What does the research say?
In a study of 80 people with treatment-resistant panic disorder or social anxiety disorder, CBD or placebo was given before sessions of therapy that involves facing feared situations step by step (exposure therapy). No difference was seen between the two groups in the results of therapy, including at 3- and 6-month follow-up.
In a detailed analysis of the same study, CBD’s effect on fear learning was limited. In participants taking antidepressants, however, CBD affected the renewed reduction of fear worse than placebo did; this finding is exploratory and comes from a small subgroup.
In a study in which healthy volunteers breathed air with a high carbon dioxide level to trigger panic-like symptoms, CBD at three different doses had no effect on fear, panic symptoms or heart rate. For now, the idea that CBD may have an anti-panic effect rests on animal studies and data from healthy volunteers. The two most recent reviews that gather cannabinoid trials in mental health conditions also contain no new study specific to panic disorder: one found no study focusing on panic disorder in which patients were randomly assigned to groups; the other, covering 54 studies, found no clear difference in anxiety-related outcomes but did not give a separate result for panic disorder.
The link between cannabis (marijuana) use and panic disorder has also been studied; but in these studies cannabis was not given, people’s own use was followed over years, and the results do not agree with each other. In a group followed from high school age to young adulthood, panic disorder was later seen more often in those who used cannabis, but this difference disappeared once smoking was taken into account. In a follow-up study of adults in the Netherlands, no clear link was seen. Of the analyses from a US national study that followed tens of thousands of people, one found that panic disorder with fear of crowded or hard-to-escape places (agoraphobia) began more often in regular users; the other found no clear link, and in this analysis people with panic disorder were more likely to start cannabis later, meaning the link may go both ways. In an analysis that pooled three follow-up studies, the link was also not statistically clear. These are observational studies; they cannot show for certain that cannabis causes or does not cause panic disorder.
Strength of evidence: ○○○○ Insufficient evidence. Finding: Not studied enough. What does this mean?
Ongoing research on this topic
No ongoing CBD trial on this topic appears on ClinicalTrials.gov right now. All ongoing trials
Possible side effects and drug interactions
In the panic and social anxiety study, the rate of side effects was similar with CBD and placebo (10.3% vs 15.4%). In other anxiety studies, a mild decrease in attention, raised liver enzymes in some people and a severe drug rash in one person were reported.
CBD can slow down how the body breaks down some medicines. Blood levels of citalopram and escitalopram, which are used for anxiety and depression, rose with CBD; clobazam levels also rose clearly. There is no direct study of other sedatives such as alprazolam or clonazepam.
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.
| 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?
In controlled studies, CBD was given as a single 300 mg dose (study dose; not a personal recommendation) before therapy sessions, or as a single 150, 300 or 600 mg dose (study dose; not a personal recommendation) before a lab test. No dose showed a clear benefit for panic symptoms. There is no study of long-term, regular CBD use in panic disorder.
Study details (for health professionals)
No RCT testing CBD on its own in panic disorder was found. In treatment-resistant panic disorder and social anxiety, adding 300 mg of CBD to exposure therapy gave no benefit. In a study in healthy volunteers using inhalation of 10% CO₂ (a panic model), no effect was seen at any dose. The review reporting a positive result (Soares 2017) relies on animal, healthy volunteer and social anxiety patient data; it includes no panic disorder patients. The two most recent reviews gathering cannabinoid RCTs in mental health conditions add no new data for panic disorder: in a meta-analysis of 54 RCTs, there was no significant difference between cannabinoids and placebo in anxiety-related outcomes, and no separate result is given for panic disorder (Wilson 2026; certainty of evidence low for most outcomes); a scoping review of RCTs found no RCT targeting panic disorder (Cooling 2026). There is no treatment study of THC-containing products in panic disorder. Prospective observational studies looking at whether panic disorder develops later with recreational cannabis use are conflicting: in a cohort followed from adolescence to young adulthood, cannabis use and dependence were associated with panic disorder, but the association disappeared once daily smoking and other substance dependencies were taken into account (Zvolensky 2008); in adults in the Netherlands, the association was not significant after adjustment (van Laar 2007); one analysis from the US national follow-up (NESARC) found that weekly use predicted panic disorder with agoraphobia (Cougle 2015; the size of the risk is not in the abstract), while another from the same data found no significant association between cannabis dependence and panic disorder and, conversely, showed that people with panic disorder at baseline started cannabis more often (Feingold 2016); in a meta-analysis pooling van Laar 2007, Zvolensky 2008 and Feingold 2016 from these three cohorts, the association was not significant (OR 1.52; 95% CI 0.96–2.40; Xue 2021). In patients being treated for panic disorder, using cannabis at least once a month did not change the effect of treatment on panic symptoms (Bricker 2007; observational secondary analysis of a trial). October 2026 search (PubMed, Cochrane, ClinicalTrials.gov): 2 controlled studies with cannabinoids on this topic were found (one with CBD added to therapy in patients, one a lab study in healthy volunteers; the fear-conditioning substudy of the first was published separately and is mentioned in the main study’s row in the table); there are no controlled studies with THC-containing products, no Cochrane review, and no study with registered but unpublished results. Besides these, the table has 2 recent reviews gathering cannabinoid trials in mental health conditions, 1 meta-analysis on cannabis use and panic disorder risk, 5 observational studies and 1 narrative review.
