncontrolled case series 25–175 mg/day

Starting dose and titration

The only anxiety study that reported the dose-increase schedule in detail is Berger 2022: it started at 200 mg/day and, if the response was inadequate, increased in 200 mg steps (at most 400 at week 1, 600 at week 4 and 800 mg/day at week 8). Most other controlled studies used a fixed dose; in stressed students, a low-dose full-spectrum oil was increased step by step according to body weight over 30 days (Winkler 2025); the schedule of Gundugurti 2024 is unknown

These are doses researchers gave under medical supervision; they are not a recommended dose for you. "mg/kg/day" means milligrams per kilogram of body weight per day.

Anxiety and CBD: studies reviewed
Study	Participants	Product	Dose and titration	Duration	Result	Source
Gundugurti 2024 Phase 3, double-blind, placebo-controlled, multicenter RCT (India; 6 of the 7 authors are affiliated with pharmaceutical companies: 5 are executives or employees of Leiutis Pharmaceuticals, which funded the pharmacokinetic part of the trial, and 1 is the medical director of Biophore Pharma)	178 randomized (89 CBD, 89 placebo); number analyzed not in the abstract Mild to moderate generalized anxiety disorder; people not taking psychotropic medicines	Nanodispersion oral solution of synthetic CBD (150 mg/mL; product description from the pharmacokinetic publication of the same trial)	Unknown (full text could not be accessed; no mg dose in the registration) Unknown (full text could not be accessed)	About 15 weeks (including a placebo run-in period); primary outcome at week 11	GAD-7 difference −7.02; HAM-A difference −11.9 (p<0.0001); PHQ-9 and sleep also improved. The reported standard error (0.25 for GAD-7) in an 89-vs-89 study means a between-person spread of only about 1.7 points on a 0–21 point scale; this is unusually small for a psychiatry study. The effect size is much larger than in other studies and has not been independently repeated. The expert committee of India's drug regulator (November 26–27, 2024), for a phase 3 trial whose features match this study (in the minutes: 178 people, 150 mg/mL oral CBD solution, mild to moderate anxiety disorder, six centers), asked for an explanation of the absence of any placebo response in the placebo group, raw data from all centers, data on dependence potential and a new, larger, comparative phase 3 protocol. On May 6, 2026, the committee recommended granting manufacturing and marketing permission on condition of a phase 4 study comparing it with an active medicine and sale only on a psychiatrist's prescription. The minutes have no trial identifier or publication title, and the applicant company is Zenara Pharma; it is not certain that the minutes belong to the trial in this publication, although the product, number of participants, indication and multicenter design match Side effects: No serious side effects (abstract); side effect counts not in the abstract. In May 2026, the expert committee asked for all side effects and a section on dependence potential to be added to the product information	PMID 38797087, doi:10.1016/j.ajp.2024.104073, Clinical Trials Registry of India CTRI/2023/01/049110. Pharmacokinetic study that is part of the same trial: Gundugurti 2026, PMID 41613360, 300 mg single dose, funded by Leiutis Pharmaceuticals). Research letter from the same team: Gundugurti 2026, PMID 42901095, full text not open, content could not be verified)
Gournay 2023 Double-blind, placebo-controlled RCT	63 People with high levels of worry	Oral CBD	50 or 300 mg/day None	Single dose + 2 weeks	No effect with a single dose; worry did not decrease under any condition; 300 mg for 2 weeks reduced anxiety symptoms compared with placebo (from the abstract only; analysis details and effect size could not be verified); the authors write that the effect may be limited to the physical symptoms of anxiety. Conflict of interest statement and funding not in the abstract Side effects: Not reported (in the abstract); no sedation or cognitive impairment was seen in the sleep publication of the same trial (Gournay 2026)	PMID 37552290, doi:10.1007/s00213-023-06437-0, Sleep results of the same trial: Gournay 2026, PMID 41678223, difference from placebo not significant, p = 0.10, d = 0.07, no sedation or cognitive impairment)
NCT02548559 (McLean Hospital, double-blind phase; registry results) Phase 2, two-phase trial: phase 1 open-label (Dahlgren 2022, in this table), phase 2 randomized, triple-blind, placebo-controlled, parallel-group. Results only on ClinicalTrials.gov; no peer-reviewed publication	46 enrolled: 15 in phase 1 (14 completed), 31 in phase 2 (full-spectrum 19, pure CBD 6, placebo 6); in the analysis, the full-spectrum arm includes the 32 completers of both phases together Adults reporting moderate or severe anxiety (those using cannabinoids more than once a month were excluded; US, McLean Hospital)	Sublingual solution: full-spectrum CBD (10 mg/mL CBD; THC measured in phase 1 0.23 mg/mL) or single-compound (pure) CBD (10 mg/mL); placebo solution	1 mL 3 times a day (30 mg of CBD a day; in the full-spectrum arm, also under 1 mg of THC a day) None (fixed dose)	4 weeks	For all four primary anxiety scales (BAI, OASIS, STAI, HAM-A), the registry has only one-sided t-tests within each group; the CBD arms were not compared statistically with placebo. Self-reported anxiety also fell clearly in those taking placebo (6 people) (BAI from 21.0 to 8.2; OASIS from 11.2 to 5.5); BAI fell from 21.0 to 6.9 in the full-spectrum arm and from 22.5 to 10.0 in the pure CBD arm. On the interviewer-rated HAM-A, the drop in the placebo group was small and not significant (from 20.2 to 17.5; p = 0.13), and large in the full-spectrum (from 21.5 to 5.1) and pure CBD (from 23.7 to 9.7) arms. The groups are very small and the full-spectrum arm also includes patients from the open-label phase 1; with these numbers it cannot be said whether there is a difference between CBD and placebo Side effects: No serious side effects. Mild side effects in 8 of 34 people in the full-spectrum arm (such as dry mouth or throat, abdominal pain, palpitations, panic attack symptoms, a feeling of unreality; each in 1–2 people), in 2 of 6 in the pure CBD arm, and in 1 of 6 on placebo	NCT02548559, results posted to the registry on March 27, PMID 36352103, in this table
Fabre 1981 Double-blind, placebo-controlled clinical study (randomization method not in the abstract)	25 outpatients (allocation to groups not in the abstract) Outpatients followed for anxiety complaints (US; diagnostic criteria not in the abstract)	Nabilone (a synthetic THC-like cannabinoid; not THC)	Not in the abstract (full text could not be read) Not in the abstract	28 days	Clear improvement compared with placebo was reported in the nabilone group on the Hamilton Anxiety Scale and in the patients' global assessment (p < 0.001). A small, single-center study published in 1981; method details and effect size are not in the abstract. No other anxiety treatment study with nabilone was found in this search; in two small nabilone studies with anxious volunteers from the same period, the results were weak or inconsistent (Glass 1980, Nakano 1978) Side effects: Dry mouth and eyes, sleepiness; patients did not report a marijuana-like altered state of consciousness (abstract)	PMID 6117575, doi:10.1002/j.1552-4604.1981.tb02617.x
Glass 1980 Single-blind, placebo-controlled, single-dose study in the same people in a balanced Latin square design (one session a week)	8 anxious volunteers (two series of 4 people) Anxious volunteers (diagnostic criteria not in the abstract)	Nabilone (a synthetic THC-like cannabinoid; not THC)	Three single doses set according to each person's response to a test dose; 1–5 mg in the first series, lower doses in the second series The dose range was first set in each person with a test dose	5 sessions, 1 week apart (2 placebo, 3 doses)	No significant change in anxiety score (POMS anxiety) at the group level. 2 of the 4 people in the first series had reduced anxiety at a low dose (1–2 mg); no reduction in anxiety was seen in the second series, which received lower doses. There was marked sleepiness at high doses Side effects: At 4–5 mg, a drop in blood pressure on standing (orthostatic hypotension), a mild dose-related rise in heart rate, marked sleepiness	PMID 6108592, doi:10.1007/BF00434401, Other publications of the same study: Glass 1981, PMID 6117576, behavioral tasks added), PMID 373011
Gilman 2022 Pragmatic RCT (getting a medical cannabis card immediately or after 12 weeks; 2:1 randomization; participants not blinded, only assessors blinded)	269 randomized; 186 analyzed (105 immediate, 81 delayed; those with a baseline and at least one follow-up measurement); anxiety analysis in 83 people who applied for anxiety or depression (46/37) Adults aged 18–65 seeking medical cannabis for pain, insomnia, or symptoms of anxiety or depression; daily cannabis users and people with cannabis use disorder were excluded (US, Boston)	Cannabis products chosen by participants themselves at a dispensary (THC and/or CBD; ratios in a supplementary table, not read)	Participant's choice (product, dose and frequency unrestricted) None (participants adjusted it themselves)	12 weeks	For the primary outcome of anxiety symptoms (HADS anxiety; only in those who applied for anxiety or depression; baseline mean 9.4 in both groups), no difference between groups (mean difference −0.1; 95% CI −1.1 to 1.0; p = 0.90); no difference in depression or pain either, only the insomnia score improved (−2.90; 95% CI −4.31 to −1.51). Cannabis use disorder symptoms increased (0.28; 95% CI 0.15–0.40). Because product and dose were unrestricted, it gives no information about the effect of a specific cannabinoid Side effects: At 12 weeks, cannabis use disorder 17.1% in those who got the card immediately, 8.6% in those who waited (adjusted OR 2.88; 95% CI 1.17–7.07); 28.3% vs. 10.8% in those who applied for anxiety or depression	PMID 35302633, doi:10.1001/jamanetworkopen.2022.2106, NCT03224468
