Subjective, behavioral and neurobiological effects of cannabis and cannabinoids in social anxiety.
Bárbara Dos Anjos Rosário, Jéssica Alves Lemes, Maria Paula De Lima, Daniel Araki Ribeiro, Milena de Barros Viana
Reviews in the Neurosciences February 26, 2024 DOI: 10.1515/revneuro-2023-0078 (opens in new tab)
Study at a glance
AI-extracted from the abstract| Characteristics | Systematic review Peer reviewed |
|---|---|
| Population | Patients with social anxiety disorder or healthy volunteers performing tasks that assessed social anxiety, across 18 selected studies |
| Interventions | Cannabidiol (CBD) Δ9-tetrahydrocannabinol (THC) |
| Dose | CBD 300-600 mg orally; THC 6-7.5 mg (lower doses) |
| Topics | Cannabis Anxiety |
| Keywords | Cannabinoids Social anxiety disorder |
| Key findings | CBD reduced social anxiety at intermediate oral doses (300–600 mg) but not at lower or higher doses, producing an inverted U-shaped dose response. THC reduced social anxiety at lower doses (6–7.5 mg) and increased it at higher doses, and CBD attenuated THC's anxiogenic effects. The authors associate these effects with modulation of fronto-limbic regions and call for larger clinical trials in both sexes. |
Abstract
Social anxiety disorder (SAD) is a debilitating disorder, characterized by fear and anxiety in social situations. Evidence suggests that the levels of SAD are rising, in particularly after the COVID-19 pandemic. Serotonin and noradrenaline reuptake inhibitors and cognitive-behavioral therapy are effective treatments for SAD. Nevertheless, a significant number of patients do not respond well to these therapeutic options. During the last years, Cannabis and cannabinoid-containing products have been investigated for the treatment of different neuropsychiatric disorders. Nevertheless, their efficacy for the treatment of anxiety disorders is still a matter of debate. The purpose of this review was to investigate subjective, behavioral, and neurobiological effects of Cannabis and cannabinoids in social anxiety and SAD. A search in the PubMed database for articles published between the years of 2003-2023 was conducted. One hundred and seventeen (117) original studies were identified. After the exclusion criteria, eighteen (18) studies were selected. The studies investigated the effects of the cannabinoids Δ9-tetrahydrocannabinol (THC) and cannabidiol (CBD) in patients or healthy volunteers submitted to tasks that assessed social anxiety. Results showed that CBD decreases social anxiety, producing an inverted U-shaped curve, with anxiety measurements being reduced at intermediate doses administered orally (300-600 mg), but not at lower or higher doses. THC either reduces (lower doses, 6-7.5 mg) or increases (higher doses) social anxiety measurements. CBD attenuates the anxiogenic effects of THC. The effects of THC and CBD in anxiety are associated to the modulation of fronto-limbic regions. Further clinical trials, conducted with male and female patients and larger cohorts are still necessary to consolidate these results.
Comparable studies
Other systematic reviews and meta-analyses on cannabis for anxiety, most cited first.
| Study | Year | Design | Participants |
|---|---|---|---|
| Medicinal cannabis for psychiatric disorders: a clinically-focused systematic review | 2020 | Systematic review | |
| Cannabis, a cause for anxiety? A critical appraisal of the anxiogenic and anxiolytic properties | 2020 | Systematic review | |
| What are the psychological effects of using synthetic cannabinoids? A systematic review Synthetic cannabinoid users, natural cannabis users, and non-users from 17 studies | 2019 | Systematic review | |
| “Noids” in a nutshell: everything you (don’t) want to know about synthetic cannabimimetics | 2014 | Systematic review and descriptive analysis | |
| Cannabis and Anxiety: A Critical Review | 2024 | Systematic review |
Citations in the library
Cites 11
- Distinct Effects of Δ9-Tetrahydrocannabinol and Cannabidiol on Neural Activation During Emotional Processing Archives of General Psychiatry 2009
- Inverted U-Shaped Dose-Response Curve of the Anxiolytic Effect of Cannabidiol during Public Speaking in Real Life Frontiers in Pharmacology May 11, 2017
- Cannabis, a cause for anxiety? A critical appraisal of the anxiogenic and anxiolytic properties Journal of Translational Medicine October 2, 2020
- Effects of delta-9-tetrahydrocannabinol on evaluation of emotional images Journal of Psychopharmacology May 13, 2012
- Cannabinoid Modulation of Amygdala Subregion Functional Connectivity to Social Signals of Threat The International Journal of Neuropsychopharmacology December 28, 2014
and 6 more in the library