Evidence assessment: Insufficient
CBD alone
There is no controlled human study showing an effect of pure CBD in panic disorder; the existing controlled data are negative.
Products containing THC
No treatment study of THC-containing products (cannabis, THC, nabilone, dronabinol, a mouth spray containing THC and CBD) in panic disorder was found. The results of observational studies following recreational cannabis use over years do not agree with each other: in some, panic disorder was later seen more often in cannabis users, in others it was not; in the analysis pooling three follow-up studies, the link was not statistically clear. In one study the link disappeared once smoking was taken into account; in another, people with panic disorder were more likely to start cannabis later, meaning the link may go both ways. There is no evidence for treatment; because the findings on risk are only observational and conflicting, they are weak and do not show cause and effect.
Evidence: Insufficient: no treatment studies; findings on cannabis use come only from observational studies
Dose range in studies
In controlled studies, 300 mg (before a therapy session) and 150–600 mg single doses
Starting dose and titration
Not reported in detail in the studies.
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.
| Study | Participants | Product | Dose and titration | Duration | Result | Source |
|---|---|---|---|---|---|---|
| Kwee 2022 (RCT) Double-blind, placebo-controlled parallel RCT, 3 centers | 80 (39 CBD, 41 placebo) Treatment-resistant panic disorder + agoraphobia or social anxiety disorder | Synthetic CBD (purity >99.9%; STI/THC Pharm), capsule; placebo lactose | 300 mg, about 2 hours before each exposure session (8 doses in total) None | 8 weekly sessions (1 a week); 3- and 6-month follow-up | On the primary outcome (Fear Questionnaire, FQ), no difference over time between CBD and placebo in the outcome of exposure therapy (all patients β = 0.32; 95% CI −0.60 to 1.25; looking at diagnostic groups separately β = −0.11; −1.62 to 1.40); no difference on panic scales (PDSS, ACQ, MI) either. The placebo group improved numerically more Side effects: No serious side effects; side effect rate similar (CBD 4/39, 10.3%; placebo 6/39, 15.4%): with CBD, dizziness, sleepiness, tiredness | PMID 35561538, doi:10.1016/j.euroneuro.2022.04.003, Protocol: van der Flier 2019, PMID 30760241, fear-conditioning substudy: Kwee 2024, PMID 38044339, after the first single 300 mg dose: CBD reduced threat expectancy and did not increase re-extinction of fear, in an exploratory subgroup analysis, re-extinction of subjective fear was worse with CBD than with placebo in people taking serotonergic antidepressants, and safety learning was impaired in women taking antidepressants) |
| Leen-Feldner 2025 Double-blind, placebo-controlled RCT, 4 groups (healthy volunteer lab study) | 61 analyzed (actual enrollment in the ClinicalTrials.gov registration 84 people; the difference is not explained in the abstract, and the full text could not be read) Healthy young adults; 10% CO₂ inhalation (panic model) | Oral hemp-derived CBD in MCT oil (CHI-554; the product was donated by the sponsor Canopy Growth), 90 min before the CO₂ test; placebo MCT oil. The publication’s methods section could not be read; in the publication of another study whose registration lists the same product code (CHI-554) and which was funded by the same company, the product is described as CBD isolate in MCT oil (Wolinsky 2026, NCT05317507) | 150 / 300 / 600 mg single dose None | Single session | No difference from placebo at any dose in fear, panic symptoms or heart rate. The study was supported by a CBD manufacturer (Canopy Growth); three of the authors are company employees Side effects: Not reported (in the abstract; the full text could not be read) | PMID 36241853, doi:10.1007/s00213-022-06258-7, NCT04577612, no results entered) |
| Soares 2017 Narrative review (PubMed, 1990–July 2015) | Animal studies, healthy volunteers and social anxiety patients; no panic disorder patients | CBD | The authors suggest that CBD has an anti-panic effect; but they state that there are no studies in panic disorder patients and that the dose range is unknown | PMID 27157263, doi:10.2174/1570159x14666160509123955 | ||