Nayak 2024 Phase 2, double-blind, placebo-controlled RCT	50 randomized (25 CBD, 25 placebo) Women with advanced breast cancer, clinical-level anxiety at baseline, awaiting a tumor assessment scan (US, Dana-Farber); an anxiety disorder diagnosis was not required	FDA-approved oral CBD solution (pure); placebo syrup	400 mg single dose None	Single dose (within 48 hours before the scan)	The primary outcome (change on the fear subscale of the Visual Analog Mood Scale from before to 2–4 hours after the drug) did not differ between groups (−19.1 vs. −15.0; p = 0.37). In a secondary comparison, the fear score 2–4 hours after the drug was lower in the CBD group (T score 51.5 vs. 58.0; p = 0.02); this was not the prespecified main outcome. Funded by two foundation grants Side effects: No grade 3–4 side effects; in the CBD group, grade 1 nausea in 1 person, grade 2 nausea and pain in 1 person	PMID 39680411, doi:10.1001/jamanetworkopen.2024.50391, NCT04482244
de Andrade Silva 2024 Double-blind, placebo-controlled RCT	Not in the abstract (full text could not be read) Dental patients scheduled for root canal treatment (Brazil, Recife); an anxiety disorder diagnosis was not required	CBD-rich cannabis extract, by mouth (THC content not in the abstract)	Not in the abstract None	Single dose (before the procedure); pain followed for 7 days	No significant difference between CBD and placebo in dental anxiety (Modified Dental Anxiety Scale and visual analog scale) at the start of and during the procedure; mean anxiety scores were slightly higher in the CBD group at every measurement (5.06 vs. 3.07 before the procedure). No difference in pain after the procedure either Side effects: Not reported (in the abstract)	PMID 39505200, doi:10.1016/j.joen.2024.10.010
Winkler 2025 RCT, 3 arms (CBD oil / placebo oil / no treatment)	180 randomized (CBD oil 59, placebo oil 61, no treatment 60); 166 analyzed (52/58/56) Stressed university students at risk of depression (Germany); an anxiety disorder diagnosis was not required	10% full-spectrum CBD oil (over-the-counter product; 1000 mg of CBD in 10 mL, a small amount of THC, amount not reported); placebo hemp seed oil	By body weight: 0.02 mg/kg on day 1, 1 mg/kg on day 30 (about 1.7–85 mg a day for 85 kg) Increase every three days (0.02 → 1 mg/kg)	30 days	No difference among the three groups on the secondary outcome of anxiety symptoms (DASS-21 anxiety subscale); no difference between CBD oil and placebo oil on any outcome. On the primary outcomes of stress and depression symptoms, both oil groups improved more than the group that received nothing; the authors attribute the improvement largely to the placebo effect Side effects: Not reported (side effects were asked about on day 30, but the paper does not give the results)	PMID 41316488, doi:10.1186/s42238-025-00366-9, German Clinical Trials Register DRKS00030971 (preregistered on December 22, 2022)
Crippa 2021 Open-label RCT (CBD + standard care vs. standard care alone; no placebo; only assessors blinded)	120 randomized (61 CBD, 59 control); 118 analyzed Frontline healthcare workers during COVID-19	Pure CBD (99.6%), 150 mg/mL in MCT oil	300 mg/day (2 × 150 mg) None	28 days	The emotional exhaustion score decreased on days 14, 21 and 28; GAD-7 fell by an average of 2.79 points from baseline on day 28 (95% CI 1.03–4.56; secondary outcome; group × time interaction p = 0.001). There was no placebo and participants knew what they were taking. 7 of the 24 authors hold or have applied for patents related to CBD compounds (the patents are outside the subject of this study); the CBD was donated by a company Side effects: 5 serious side effects, all in the CBD group: 4 liver enzyme elevations (1 critical, 3 mild), 1 severe drug rash; CBD was stopped in 2 people, both recovered fully. The most common side effects (sleepiness, tiredness) were similar in both groups	PMID 34387679, doi:10.1001/jamanetworkopen.2021.20603, NCT04504877, 3-month follow-up publication: Souza 2022, in this table
Souza 2022 Non-randomized comparison: CBD group from Crippa 2021, control group from a separate observational study in the same period; 3 months of follow-up	300 at baseline (100 CBD, 200 control); 150 completed 3 months (71/79) Healthcare workers	Oral CBD	300 mg/day None	28 days of treatment + follow-up	The reduction in GAD-7 compared with the control group lasted until 1 month after treatment ended (time × group interaction at weeks 2, 4 and 8, p = 0.006–0.04). The control group came from a separate observational study in the same period; no randomization or blinding. 7 of the 23 authors hold or have applied for patents related to CBD compounds (outside the subject of the study); the CBD was donated by a company Side effects: No new side effect data in this publication (refers to Crippa 2021)	PMID 36263136, doi:10.3389/fphar.2022.856846, NCT04504877, in this table
Bidwell 2024 Quasi-experimental study: participants who would use cannabis were randomly assigned to one of three product types; the non-using comparison group was self-selected; no placebo, participants bought their products themselves from a dispensary (only researchers blinded)	300 analyzed (258 cannabis users: THC-dominant 86, CBD-dominant 92, THC+CBD 80; 42 non-users) Adults with at least mild anxiety (GAD-7 ≥ 5) who wanted to use cannabis to cope with anxiety (US, Colorado)	Cannabis flower from the legal market: THC-dominant (24% THC, <1% CBD), THC+CBD (12%/12%) or CBD-dominant (<1% THC, 24% CBD)	Free use (ad libitum); average use 3–4 days a week None (participants adjusted it themselves)	4 weeks (a single at-home use session at the end)	Over 4 weeks, anxiety decreased in all groups (including non-users) (DASS anxiety). The three cannabis-using groups reported feeling more improvement than non-users (a single-item global impression scale), but there was no difference among the four groups on the DASS subscales. Only among users, and after accounting for frequency of use, CBD-dominant flower was linked to a slightly larger drop in DASS anxiety than THC-dominant flower (difference −1.03; SE 0.45; p = 0.02). Right after use, the CBD-dominant product reduced tension; THC-dominant and THC+CBD products slightly increased suspiciousness (paranoia). No placebo, and participants knew their products; the authors write that expectation may have affected the results. Public funding (US National Institute on Drug Abuse); the authors reported no conflicts of interest Side effects: With THC-dominant and THC+CBD flower, a slight increase in suspiciousness right after use; 4 weeks of use did not increase anxiety	PMID 38252547, doi:10.1089/can.2023.0187, NCT03491384, PMID 41752306, 30-day daily diary with flower and edible products, 345 people), PMID 40522823, PMID 40667474, 41864773), PMID 39458976, PMID 38608236
Berger 2022 Open-label, no control group	31 Young people aged 12–25 with treatment-resistant anxiety disorder (no response to CBT and/or an antidepressant)	Pure CBD capsule (200 mg, purity >99.9%), add-on treatment	200–800 mg/day (at week 12, 19 people on 800, 9 on 600, 1 on 400 mg/day) Started at 200 mg/day; if improvement was inadequate, increased in 200 mg steps; upper limit 400 at week 1, 600 at week 4, 800 mg/day at week 8; after 12 weeks, tapered off over 1 week	12 weeks	OASIS 10.8 → 6.3 (−42.6%); depression, CGI and functioning improved; at least a 50% reduction in 12 of 30 people. After treatment ended, the improvements did not last at week 26. Because there was no control group and usual treatment (therapy, antidepressants) continued, the effect cannot be attributed to CBD alone Side effects: Side effects in 80.6% (drug-related or possibly drug-related in 61.3%): tiredness, low mood, appetite change, sleepiness, nausea, diarrhea, dry mouth, insomnia, hot flashes/chills; all mild to moderate, no serious side effects	PMID 35921510, doi:10.4088/JCP.21m14130, ANZCTR ACTRN12617000825358
Dahlgren 2022 Open-label (first phase of a phase 2 study)	15 enrolled, 14 analyzed Outpatients with moderate to severe anxiety	Full-spectrum sublingual solution (9.97 mg/mL CBD, 0.23 mg/mL THC)	1 mL 3 times a day (target 30 mg CBD + <1 mg THC/day); actual use average 34.7 mg CBD + 0.8 mg THC/day None	4 weeks	Reduction in BAI and OASIS (no control) Side effects: Sleepiness/tiredness, increased energy, dry mouth (each in 3 of 14 people); no severe side effects, intoxication or serious side effects; urine THC test positive in 7 of 14 patients at week 4 (Dahlgren 2021)	PMID 36352103, doi:10.1038/s43856-022-00202-8, NCT02548559, results of the double-blind phase 2 are in the registry, a separate row in this table). Urine THC test in the same 14 patients: Dahlgren 2021, PMID 33146684
Smith 2025 Open-label pilot (funded by the product manufacturer Charlotte's Web)	15 enrolled, 12 completed Patients diagnosed with GAD (DSM-5) with at least moderate anxiety	Hemp-derived full-spectrum sublingual solution (31.52 mg/mL CBD, 0.77 mg/mL THC)	0.5 mL twice a day (target 30 mg CBD/day; actual average 31.3 mg CBD + 0.6 mg THC/day) None (fixed dose)	6 weeks	Anxiety decreased; mood, sleep and quality of life improved (no control) Side effects: 3 moderate side effects (decreased libido, nausea, weight gain; 1 person each); no serious side effects. Urine THC metabolite positive in half of the patients	PMID 40868129, doi:10.3390/biomedicines13081874, NCT04286594, McLean Hospital, results in the registry)
