←Anxiety Disorders
Study register · detail RCT (cross-over) · Anxiety Disorders · 2022

Cannabis containing equivalent concentrations of delta-9-tetrahydrocannabinol (THC) and cannabidiol (CBD) induces less state anxiety than THC-dominant cannabis

Hutten et al. ·Psychopharmacology Impact 2.8
Mixed GRADE Moderate 36 citations
Samplen = 26 Pat.
DurationSingle dose
ControlPlacebo cannabis
EndpointSTAI-State
Blindingdoppelblind
DesignRCT (cross-over)
Cannabinoidkombination
THC:CBD1:1
Max. dose27.5 mg
Routeinhalativ
Key finding

CBD mitigates THC-induced state anxiety, particularly in individuals with low baseline anxiety level.

Summary

n=26 healthy cannabis users, randomized placebo-controlled (within-subjects), vaporized THC (13,75 mg), CBD (13,75 mg), THC/CBD (13,75 mg/13,75 mg) vs. placebo. THC and THC/CBD significantly increased self-reported anxiety vs. placebo (p<0.05); THC/CBD-induced anxiety was significantly lower than after pure THC. At low baseline anxiety CBD completely neutralized THC-induced anxiety; at high baseline anxiety CBD showed no anxiolytic counter-effect.

P
PopulationHealthy, experienced recreational cannabis users, n=26
I
InterventionVaporized cannabis in three variants: THC-dominant (13,75 mg THC), CBD-dominant (13,75 mg CBD) and THC/CBD-equivalent (13,75 mg THC + 13,75 mg CBD), single dose, crossover
C
ControlPlacebo cannabis (vaporized)
O
OutcomeTHC and THC/CBD significantly increased self-reported state anxiety compared to placebo; state anxiety after THC/CBD significantly lower than after THC alone; at low baseline anxiety level complete counter-regulation by CBD
Confidence in the evidence
Moderate

The third of four GRADE levels, the effect estimate is probably reliable.

Downgraded for
Imprecision
Quality profile
Sample size ★★★★★
Blinding Double-blind
Effect size Mixed
Citations / year ★★★★★
Authors
Hutten NRPW, Arkell TR, Vinckenbosch F, Schepers J, Kevin RC, Theunissen EL, Kuypers KPC, McGregor IS, Ramaekers JG
DOI 10.1007/s00213-022-06248-9↗
Design: RCT (cross-over)
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Indication
Further studies on Anxiety Disorders
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A Kedzior et al. · 2014 · BMC psychiatry
299 citations
A positive association between anxiety disorders and cannabis use or cannabis use disorders in the general population--a meta-analysis of 31 studies.
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Medicinal cannabis in the management of anxiety disorders: A systematic review.
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The impediment to action advances action. — Marcus Aurelius