| Wilson 2026 Systematic review and meta-analysis of RCTs (1980–May 13, 2025; PROSPERO CRD42023392718) | 54 RCTs; 2477 participants (all mental disorders and substance use disorders) People whose primary diagnosis is a mental disorder or a substance use disorder; anxiety was examined under a separate heading; no separate result for panic disorder in the abstract | CBD, THC, THC and CBD combinations and other cannabinoids | No significant difference was found between cannabinoids and placebo in anxiety-related outcomes (of the anxiety disorder studies, 5 used CBD alone and 1 used THC alone); no result specific to panic disorder in the abstract. Significant benefit was seen only in cannabis use disorder, insomnia, tics and Tourette syndrome, and autism; certainty of evidence low for most outcomes, high risk of bias in 44% of studies. 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) | ||
| Cooling 2026 Scoping review of RCTs (PubMed, Web of Science, PsycINFO; 1980–2024; patients with DSM-5 diagnoses) | 28 RCTs (12 mental health conditions); 3 RCTs in anxiety disorders Patients with a DSM-5 mental disorder diagnosis; in anxiety disorders, 2 social anxiety studies and Kwee 2022, which also included patients with panic disorder with agoraphobia | Pure CBD, mouth sprays containing THC and CBD, cannabis flower containing THC/CBD | The authors write that they found no RCT targeting panic disorder and see this as an example of the gap between cannabis prescribing in clinics and the evidence. They assessed Kwee 2022 under anxiety disorders: CBD did not change the outcome of exposure therapy. None of the studies reviewed showed long-term efficacy Side effects: For Kwee 2022: side effect rate CBD 10.3%, placebo 15.4% | PMID 41343139, doi:10.1007/s40261-025-01501-3 | ||
| 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; 3 studies for panic disorder General community and adolescent cohorts (8 countries) | Recreational cannabis use (contains THC; not given in the studies) | Not applied (observational; frequency of use self-reported) | Follow-up of up to 20 years in the studies | Cannabis use was weakly but significantly associated with later development of 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). For panic disorder, the pooled association was not significant (OR 1.52; 95% CI 0.96–2.40; I² 0%; 3 studies: van Laar 2007, Zvolensky 2008 and Feingold 2016; all three are separate rows in the table). Observational data: does not show cause and effect | PMID 32909828, doi:10.1177/0706743720952251 |
| Zvolensky 2008 Prospective community cohort (Oregon Adolescent Depression Project), 3 assessments | 1709 adolescents at the start; 1507 (about 1 year later); 941 (at age 24); 52 people with a prior history of panic excluded from the analysis High school students in the USA (western Oregon), followed into young adulthood | Recreational cannabis use, abuse and dependence (not given in the study) | Not applied (observational; diagnostic interview) | From a mean age of 16.6 to 24.2 (about 8 years) | Without taking other factors into account, cannabis use (OR 2.6; 95% CI 1.04–6.5) and cannabis dependence (OR 4.9; 1.7–14.0) were associated with later development of panic disorder; similar for panic attacks (use OR 2.5; dependence OR 3.7). Once daily smoking and other substance dependence were taken into account, cannabis had no additional association; daily smoking, on the other hand, was clearly associated with panic disorder (OR 4.8; 1.9–12.2). Few new cases of panic disorder (21) | PMID 18076905, doi:10.1016/j.jpsychires.2007.10.012 |
| Cougle 2015 Prospective nationally representative follow-up (US NESARC waves 1 and 2, 3 years apart) | 43,093 (wave 1); 34,653 (wave 2) US general adult population | Regular recreational cannabis use (weekly in the past year) (not given in the study) | Not applied (observational) | About 3 years | Weekly cannabis use in the past year predicted the new onset of panic disorder with agoraphobia over about 3 years of follow-up (also for social phobia and bipolar disorder); the size of the risk and the factors taken into account in the analysis are not in the abstract, and the full text could not be read. Feingold 2016, done with the same national data, did not find a significant association of starting cannabis with anxiety disorders or of cannabis dependence with panic disorder; cannabis use was defined differently in the two analyses. Observational data: does not show cause and effect | PMID 26022838, doi:10.1016/j.jpsychires.2015.05.004 |