Stanley 2023 Double-blind, placebo-controlled RCT	32 University students with high test anxiety	Oral CBD-rich extract (CHI-907, Canopy Growth; product description from the registration, no THC content in the registration; the full text of the paper could not be read); placebo oil (CHI-804)	150 / 300 / 600 mg single dose None	Single session (statistics exam)	No effect compared with placebo on test anxiety or general anxiety at any dose; the experimental setup successfully induced test anxiety. One of the 4 authors is an employee of a cannabis company (Canopy Growth) Side effects: Not reported (in the abstract)	PMID 35861792, doi:10.1089/can.2022.0062, NCT04269252, matched by sponsor, partner university, title, number of participants and dose groups, sponsor Canopy Growth, partner institution James Madison University, 32 people, three single doses and placebo, the registration describes the product as a 'CBD-rich extract' CHI-907, terminated when recruitment became difficult because of COVID, no results in the registry)
Bloomfield 2022 Double-blind, placebo-controlled, crossover; fMRI	24 Healthy	Synthetic pure CBD capsule	600 mg single dose None	Single dose, 2.5 hours before testing; two sessions an average of 9.5 days apart	No effect on brain responses, emotion processing or experimental anxiety Side effects: Side effects not systematically reported; no difference in heart rate or blood pressure	PMID 35445839, doi:10.1007/s00213-022-06070-3
Hundal 2018 Double-blind RCT, virtual reality	32 Non-clinical volunteers with high paranoia proneness	Oral CBD	600 mg single dose None	Single session	No effect on anxiety or paranoia; trend toward increased anxiety (p=0.09) Side effects: Not reported (in the abstract)	PMID 29086614, doi:10.1177/0269881117737400
Crippa 2004 Double-blind, crossover RCT, SPECT	10 Healthy men	Oral CBD	400 mg single dose None	2 sessions, 1 week apart	Subjective anxiety decreased; blood flow changed in limbic regions Side effects: Increased 'mental sedation'	PMID 14583744, doi:10.1038/sj.npp.1300340
Rudisill 2023 Double-blind RCT (feasibility)	40 (21 CBD, 19 placebo) Healthy university students	Commercial CBD oil (THC 0.006% in independent analysis)	300 mg single dose None	Testing after 120 min	Subjective anxiety did not change; attention lapse duration longer with CBD (76 vs. 66 ms) Side effects: Participants reported no side effects; on testing, attention lapse duration increased (a sign of mild impairment in alertness)	PMID 36625844, doi:10.1111/fcp.12868
Das 2013 Double-blind, placebo-controlled, fear conditioning	48 Healthy	Vaporized CBD (as reported by Kwee 2022; the full text of Das was not read)	32 mg None	Before or after extinction	CBD given after extinction enhanced the consolidation of extinction learning (shock expectancy measure) Side effects: Not reported (in the abstract)	PMID 23307069, doi:10.1007/s00213-012-2955-y
Nakano 1978 Double-blind, placebo-controlled lab study (nabilone, diazepam and placebo; single dose)	Not in the abstract (full text could not be read) Volunteers selected for high trait (personality) anxiety; experimental stress: mirror drawing and the Stroop color-word test	Nabilone (a synthetic THC-like cannabinoid; not THC); comparison drug diazepam	Nabilone 2 mg or diazepam 5 mg, single dose None	Single-dose sessions	Diazepam reduced the anxiety caused by experimental stress; nabilone also reduced it, but less. The authors write that the doses and durations of action of the two drugs may not be equivalent and that the comparison should be interpreted with caution; the number of participants and statistics are not in the abstract Side effects: Not reported (in the abstract)	PMID 22419, doi:10.1002/cpt197823154
Hutten 2022 Double-blind, placebo-controlled, randomized, 4 conditions in the same people (at least 7 days apart)	26 Healthy occasional marijuana users	Vaporized marijuana (THC / CBD / THC+CBD / placebo; THC <1% in the CBD-rich variety as well)	13.75 mg CBD; 13.75 mg THC None	Single sessions	THC+CBD caused less anxiety than THC alone; if baseline anxiety was high, CBD did not prevent the anxiety caused by THC Side effects: THC and THC+CBD increased state anxiety	PMID 36227352, doi:10.1007/s00213-022-06248-9
Childs 2017 Double-blind, placebo-controlled RCT (3 parallel dose groups; each participant had 2 sessions, with a stressful and a non-stressful task)	42 (placebo 13, 7.5 mg 14, 12.5 mg 15) Healthy young adults (aged 18–40; no mental disorder, using cannabis at most once a week; those who had experienced anxiety with cannabis were excluded); Trier Social Stress Test (speech in front of a panel and mental arithmetic)	Oral dronabinol (synthetic THC; Marinol) capsule; placebo dextrose	7.5 or 12.5 mg single dose (2.5 hours before the tasks) None	2 sessions (5 days apart)	7.5 mg THC made subjective distress after the stress test pass more quickly (total distress over time lower than placebo, p < 0.05; no difference at the peak value, p = 0.18) and led participants to rate the test afterward as less "stressful" and "challenging". 12.5 mg THC, on the other hand, increased negative mood and anxiety even before the tasks began, raised distress in both the stressful and the non-stressful task, and borderline increased pausing during the speech (p = 0.052). Not tested in people with anxiety disorders; single session Side effects: 12.5 mg: increased negative mood, anxiety and mental clouding; the rise in blood pressure during the stress test was blunted. 7.5 mg: slight increase in heart rate	PMID 28599212, doi:10.1016/j.drugalcdep.2017.03.030
Cuttler 2026 Randomized, double-blind, placebo-controlled, parallel-group lab study (3 groups)	120 (56 men, 52 women, 12 nonbinary or trans); group sizes not in the abstract Adults who use cannabis regularly (US); an anxiety disorder diagnosis was not required	Vaporized inhaled cannabis: placebo, moderate dose (20 mg THC) or high dose (40 mg THC)	20 or 40 mg THC, single dose (vaporized) None	Single session (60 minutes of follow-up after vaporizing)	The subjective stress score decreased to a similar extent in all three groups (including placebo); the authors interpret this as an effect of expectation, not of cannabis. Cannabis lowered salivary cortisol and the skin conductance response, but the high dose raised heart rate more than placebo; no effect on heart rate variability. Read only from the abstract; the abstract does not mention a separate stress task. Two of the 7 authors received study materials from a vaporizer manufacturer; the first author has received research funding from cannabis and cannabinoid companies outside this study Side effects: At the high dose (40 mg THC), heart rate significantly higher than placebo during and right after vaporizing	PMID 42632818, doi:10.1038/s41386-026-02533-9
Wilson 2026 Systematic review and meta-analysis of RCTs (1980 to May 13, 2025; PROSPERO CRD42023392718; GRADE)	54 RCTs; 2,477 participants (all mental disorders and substance use disorders) People whose primary diagnosis is a mental disorder or substance use disorder; anxiety was examined under a separate heading; no separate result for generalized anxiety disorder in the abstract	CBD, THC, mixtures of THC and CBD, and other cannabinoids			For anxiety-related outcomes, no significant difference was found between cannabinoids and placebo (of the anxiety disorder studies, 5 used CBD alone and 1 used THC alone); no result specific to generalized anxiety disorder in the abstract. A significant benefit was seen only in cannabis use disorder, insomnia, tics and Tourette syndrome, and autism; the certainty of the evidence is low for most outcomes, with a high risk of bias in 44% of studies; the authors conclude that routine use of cannabinoids in mental disorders can rarely be justified for now. The correction published in the journal (June 16, 2026) corrected the axis of a figure and the study counts in the table; the results did not change Side effects: Any side effect more common with cannabinoids (OR 1.75; 95% CI 1.25–2.46; number needed to harm 7); no difference in serious side effects or dropping out of the study	PMID 41856154, doi:10.1016/S2215-0366(26)00015-5, Correction: Lancet Psychiatry 2026, 13(8):e11, PMID 42302809, 2026, the axis of a figure and the study counts in the table were corrected, results unchanged)
Bharat 2026 Systematic review and meta-analysis of experimental and observational studies (up to May 2025; PROSPERO CRD42023467536; GRADE)	82 experimental and 118 observational studies Adults with ADHD, anxiety, depression, PTSD, psychosis, Tourette syndrome or substance use disorder, or in whom these symptoms were measured	THC, CBD, a mix of the two and other cannabinoids; medical cannabis			In RCTs, cannabinoids reduced anxiety symptoms by a small to moderate amount (SMD −0.40; 95% CI −0.57 to −0.23), but there is very large inconsistency between studies (I² 90%) and most of the anxiety evidence was measured as a secondary outcome in other diseases. The certainty of the evidence is mostly very low; the authors write that the signal for anxiety is limited because of indirect evidence and low certainty, and they do not support cannabinoids as a first-choice treatment. Observational studies suggest improvement but have a high risk of bias Side effects: The only significant safety finding: stopping because of side effects was more common with THC (OR 2.78; 95% CI 1.66–4.65)	PMID 42617303, doi:10.1016/j.psychres.2026.117380
