Plain language summary
After the psychoactive tetrahydrocannabinol (THC), cannabidiol (CBD) is the second most abundant, and non-psychoactive, cannabinoid of the cannabis plant. CBD appears to have a calming effect on the central nervous system, however, clinical evidence for its use is limited. The purpose of the present study is to describe the effects of CBD on anxiety and sleep. A retrospective chart review of 72 adult patients with primary concerns of anxiety (47 patients) or poor sleep (25 patients) and treated with CBD for at least 1 month as an adjunct to usual treatment, was conducted at a large integrative psychiatric outpatient clinic. Nearly all patients were given CBD 25 mg/d in capsule form. If anxiety complaints predominated, the dosing was every morning, after breakfast. If sleep complaints predominated, the dosing was every evening, after dinner. Monthly visits included clinical evaluation and documentation of patients’ anxiety and sleep status. Whilst anxiety scores showed a rapid and sustained decrease over the three months study period, no sustained improvements in sleep was seen. The treatment with CBD was generally well accepted and tolerated. The authors conclude that these results support the existing scientific evidence, and that more clinical research is needed to provide better clinical guidance on the use of CBD.
Abstract
CONTEXT Cannabidiol (CBD) is one of many cannabinoid compounds found in cannabis. It does not appear to alter consciousness or trigger a "high." A recent surge in scientific publications has found preclinical and clinical evidence documenting value for CBD in some neuropsychiatric disorders, including epilepsy, anxiety, and schizophrenia. Evidence points toward a calming effect for CBD in the central nervous system. Interest in CBD as a treatment of a wide range of disorders has exploded, yet few clinical studies of CBD exist in the psychiatric literature. OBJECTIVE To determine whether CBD helps improve sleep and/or anxiety in a clinical population. DESIGN A large retrospective case series at a psychiatric clinic involving clinical application of CBD for anxiety and sleep complaints as an adjunct to usual treatment. The retrospective chart review included monthly documentation of anxiety and sleep quality in 103 adult patients. MAIN OUTCOME MEASURES Sleep and anxiety scores, using validated instruments, at baseline and after CBD treatment. RESULTS The final sample consisted of 72 adults presenting with primary concerns of anxiety (n = 47) or poor sleep (n = 25). Anxiety scores decreased within the first month in 57 patients (79.2%) and remained decreased during the study duration. Sleep scores improved within the first month in 48 patients (66.7%) but fluctuated over time. In this chart review, CBD was well tolerated in all but 3 patients. CONCLUSION Cannabidiol may hold benefit for anxiety-related disorders. Controlled clinical studies are needed.
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