| Feingold 2016 Prospective nationally representative follow-up (US NESARC waves 1 and 2) | 34,653 people who took part in both waves (according to the Xue 2021 table); analysis subsamples not in the abstract US general adult population; anxiety disorders at the start (generalized anxiety, social anxiety, panic disorder, specific phobia) were taken into account | Recreational cannabis use and cannabis use disorder (not given in the study) | Not applied (observational) | 3 years | Starting cannabis (starting between the two interviews after never having used it before) was not associated with the new onset of any anxiety disorder over 3 years (adjusted OR 1.12; the confidence interval in the abstract is written inconsistently); similar for cannabis use disorder. The result specific to panic disorder is in the Xue 2021 table: cannabis dependence was not significantly associated with a new panic disorder diagnosis (OR 1.69; 95% CI 0.88–3.25). Conversely, people with panic disorder at the start were more likely to start cannabis during follow-up (adjusted OR 2.2; 95% CI 1.15–4.18); the authors think this may be a kind of attempt at self-medication. Observational data: does not show cause and effect | PMID 26775742, doi:10.1016/j.euroneuro.2015.12.037 |
| van Laar 2007 Prospective community cohort (Netherlands NEMESIS), 3-year follow-up | 3854 (adults without a lifetime anxiety disorder at the start) General adult population ages 18–64 in the Netherlands | Recreational cannabis use, lifetime (more than 5 times, according to the Xue 2021 table); not given in the study | Not applied (observational; diagnostic interview, CIDI, DSM-III-R) | 3 years | Once other strong factors that could affect the outcome were taken into account, none of the associations between cannabis use and the later first onset of anxiety disorders remained significant. Adjusted OR for panic disorder 1.29 (95% CI 0.61–2.71; according to Xue 2021 Table 1). Observational data: does not show cause and effect | PMID 17624975, doi:10.1111/j.1360-0443.2007.01875.x |
| Bricker 2007 Secondary analysis of a randomized effectiveness trial (CCAP); cannabis use observational | 232 (the number using at least once a month is not in the abstract) Adults with panic disorder at 6 primary care clinics in the USA | Recreational cannabis (not given in the study); those using at least once a month were compared with those using less often or not at all | Not applied (observational) | 12-month trial (assessments at months 3, 6, 9 and 12) | Using cannabis at least once a month did not change the effect of collaborative care delivered with cognitive behavioral therapy and medication on panic disorder and social phobia symptoms (interaction p > 0.05). There was an interaction for depression symptoms: monthly users receiving usual care had more depression symptoms, while there was no difference in those receiving collaborative care. Cannabis use was not determined by randomization; the number of monthly-using patients is not in the abstract, and the full text could not be read | PMID 17096386, doi:10.1002/da.20248, Main trial: Roy-Byrne 2005, PMID 15753242, PMID 15993254 |
Reported side effects
- Kwee 2022 (300 mg, 8 doses): no serious side effects; side effect rate similar to placebo (10.3% vs 15.4%)
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 of 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 a strong tendency toward paranoia, 600 mg showed a trend toward increased anxiety (Hundal 2018, PMID 29086614); 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; signals of harm to prenatal development in animals (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; lapses in attention lasted longer after 300 mg of oral CBD (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, PMID 34387679)
- Young people (ages 12–25): the only data are open-label, with side effects in 80.6% of participants (Berger 2022, PMID 35921510); an interaction has been shown with citalopram/escitalopram, which are commonly used at this age
- Allergic skin reaction: 1 severe drug rash with 300 mg/day (Crippa 2021, PMID 34387679)
- Athletes: in the urine of healthy volunteers who used 150 mg a day of broad-spectrum CBD oil for 10 weeks, CBG and CBDV, which are prohibited under WADA’s 2026 list, were detected (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 disorder
Drug interactions
- Citalopram/escitalopram: when CBD (200–800 mg/day) was added, citalopram blood levels rose significantly in 6 patients; in the lab, breakdown via CYP3A4 and CYP2C19 was inhibited (Anderson 2021, PMID 34121064)
- Sertraline, fluoxetine, mirtazapine: in the lab, CBD affected 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, substudy of the Kwee 2022 trial; 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). In 10 of 13 patients, side effects resolved when the clobazam dose was reduced (Geffrey 2015, PMID 26114620)
- Other benzodiazepines (alprazolam, clonazepam, etc.): no direct interaction study in an anxiety population was found
- 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
- You can talk about your panic attacks with a mental health professional; CBD has not been shown to replace the treatments in this area.