Bilbao 2022 Systematic review and meta-analysis of RCTs split by drug type (8 databases, up to October 2021; PROSPERO CRD42021229932; GRADE)	152 RCTs, 12,123 participants (all indications); 27 placebo-controlled RCTs measuring anxiety (dronabinol 4, nabilone 6, CBD 11, nabiximols 6) and 3 RCTs compared with an active drug All medical indications; anxiety studies in different diseases and anxiety models	Dronabinol, nabilone, pure CBD and nabiximols (natural products such as smoked cannabis excluded)			With all cannabinoids together, a borderline small reduction in anxiety (SMD −0.19; 95% CI −0.37 to −0.00; p = 0.05); none of the subanalyses by drug type (including CBD) showed significant improvement; for dronabinol SMD −0.03 (−0.47 to 0.41). The quality of the evidence is low or very low. Later RCTs (2022–2026) were not included in this analysis Side effects: Across all indications, the likelihood of any side effect with CBD was higher than with placebo (OR 1.82; 95% CI 1.08–3.07)	PMID 35982439, doi:10.1186/s12916-022-02459-1, PROSPERO CRD42021229932
Raminelli 2025 Systematic review and meta-analysis (21 placebo-controlled RCTs; SAD 5, GAD 1, PTSD 7, OCD 1, Tourette 7)	Anxiety-related disorders and Tourette syndrome	Pure or CBD-rich products			Overall effect not significant (SMD −0.40; −0.84/0.03); only in the pure CBD subgroup SMD −0.61 (−1.15/−0.07). The authors: 'low-quality evidence, limited efficacy' for SAD and GAD	PMID 40956670, doi:10.1177/25785125251378242
Han 2024 Systematic review and meta-analysis (8 studies)	316 Anxiety disorders	CBD			Hedges g = −0.92 (95% CI −1.80 to −0.04); very wide confidence interval, small sample	PMID 38924898, doi:10.1016/j.psychres.2024.116049
Kwee 2022 (systematic review) Systematic review (87 studies, human and animal)	Clinical and preclinical anxiety research	CBD			In 70.3% of observations, CBD had no effect on anxiety; no consistent relationship between blood CBD level and effect	PMID 36239014, doi:10.1177/02698811221124792
Rutledge 2026 Systematic review (brain imaging, 12 studies)	146 (7 cohorts) Stress and anxiety	CBD			Effects on the brain inconsistent; GRADE certainty low to very low	PMID 42494831, doi:10.3389/fnimg.2026.1860919
Rifkin-Zybutz 2023 (UK Medical Cannabis Registry) Prospective patient registry (no control group); United Kingdom	302 patients with generalized anxiety disorder; data available for 94 of the 150 people who could be assessed at month 6 Adults with a primary diagnosis of generalized anxiety disorder who started a cannabis-based medicine on a specialist's prescription (69% men; 86% had previous or current experience with cannabis; half were taking antidepressants)	Prescribed cannabis-based medicines: dried flower (vaporized) and/or oil; the most commonly prescribed product was a 20% THC flower with no CBD	At baseline, median daily THC 21 mg, CBD 2 mg; in the 12-month analysis, in flower-only users, median THC 200 mg/day, CBD 10 mg/day Prescription adjusted by the physician; no standard schedule	6 months (12-month analysis of the same patients: Murphy 2024)	GAD-7 fell from baseline by 5.3 points at month 1, 5.5 at month 3 and 4.5 at month 6 (all p < 0.001); clinically meaningful (at least 4 points) improvement in 43.6% of those with data at month 6. In the 12-month analysis of the same 302 patients, when missing data were replaced with the baseline score, mean GAD-7 went from 13.3 to 10.2 at month 12 (Murphy 2024). No control group, most patients were already using cannabis and data loss was high; expectation and selection effects cannot be ruled out. 11 of the 14 authors work for or are former executives of the clinic chain that runs the registry (Sapphire Medical Clinics); one is the medical director of the producer of the most commonly prescribed products (Curaleaf International) Side effects: Over 6 months, 39 patients (12.9%) reported 269 side effects, 11 (3.6%) at least one severe side effect; most common were dry mouth (8.3%), tiredness (7.3%), insomnia (6.3%), sleepiness, lack of energy and nausea (5.3%); no life-threatening side effects. In the 12-month analysis, 55 patients (18.2%) reported a total of 707 side effects	PMID 37314478, doi:10.1007/s00213-023-06399-3, PMID 34937473, first 67 patients), PMID 38155535, same 302 patients, 12 months), PMID 39526700, 302 patients, comparison of product forms), PMID 38299624, a single producer's products, 120 patients)
Lee 2022 Observational cohort (records of medical cannabis clinics in Canada, 2014–2019); no control group	84,809 authorized patients; baseline GAD-7 in 37,303, a follow-up measurement in 5,075 (13.6%); analysis in these 5,075 people Adults authorized to use medical cannabis (Ontario and Alberta; average age 54); 45.6% reported anxiety complaints at baseline	Medical cannabis (product type and THC/CBD ratios not in the analysis)	Not reported	Average follow-up of about 9 months (up to 3.2 years)	Mean GAD-7 went from 9.11 to 9.04 (mean change −0.23; 95% CI −0.28 to −0.17); statistically significant but clinically unimportant. No change in 90.8% of patients, clinically meaningful improvement in 3.7%, meaningful worsening in 1.3%; the authors write that they found no clinical benefit or harm for anxiety. Follow-up measurements exist only for a small portion and there is no control group. One of the 6 authors is a former board member of a cannabis producer (Aurora Cannabis) and has a financial interest in the company; another previously consulted for a cannabis clinic chain	PMID 34520280, doi:10.1177/07067437211043393
Martin 2021 Observational, prospective online survey study (comparison group of cannabis users and non-users; follow-up every 3 months)	538 (368 users, 170 non-users); at follow-up, 36 new starters, 121 continuing users, 23 who did not start Adults reporting a diagnosis of anxiety or depression (US; mostly women and white); from the Realm of Caring patient registry	Medical cannabis products: of those who knew the content, 82% used a CBD-dominant and 23% a THC-dominant product; 26% did not know the content	In CBD-dominant products for which a certificate of analysis was obtained, an average of 61 mg of CBD (median 30 mg) and 2.1 mg of THC (median 1 mg) a day by mouth	Follow-up at 3-month intervals (duration varies by person)	At baseline, there was no difference in anxiety score (HADS) between cannabis users and non-users (the depression score was lower in users). At follow-up, the anxiety score fell by 2.52 points in those who started cannabis (36 people) (p < 0.001) and by 1.40 points in those who continued using it (121 people), and did not change in those who did not start (23 people). No randomization, all measurements self-reported; the authors write that an expectation effect cannot be ruled out. The study was supported by a nonprofit cannabinoid patient foundation (Realm of Caring) and fellowship programs of the US National Institute on Drug Abuse; two of the seven authors have ties to cannabis companies (one is a Canopy Growth employee) Side effects: Side effects were reported more often by people using THC-dominant products (38% vs. 26%); no difference between those using CBD-dominant products and non-users	PMID 34566726, doi:10.3389/fpsyt.2021.729800
Shannon 2019 Retrospective case series (psychiatry clinic, add-on treatment)	72 (47 anxiety, 25 sleep) Adults	CBD capsule (provided by CV Sciences; content and THC content not reported)	25 mg/day in most; 50–75 mg/day in a few patients; 175 mg/day in 1 patient No standard schedule; at the physician's discretion	Monthly follow-up, up to 3 months	In the first month, the anxiety score fell in 57 patients (79.2%) (no control) Side effects: 3 patients could not tolerate it: 2 stopped in the first week because of tiredness; in 1 patient with a developmental disorder, CBD was stopped because of increased inappropriate sexual behavior. Mild sedation at first in 3 patients	PMID 30624194, doi:10.7812/TPP/18-041
Feingold 2018 Prospective nationally representative follow-up (US NESARC waves 1 and 2)	3,723 people with any anxiety disorder diagnosis in wave 1 US adults with a diagnosis of social anxiety, panic disorder, generalized anxiety disorder or specific phobia at baseline	Recreational cannabis use and cannabis use disorder (not given in the study)	Not administered (observational)	About 3 years between the two interviews	As the level of cannabis use increased, the rate of recovery from anxiety disorder fell, but this association disappeared when baseline factors were taken into account. In people with cannabis use disorder, only a few functioning outcomes were worse (end of a romantic relationship: adjusted OR 3.85; 95% CI 1.66–8.97; repeatedly dropping out of school: adjusted OR 6.02; 95% CI 2.65–13.66); no adjusted differences in suicidal thoughts, general functioning or quality of life. Observational data: does not show cause and effect	PMID 29486095, doi:10.1002/da.22735
Xue 2021 Systematic review and meta-analysis of longitudinal (prospective) studies (MEDLINE, Embase, PsycINFO; up to May 31, 2020)	24 cohort studies; 10 in the quantitative analysis; 4 studies for generalized anxiety disorder General population and adolescent cohorts (8 countries)	Recreational cannabis use (contains THC; not given in the studies)	Not administered (observational; frequency of use self-reported)		Cannabis use was weakly but significantly associated with later developing any anxiety condition (OR 1.25; 95% CI 1.01–1.54; 7 studies); when only high-quality studies were included, the association lost significance (OR 1.10; 0.82–1.47). The pooled association for generalized anxiety disorder was not significant (OR 1.44; 95% CI 0.94–2.22; I² 35%; 4 studies). Observational data: does not show cause and effect	PMID 32909828, doi:10.1177/0706743720952251