- If you take antidepressants or sedatives, talk with your doctor and pharmacist about interactions before adding CBD.
- Do not reduce or stop your medicines on your own.
- Full-spectrum products may contain THC; check the label and the independent certificate of analysis.
- If you have a history of psychosis or bipolar disorder, or if you are pregnant or breastfeeding, be sure to tell your doctor; the safety of CBD has not been shown in these situations.
Choose your age group, medicines and situation to prepare a short summary you can take to your doctor. Nothing you enter is sent anywhere.
Bottom line
There is not yet a human study showing a benefit of CBD in panic disorder; the few controlled studies that have been done also found no clear effect. Panic attacks can be very draining, but you are not alone; talking with a professional is a good start.
Frequently asked questions
Does CBD oil work for panic disorder?
There is no evidence to support this yet. There is no study testing CBD on its own in panic disorder; in the study that tried CBD added to therapy, there was no difference compared with an inactive pill (placebo). The most recent reviews also contain no other controlled study specific to panic disorder.
Does taking CBD during a panic attack help?
There is no study that tests this directly. In a test where panic-like symptoms were brought on in healthy volunteers, CBD taken beforehand did not reduce fear or panic symptoms.
Does CBD make therapy work better?
In people with treatment-resistant panic or social anxiety disorder, CBD given before therapy sessions did not affect the results of therapy differently from placebo.
Does CBD interact with the medicines I take for panic?
It can. CBD can raise blood levels of citalopram and escitalopram; it has also been shown to raise clobazam levels. There are no direct studies with other sedatives. So if you are thinking about CBD, talk to your doctor and pharmacist.
Can CBD oil be obtained with a prescription for panic attacks 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, may be sold only in pharmacies. Those classed as medicines and health products are dispensed with a prescription; the regulation does not state a prescription requirement for support 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 to your doctor first.
References
Show 11 references
- Kwee 2022 (RCT). Double-blind, placebo-controlled parallel RCT, 3 centers. PMID 35561538, doi:10.1016/j.euroneuro.2022.04.003, Protocol: van der Flier 2019, PMID 30760241, fear-conditioning substudy: Kwee 2024, PMID 38044339, after the first single 300 mg dose: CBD reduced threat expectancy and did not increase re-extinction of fear, in an exploratory subgroup analysis, re-extinction of subjective fear was worse with CBD than with placebo in people taking serotonergic antidepressants, and safety learning was impaired in women taking antidepressants)
- Leen-Feldner 2025. Double-blind, placebo-controlled RCT, 4 groups (healthy volunteer lab study). PMID 36241853, doi:10.1007/s00213-022-06258-7, NCT04577612, no results entered)
- Soares 2017. Narrative review (PubMed, 1990–July 2015). PMID 27157263, doi:10.2174/1570159x14666160509123955
- Wilson 2026. Systematic review and meta-analysis of RCTs (1980–May 13, 2025; PROSPERO CRD42023392718). 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)
- Cooling 2026. Scoping review of RCTs (PubMed, Web of Science, PsycINFO; 1980–2024; patients with DSM-5 diagnoses). PMID 41343139, doi:10.1007/s40261-025-01501-3
- 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
- Zvolensky 2008. Prospective community cohort (Oregon Adolescent Depression Project), 3 assessments. PMID 18076905, doi:10.1016/j.jpsychires.2007.10.012
- Cougle 2015. Prospective nationally representative follow-up (US NESARC waves 1 and 2, 3 years apart). PMID 26022838, doi:10.1016/j.jpsychires.2015.05.004
- Feingold 2016. Prospective nationally representative follow-up (US NESARC waves 1 and 2). PMID 26775742, doi:10.1016/j.euroneuro.2015.12.037
- van Laar 2007. Prospective community cohort (Netherlands NEMESIS), 3-year follow-up. PMID 17624975, doi:10.1111/j.1360-0443.2007.01875.x
- Bricker 2007. Secondary analysis of a randomized effectiveness trial (CCAP); cannabis use observational. PMID 17096386, doi:10.1002/da.20248, Main trial: Roy-Byrne 2005, PMID 15753242, PMID 15993254
Points that could not be verified from the full text