Reported side effects

Sedation/'mental sedation' (Crippa 2004); mild impairment in alertness, longer duration of attention lapses (Rudisill 2023)
Berger 2022 (12 weeks, 200–800 mg/day): side effects in 80.6% (drug-related or possibly drug-related in 61.3%), all mild to moderate — tiredness, low mood, hot flashes/chills
Crippa 2021 (300 mg/day, 28 days): 5 serious side effects, all in the CBD group (4 liver enzyme elevations, 1 of them critical; 1 severe drug rash)
Bogenschutz 2026 (PMID 41312717; in people with PTSD and alcohol use disorder, 600–1200 mg/day): 22.6% of those taking CBD reduced the dose or stopped because of side effects; nausea (20% vs. 0%) and diarrhea (27% vs. 12%) more common
Kwee 2022 RCT (add-on to therapy in social anxiety and panic disorder; 300 mg, 8 doses): no serious side effects; side effect frequency similar to placebo (10.3% vs. 15.4%)
Gilman 2022 (medical cannabis card, 12 weeks): cannabis use disorder 17.1% in those who got the card immediately, 8.6% in those who waited; 28.3% vs. 10.8% in those who applied for anxiety or depression
Rifkin-Zybutz 2023 (UK patient registry, mostly THC-rich flower, 6 months): 39 of 302 patients (12.9%) reported side effects, 11 severe; most common were dry mouth, tiredness, insomnia and sleepiness
Wilson 2026 (54 RCTs in mental disorders): any side effect more common with cannabinoids (OR 1.75; number needed to harm 7); no difference in serious side effects
Nabilone: at a high single dose (4–5 mg), a drop in blood pressure on standing and a mild increase in pulse (Glass 1980); with 4 weeks of use, dry mouth and eyes, sleepiness (Fabre 1981)

Monitoring done in studies

With long-term use, monitoring of liver tests is the physician's decision

Who should be careful

Bipolar disorder: in mania, 600–1200 mg/day CBD was ineffective in 2 patients (Zuardi 2010, PMID 18801823); in bipolar depression, 150–300 mg/day was not superior to placebo, and no increase in mania was seen (Pinto 2024, PMID 37920963); there is no evidence that CBD works in treating mania
History of psychosis: no controlled data were found showing that CBD alone triggers psychosis, but in people with high paranoia proneness, 600 mg showed a trend toward increased anxiety (Hundal 2018); the main risk is THC-containing products. A person with a history of psychosis should not use CBD without consulting a physician (this is a precautionary recommendation, not a direct study result)
Pregnancy and breastfeeding: no human studies show it is safe; in animals, signals of harm to prenatal development (Sarrafpour 2020, PMID 32524214; Argueta 2020, PMID 32425793)
Driving: 13.75 mg of vaporized CBD-dominant marijuana did not impair driving, but clinically important impairment could not be fully ruled out; CBD did not prevent THC's driving-impairing effect; after 300 mg of oral CBD, the duration of attention lapses increased (Arkell 2020, PMID 33258890; Rudisill 2023, PMID 36625844)
Liver: in healthy adults, ALT/AST >3×ULN in 5.6% with 5 mg/kg/day (Florian 2025, PMID 40622698); with 300 mg/day, 4 liver enzyme elevations, 1 of them critical (Crippa 2021)
Young people (aged 12–25): the only data are open-label, with side effects in 80.6% of participants (Berger 2022); an interaction was shown with citalopram/escitalopram, which are commonly used at this age
Allergic skin reaction: 1 severe drug rash with 300 mg/day (Crippa 2021)
Athletes: in healthy volunteers who used 150 mg a day of a broad-spectrum CBD oil for 10 weeks, CBG and CBDV, which are prohibited under WADA's 2026 list, were detected in urine (42% and 68% of pre-exercise samples, 74% and 84% of post-exercise samples); THC was not detected. CBDV was not listed on the product's certificate of analysis (Gillham 2026, PMID 40920736)
No study has shown that CBD is a first-line treatment for anxiety disorders; cannabinoids are not included in the anxiety disorder treatment guidelines that could be read (Germany 2022, Brazil 2024)
It cannot be said that 300 mg is the best dose: a moderate dose was found more effective only in two small studies in healthy volunteers (single dose, public speaking; Zuardi 2017, PMID 28553229; Linares 2019, PMID 30328956; on the Social Anxiety page); this could not be repeated in other conditions
Urine test: in 7 of 14 people who used a full-spectrum product containing about 30 mg of CBD and less than 1 mg of THC a day for 4 weeks, the urine THC test was positive (Dahlgren 2021); in a similar 6-week study, a rapid urine test was positive in 25–33% of patients and a more sensitive laboratory measurement in half (Smith 2025)
Cannabis use disorder: in people given early access to medical cannabis for anxiety or depression, cannabis use disorder at 12 weeks was 28.3% vs. 10.8% (Gilman 2022)