- Kwee 2024 and Leen-Feldner 2025 from the PubMed abstract only (full text not accessible; tried again on October 27, 2026, paywalled at the publisher); the other studies were checked against the full text (October 19, 2026). Wilson 2026, Cougle 2015, Feingold 2016, van Laar 2007 and Bricker 2007, added in October 2026, were also read from the abstract only (the panic disorder results of Feingold 2016 and van Laar 2007 from the table in Xue 2021); the correction to Wilson 2026 published in the journal was read on October 29, 2026: only the axis of one figure and the study counts in a table were corrected, and the results did not change; according to the corrected table, 5 of the anxiety disorder studies were done with CBD alone and 1 with THC alone. Leen-Feldner 2025 has 84 participants in its registration and 61 in its publication; the difference is not explained in the abstract. The product of Leen-Feldner 2025 (CHI-554) is not described in the open parts of the publication; the registration says 'hemp-derived CBD in MCT oil', and the full text of another study with the same product code states that the product is a CBD isolate (October 28, 2026)
- The only registered study that also covers panic disorder is NCT03549819 (GAD/SAD/panic, CBD 200–800 mg/day): its status has not been updated since 2023, and there are no results; NCT04569760 was canceled before it started. The status of NCT04726475, which was to test a CBD-rich cannabis oil with a 35% CO₂ test in volunteers who fear bodily sensations, has not been updated since January 2022; its protocol was published in 2022, but there is no results record or results publication (checked on October 27, 2026)
Research history
Here we record what changed on this page, when and why, with dates. The newest change is at the top.
October 2026 supplementary review: sources found for this page during the searches for other topics were read and added to the page. The fear-conditioning substudy of the therapy study (Kwee 2022) was removed as a separate row because it is a secondary publication of the same trial; its finding, including the exploratory subgroup result in people taking antidepressants, was moved to the main study’s row. The product of the CO₂ study in healthy volunteers was re-examined: according to the study registration and the publication of another study registered with the same product code, it is a CBD isolate; the article’s own methods section could not be read, and the product type (pure CBD) did not change. The conclusion and strength of evidence did not change.
Display fix: internal working notes left over from the previous cleanup were removed; content and evidence did not change.
PubMed, Cochrane and ClinicalTrials.gov were searched again systematically in October 2026 (665 records in PubMed, 113 in ClinicalTrials.gov). No new controlled study with cannabinoids in panic disorder was found. Added: the two most recent reviews gathering cannabinoid trials in mental health conditions, a meta-analysis on recreational cannabis use and panic disorder risk, and five observational studies; a separate conclusion text and evidence level for THC-containing products ('Insufficient': no treatment studies) were written for the first time. Corrected: the primary outcome numbers and protocol registration of the therapy study, the exploratory findings in the substudy, the registration number of the CO₂ study in healthy volunteers, the participant numbers in the registration and the publication, the fact that it was a lab study and its manufacturer support, and the description of the data the review relies on. The conclusion and the strength of evidence for CBD did not change.
Related studies: 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)); Cooling 2026, published January 2026 (PMID 41343139, doi:10.1007/s40261-025-01501-3); Xue 2021, published February 2021 (PMID 32909828, doi:10.1177/0706743720952251); Zvolensky 2008, published October 2008 (PMID 18076905, doi:10.1016/j.jpsychires.2007.10.012); Cougle 2015, published July–August 2015 (PMID 26022838, doi:10.1016/j.jpsychires.2015.05.004); Feingold 2016, published March 2016 (PMID 26775742, doi:10.1016/j.euroneuro.2015.12.037); Bricker 2007, published 2007 (PMID 17096386, doi:10.1002/da.20248, Main trial: Roy-Byrne 2005, PMID 15753242, PMID 15993254); van Laar 2007, published August 2007 (PMID 17624975, doi:10.1111/j.1360-0443.2007.01875.x)
Older changes (3)
The names of the finding labels were simplified: the "Not enough research" label on this page became "Not studied enough". The assessment did not change.
The full texts of the studies were reread and the information on the page was checked against its sources. Corrected: outcome, participant, duration and side effect details in the study table; drug interaction notes; the "Who should be careful" list; reported side effects; the evidence summary. Points that could not be verified from the full text went down from 3 items to 2. The year of 6 publications named on the page was corrected to the journal’s print year instead of the online publication year. The conclusion and strength of evidence did not change.
Page published. In this first assessment, 4 studies were reviewed.