Drug interactions

Citalopram/escitalopram: when CBD (200–800 mg/day) was added, citalopram blood levels rose significantly in 6 patients; in the lab, breakdown through CYP3A4 and CYP2C19 was inhibited (Anderson 2021, PMID 34121064)
Sertraline, fluoxetine, mirtazapine: in the lab, CBD affected their breakdown very little; not measured in patients (Anderson 2021, PMID 34121064)
In people taking serotonergic antidepressants, CBD affected the re-extinction of subjective fear worse than placebo (Kwee 2024, PMID 38044339, exploratory subgroup)
Clobazam: in 13 children with epilepsy, the active metabolite N-desmethylclobazam rose by an average of 500%; the rise in clobazam itself (average 60%) was uncertain (confidence interval −2 to 91). In healthy volunteers, clobazam did not change and the metabolite rose ~3-fold (FDA/EMA). Side effects in 10 of 13 patients, which resolved when the clobazam dose was reduced (Geffrey 2015, PMID 26114620)
Other benzodiazepines (alprazolam, clonazepam, etc.): no direct interaction study was found in an anxiety population
THC-containing products: CBD does not consistently reduce THC's effects; full-spectrum products may contain THC (e.g., 0.23 mg/mL)
Antipsychotic + 1000 mg/day CBD (schizophrenia) was well tolerated (McGuire 2017, PMID 29241357)
No direct interaction study was found with venlafaxine, duloxetine, pregabalin, buspirone or hydroxyzine

Abbreviations: RCT, randomized controlled trial (a study in which participants are assigned to groups by chance); placebo, an inactive substance; SMD, OR and RR, effect measures used in analyses that pool studies; CYP, liver enzymes that break down medicines.

If you are considering CBD

If your anxiety makes daily life hard, you can talk with a mental health professional; no study has shown that CBD is a first choice for anxiety disorders.
If you take an antidepressant (especially citalopram or escitalopram) or a sedative, talk with your doctor and pharmacist about interactions.
If you have a history of psychosis or bipolar disorder, or are pregnant or breastfeeding, be sure to tell your doctor; CBD's safety has not been shown in these situations.
CBD can cause sleepiness and reduced attention; keep this in mind when driving.

Choose your age group, medicines and situation to prepare a short summary you can take to your doctor. Nothing you enter is sent anywhere.

Open the personal warnings tool Convert drops ↔ mg

Bottom line

Interest in CBD for anxiety is high, but research does not yet paint a clear picture: one promising large study has not been repeated, and the results of the other studies are mixed. You are not alone in coping with anxiety; talking with a professional is a solid step toward finding what will work for you.

Frequently asked questions

Does CBD oil work for generalized anxiety?

The evidence on this is weak. One large study reported a strong effect but has not been repeated; the results of other controlled studies are mixed, and many found no clear difference from an inactive substance (placebo).

Is there a best CBD dose for anxiety?

There is no proven “best dose.” Claims of this kind rest only on two small, single-dose studies in healthy volunteers (a public speaking test; Zuardi 2017, PMID 28553229, and Linares 2019, PMID 30328956, on the Social Anxiety page), and they have not been repeated in other conditions.

Can CBD be used together with antidepressants?

CBD can slow down how some medicines are broken down in the body; blood levels of citalopram and escitalopram rose in patients who added CBD. There are no data measured in patients for other medicines such as sertraline. Talk to your doctor and pharmacist before using them together.

Are full-spectrum products more effective for anxiety?

No study shows this. In a small double-blind part with a low-THC full-spectrum product, self-reported anxiety also fell clearly in those taking placebo; interviewer-rated anxiety fell more in those taking the full-spectrum product, but the groups were not compared statistically (results only in the trial registry). The other data come from studies without a comparison group. Also, THC can increase state anxiety and full-spectrum products may contain some THC: in 7 of 14 people who used such a product containing less than 1 mg of THC a day for 4 weeks, the urine THC test was positive.

Can CBD oil for anxiety be obtained with a prescription in Turkey?

In Turkey, products derived from cannabis are regulated by the Kenevirden Elde Edilen Ürünlere Dair Yönetmelik (Regulation on Products Derived from Hemp) dated January 31, 2026. These products, including CBD, can be sold only in pharmacies. Those in the medicine and health product category are dispensed with a prescription; the regulation does not state a prescription requirement for supplement products and cosmetics with a THC content of at most 0.3%. As of October 2026, there is no approved (licensed) CBD medicine in Turkey. If you are thinking of using it, talk with your doctor first.

Is THC-containing cannabis good for anxiety?

There is no controlled study showing this; the evidence for THC is very weak. In a study that gave people seeking medical cannabis for anxiety or depression early access by lottery, anxiety did not improve over 12 weeks, while cannabis use disorder increased. In the lab, high doses of THC can increase anxiety; there is a single small study in which a low dose slightly reduced distress after a stress test, and in regular users the stress-reducing effect of vaporized THC was similar to placebo. Patient registries contain self-reported improvements, but there is no control group and the results are inconsistent. If you are thinking of using cannabis for your anxiety, you can talk with your doctor about it.

References

Show 38 references

Gundugurti 2024. Phase 3, double-blind, placebo-controlled, multicenter RCT (India; 6 of the 7 authors are affiliated with pharmaceutical companies: 5 are executives or employees of Leiutis Pharmaceuticals, which funded the pharmacokinetic part of the trial, and 1 is the medical director of Biophore Pharma). PMID 38797087, doi:10.1016/j.ajp.2024.104073, Clinical Trials Registry of India CTRI/2023/01/049110. Pharmacokinetic study that is part of the same trial: Gundugurti 2026, PMID 41613360, 300 mg single dose, funded by Leiutis Pharmaceuticals). Research letter from the same team: Gundugurti 2026, PMID 42901095, full text not open, content could not be verified)
Gournay 2023. Double-blind, placebo-controlled RCT. PMID 37552290, doi:10.1007/s00213-023-06437-0, Sleep results of the same trial: Gournay 2026, PMID 41678223, difference from placebo not significant, p = 0.10, d = 0.07, no sedation or cognitive impairment)
NCT02548559 (McLean Hospital, double-blind phase; registry results). Phase 2, two-phase trial: phase 1 open-label (Dahlgren 2022, in this table), phase 2 randomized, triple-blind, placebo-controlled, parallel-group. Results only on ClinicalTrials.gov; no peer-reviewed publication. NCT02548559, results posted to the registry on March 27, PMID 36352103, in this table
Fabre 1981. Double-blind, placebo-controlled clinical study (randomization method not in the abstract). PMID 6117575, doi:10.1002/j.1552-4604.1981.tb02617.x
Glass 1980. Single-blind, placebo-controlled, single-dose study in the same people in a balanced Latin square design (one session a week). PMID 6108592, doi:10.1007/BF00434401, Other publications of the same study: Glass 1981, PMID 6117576, behavioral tasks added), PMID 373011
Gilman 2022. Pragmatic RCT (getting a medical cannabis card immediately or after 12 weeks; 2:1 randomization; participants not blinded, only assessors blinded). PMID 35302633, doi:10.1001/jamanetworkopen.2022.2106, NCT03224468
Nayak 2024. Phase 2, double-blind, placebo-controlled RCT. PMID 39680411, doi:10.1001/jamanetworkopen.2024.50391, NCT04482244
de Andrade Silva 2024. Double-blind, placebo-controlled RCT. PMID 39505200, doi:10.1016/j.joen.2024.10.010
Winkler 2025. RCT, 3 arms (CBD oil / placebo oil / no treatment). PMID 41316488, doi:10.1186/s42238-025-00366-9, German Clinical Trials Register DRKS00030971 (preregistered on December 22, 2022)
Crippa 2021. Open-label RCT (CBD + standard care vs. standard care alone; no placebo; only assessors blinded). PMID 34387679, doi:10.1001/jamanetworkopen.2021.20603, NCT04504877, 3-month follow-up publication: Souza 2022, in this table
Souza 2022. Non-randomized comparison: CBD group from Crippa 2021, control group from a separate observational study in the same period; 3 months of follow-up. PMID 36263136, doi:10.3389/fphar.2022.856846, NCT04504877, in this table
Bidwell 2024. Quasi-experimental study: participants who would use cannabis were randomly assigned to one of three product types; the non-using comparison group was self-selected; no placebo, participants bought their products themselves from a dispensary (only researchers blinded). PMID 38252547, doi:10.1089/can.2023.0187, NCT03491384, PMID 41752306, 30-day daily diary with flower and edible products, 345 people), PMID 40522823, PMID 40667474, 41864773), PMID 39458976, PMID 38608236
Berger 2022. Open-label, no control group. PMID 35921510, doi:10.4088/JCP.21m14130, ANZCTR ACTRN12617000825358
Dahlgren 2022. Open-label (first phase of a phase 2 study). PMID 36352103, doi:10.1038/s43856-022-00202-8, NCT02548559, results of the double-blind phase 2 are in the registry, a separate row in this table). Urine THC test in the same 14 patients: Dahlgren 2021, PMID 33146684
Smith 2025. Open-label pilot (funded by the product manufacturer Charlotte's Web). PMID 40868129, doi:10.3390/biomedicines13081874, NCT04286594, McLean Hospital, results in the registry)
Stanley 2023. Double-blind, placebo-controlled RCT. PMID 35861792, doi:10.1089/can.2022.0062, NCT04269252, matched by sponsor, partner university, title, number of participants and dose groups, sponsor Canopy Growth, partner institution James Madison University, 32 people, three single doses and placebo, the registration describes the product as a 'CBD-rich extract' CHI-907, terminated when recruitment became difficult because of COVID, no results in the registry)
Bloomfield 2022. Double-blind, placebo-controlled, crossover; fMRI. PMID 35445839, doi:10.1007/s00213-022-06070-3
Hundal 2018. Double-blind RCT, virtual reality. PMID 29086614, doi:10.1177/0269881117737400
Crippa 2004. Double-blind, crossover RCT, SPECT. PMID 14583744, doi:10.1038/sj.npp.1300340
Rudisill 2023. Double-blind RCT (feasibility). PMID 36625844, doi:10.1111/fcp.12868
Das 2013. Double-blind, placebo-controlled, fear conditioning. PMID 23307069, doi:10.1007/s00213-012-2955-y
Nakano 1978. Double-blind, placebo-controlled lab study (nabilone, diazepam and placebo; single dose). PMID 22419, doi:10.1002/cpt197823154
Hutten 2022. Double-blind, placebo-controlled, randomized, 4 conditions in the same people (at least 7 days apart). PMID 36227352, doi:10.1007/s00213-022-06248-9
Childs 2017. Double-blind, placebo-controlled RCT (3 parallel dose groups; each participant had 2 sessions, with a stressful and a non-stressful task). PMID 28599212, doi:10.1016/j.drugalcdep.2017.03.030
Cuttler 2026. Randomized, double-blind, placebo-controlled, parallel-group lab study (3 groups). PMID 42632818, doi:10.1038/s41386-026-02533-9
Wilson 2026. Systematic review and meta-analysis of RCTs (1980 to May 13, 2025; PROSPERO CRD42023392718; GRADE). PMID 41856154, doi:10.1016/S2215-0366(26)00015-5, Correction: Lancet Psychiatry 2026, 13(8):e11, PMID 42302809, 2026, the axis of a figure and the study counts in the table were corrected, results unchanged)
Bharat 2026. Systematic review and meta-analysis of experimental and observational studies (up to May 2025; PROSPERO CRD42023467536; GRADE). PMID 42617303, doi:10.1016/j.psychres.2026.117380
Bilbao 2022. Systematic review and meta-analysis of RCTs split by drug type (8 databases, up to October 2021; PROSPERO CRD42021229932; GRADE). PMID 35982439, doi:10.1186/s12916-022-02459-1, PROSPERO CRD42021229932
Raminelli 2025. Systematic review and meta-analysis (21 placebo-controlled RCTs; SAD 5, GAD 1, PTSD 7, OCD 1, Tourette 7). PMID 40956670, doi:10.1177/25785125251378242
Han 2024. Systematic review and meta-analysis (8 studies). PMID 38924898, doi:10.1016/j.psychres.2024.116049
Kwee 2022 (systematic review). Systematic review (87 studies, human and animal). PMID 36239014, doi:10.1177/02698811221124792
Rutledge 2026. Systematic review (brain imaging, 12 studies). PMID 42494831, doi:10.3389/fnimg.2026.1860919
Rifkin-Zybutz 2023 (UK Medical Cannabis Registry). Prospective patient registry (no control group); United Kingdom. PMID 37314478, doi:10.1007/s00213-023-06399-3, PMID 34937473, first 67 patients), PMID 38155535, same 302 patients, 12 months), PMID 39526700, 302 patients, comparison of product forms), PMID 38299624, a single producer's products, 120 patients)
Lee 2022. Observational cohort (records of medical cannabis clinics in Canada, 2014–2019); no control group. PMID 34520280, doi:10.1177/07067437211043393
Martin 2021. Observational, prospective online survey study (comparison group of cannabis users and non-users; follow-up every 3 months). PMID 34566726, doi:10.3389/fpsyt.2021.729800
Shannon 2019. Retrospective case series (psychiatry clinic, add-on treatment). PMID 30624194, doi:10.7812/TPP/18-041
Feingold 2018. Prospective nationally representative follow-up (US NESARC waves 1 and 2). PMID 29486095, doi:10.1002/da.22735
Xue 2021. Systematic review and meta-analysis of longitudinal (prospective) studies (MEDLINE, Embase, PsycINFO; up to May 31, 2020). PMID 32909828, doi:10.1177/0706743720952251

Points that could not be verified from the full text

The following studies were read only from the PubMed abstract (the full text could not be accessed): Gundugurti 2024, Gournay 2023, Gournay 2026, Stanley 2023, Hundal 2018, Crippa 2004, Das 2013, Han 2024, Raminelli 2025. Berger 2022 was read from the author manuscript. Of those added in the October 2026 search, Fabre 1981, Glass 1980, Nakano 1978, de Andrade Silva 2024, Feingold 2018, Bharat 2026, Wilson 2026 and Cuttler 2026 were read only from the abstract (full text not open); the nabilone dose in Fabre 1981 and the number of participants in Nakano 1978 and de Andrade Silva 2024 (and the dose as well in de Andrade Silva) are not in the abstract. Gournay 2023's anxiety result 'compared with placebo' and its conflict of interest statement could not be verified because the full text could not be read
In Gundugurti 2024, the dose and titration are unknown: the full text could not be accessed, and the registration (CTRI/2023/01/049110) does not give a mg dose; the '300–600 mg/day, 12 weeks' in secondary sources could not be verified. In the minutes of the expert committee of India's drug regulator (March 12, 2024, 26–November 27, 2024 and May 6, 2026), the applicant company is Zenara Pharma; the trial identifier and publication title are not stated. That the minutes belong to this trial was inferred from the match of 178 people, a 150 mg/mL product, the indication of mild to moderate anxiety disorder and the multicenter design. The information on a 'placebo run-in period' and 'primary outcome at week 11' in the study duration is not in the abstract; it could not be re-verified because the Clinical Trials Registry of India could not be reached in October 2026. The abstract of the same team's research letter dated October 2026 (PMID 42901095) is not available, its full text is not open, and its content could not be read
Ongoing study: NCT07123467 (GAD; 5-week brief CBT + Epidiolex 5 or 10 mg/kg/day, placebo-controlled, target 90 people; recruiting, estimated completion August 2027; primary outcome is brain imaging, not symptoms). Other registrations with results not posted or not published (ClinicalTrials.gov, October 28, 2026): NCT03549819 (McMaster University, in partnership with a cannabis company; pure CBD 200–800 mg/day, 8 weeks, placebo-controlled, target 50 people; registration not updated since February 2023), NCT06672666 (University of Florida; hemp-derived CBD extract 50–150 mg/day, 4 weeks, placebo-controlled, 30 people; estimated completion December 2026), NCT05283382 (University of Connecticut; single dose of 600 mg, 160 people; recruiting), NCT05324449 (anxiety in children with epilepsy; open-label with an approved (licensed) CBD medicine, 20 people; ended May 2025, no results). The anxiety study in glioblastoma, NCT05753007, was terminated early with only 2 people
The correction to Wilson 2026 published in the journal (Lancet Psychiatry 2026;13(8):e11; PMID 42302809) was read on October 29, 2026: only the axis of one figure and the study counts in a table were corrected; the numbers in the row (54 RCTs, 2,477 participants, side effect OR 1.75, high risk of bias in 44% of the studies) did not change. According to the corrected table, 5 of the anxiety disorder studies were done with CBD alone and 1 with THC alone
Clinical guidelines: Germany's anxiety disorders guideline (2022 revision) and the Brazilian Psychiatric Association's generalized anxiety disorder guideline (2024) do not mention cannabinoids in their full texts; the full text of the World Federation of Societies of Biological Psychiatry guideline (2023) could not be read (the publisher's site blocked access). The ClinicalTrials.gov registration of Stanley 2023 (NCT04269252) was matched to the paper by design, number of participants and dose steps; the paper's abstract has no registration number. Because the registration describes the product as a 'CBD-rich extract' (CHI-907), the row's product type was corrected to 'CBD-rich, THC content unclear' (October 28, 2026); the full text of the paper could not be read (the publisher's site blocks automated access)

Trusted sources from around the world

Show 2 references

German guideline for the treatment of anxiety disorders, first revision (2022)German anxiety disorders guideline group (29 professional societies and patient organizations); European Archives of Psychiatry and Clinical Neuroscience, English, June 2022
The English text of this guideline, published in the journal, recommends psychotherapy and certain antidepressants as first-line treatment for anxiety disorders and does not mention cannabinoids at all.
Brazilian Psychiatric Association guideline for the treatment of generalized anxiety disorder (2024)Brazilian Psychiatric Association (Brazilian Journal of Psychiatry), English, 2024
The full text of this guideline, which recommends antidepressants, benzodiazepines and pregabalin for drug treatment and individual cognitive behavioral therapy for psychotherapy, does not mention cannabinoids at all.

These sources sell no products. All trusted sources

Research history

Here we record what changed on this page, when and why, with dates. The newest change is at the top.

October 28, 2026
October 2026 additional review: sources found for this page in the searches for other topics were read and incorporated into the page. The product of the exam anxiety study (Stanley 2023) is, according to the trial registration, a CBD-rich extract; the row's product type was corrected accordingly to 'CBD-rich, THC content unclear', and the basis for the registration match was written down. In the row of the 178-person study in India (Gundugurti 2024), the role of the company the authors are affiliated with was corrected according to the conflict of interest statement and the pharmacokinetic publication of the same trial: it is not the company that developed the product, but the company that funded the pharmacokinetic part of the trial. The conclusion and the strength of evidence did not change.
October 28, 2026
PubMed, Cochrane and ClinicalTrials.gov were systematically searched again in October 2026 (2,159 records in PubMed and 144 in ClinicalTrials.gov; together with an independent second check). Added: 8 controlled studies in patients or people experiencing anxiety or stress (one with results only in the trial registry; most found no difference from placebo), 3 lab studies in volunteers (including those showing THC's two-way effect on stress and anxiety and that its stress-reducing effect is similar to placebo), 3 meta-analyses and 5 observational studies. Older lab experiments and meta-analyses whose question is answered by a newer or larger study or review in the table were not added separately; the second publication reporting the sleep results of the same trial was removed as a separate row and moved to the main study's sources. Corrected: the company ties and unusually small standard error of the large India study, the fact that the match with the drug regulator's minutes is not certain, the patent ties of the Brazilian research group, the trial registrations and urine THC test results of the open-label studies, the statement 'only uncontrolled data exist' for THC-containing products, and the order of the table. The conclusion and the strength of evidence did not change.
Related studies: NCT02548559 (McLean Hospital, double-blind phase; registry results), published Not published; results in the registry March 27, 2026 (NCT02548559, results posted to the registry on March 27, PMID 36352103, in this table); Fabre 1981, published 1981 (PMID 6117575, doi:10.1002/j.1552-4604.1981.tb02617.x); Glass 1980, published 1980 (PMID 6108592, doi:10.1007/BF00434401, Other publications of the same study: Glass 1981, PMID 6117576, behavioral tasks added), PMID 373011); Gilman 2022, published March 1, 2022 (PMID 35302633, doi:10.1001/jamanetworkopen.2022.2106, NCT03224468); Nayak 2024, published December 2, 2024 (PMID 39680411, doi:10.1001/jamanetworkopen.2024.50391, NCT04482244); de Andrade Silva 2024, published December 2024 (PMID 39505200, doi:10.1016/j.joen.2024.10.010); Winkler 2025, published November 28, 2025 (PMID 41316488, doi:10.1186/s42238-025-00366-9, German Clinical Trials Register DRKS00030971 (preregistered on December 22, 2022)); Bidwell 2024, published August 2024 (online January 22, 2024) (PMID 38252547, doi:10.1089/can.2023.0187, NCT03491384, PMID 41752306, 30-day daily diary with flower and edible products, 345 people), PMID 40522823, PMID 40667474, 41864773), PMID 39458976, PMID 38608236); Nakano 1978, published January 1978 (PMID 22419, doi:10.1002/cpt197823154); Childs 2017, published August 1, 2017 (PMID 28599212, doi:10.1016/j.drugalcdep.2017.03.030); Cuttler 2026, published August 22, 2026 (online) (PMID 42632818, doi:10.1038/s41386-026-02533-9); Wilson 2026, published April 2026 (PMID 41856154, doi:10.1016/S2215-0366(26)00015-5, Correction: Lancet Psychiatry 2026, 13(8):e11, PMID 42302809, 2026, the axis of a figure and the study counts in the table were corrected, results unchanged)); Bharat 2026, published November 2026 (online August 11, 2026) (PMID 42617303, doi:10.1016/j.psychres.2026.117380); Bilbao 2022, published August 19, 2022 (PMID 35982439, doi:10.1186/s12916-022-02459-1, PROSPERO CRD42021229932); Rifkin-Zybutz 2023 (UK Medical Cannabis Registry), published August 2023 (PMID 37314478, doi:10.1007/s00213-023-06399-3, PMID 34937473, first 67 patients), PMID 38155535, same 302 patients, 12 months), PMID 39526700, 302 patients, comparison of product forms), PMID 38299624, a single producer's products, 120 patients)); Lee 2022, published June 2022 (online September 14, 2021) (PMID 34520280, doi:10.1177/07067437211043393); Martin 2021, published September 9, 2021 (PMID 34566726, doi:10.3389/fpsyt.2021.729800); Feingold 2018, published June 2018 (PMID 29486095, doi:10.1002/da.22735); Xue 2021, published February 2021 (PMID 32909828, doi:10.1177/0706743720952251)
October 28, 2026
Display fix: internal working notes left from the previous cleanup were removed; content and evidence did not change.

Older changes (3)

October 27, 2026
The official minutes of the decisions of the expert committee of India's drug regulator were found and added as a source; the information that in May 2026 the committee recommended approving the product on condition of a comparative phase 4 study was added. The conclusion and the strength of evidence did not change.
October 21, 2026
The full texts of the studies were reread and the information on the page was checked against its sources. Corrected: side effect, product, study design and dose information in the study table; drug interaction notes; the dose range in the studies; the starting and increase summary; the "Who should be careful" list; the reported side effects; the evidence summary. Points that could not be verified from the full text went down from 4 items to 3. The years of 7 publications named on the page were corrected to the journal's print year instead of the online publication year. The conclusion and the strength of evidence did not change.
October 19, 2026
Page published. This first review examined 20 studies.

Evidence changes across all topics