Study register · detailSystematic Review · Anxiety Disorders · 2025
Medicinal cannabis in the management of anxiety disorders: A systematic review.
Roberts et al.·Psychiatry researchImpact 4.1
MixedGRADEModerate3 citations
Samplek = 57 Studien n = 9 Pat.
Durationunclear
EndpointAnxiety symptoms
Blindingunklar
DesignSystematic Review
”Key finding
70% of the highest-quality studies showed positive effects in GAD, SAD and PTSD, but 30% reported negative results in OCD, trichotillomania and test anxiety; long-term effects remain unclear.
Summary
Systematic review on medical cannabis in anxiety disorders; k=57 studies (40% cohort, 30% RCTs, 18% cross-sectional, 12% qualitative designs). Among the 13 highest-quality studies, 70% (n=9) showed positive improvements in GAD, SAD and PTSD; 30% (n=4) negative results in OCD, trichotillomania, test anxiety and SAD. Over 90% of all studies reported positive outcomes for CBD- and THC-based cannabis. MASTER score: 62,9/100 (high risk of bias due to insufficient reporting). 53% (n=30) of studies omitted or used self-reported data on form/dosage.
P
PopulationAdults (≥18 years) with diagnosed anxiety disorders (including GAD, SAD, PTSD, OCD), pooled from 57 studies
I
InterventionMedical cannabis (CBD- and THC-based preparations, various forms of administration and dosages)
O
Outcome70 % of the 13 highest-quality studies reported positive improvements (GAD, SAD, PTSD); 30 % reported negative results (OCD, trichotillomania, test anxiety, SAD); >90 % of all studies reported positive outcomes for CBD- and THC-based preparations; high risk of bias (MASTER mean score 62,9/100)
Confidence in the evidence
Very lowLowModerateHigh
Moderate
The third of four GRADE levels, the effect estimate is probably reliable.
Downgraded for
Imprecision
Quality profile
Sample size★★★★★
Blinding—
Effect sizeMixed
Citations / year★★★★★
Authors
Roberts L, Sorial E, Budgeon CA, Lee K, Preen DB, Cumming C
Background: With rising anxiety disorder diagnoses, many individuals are seeking alternatives to standard pharmacotherapies, like medicinal cannabis. This systematic review focuses exclusively on anxiety-related disorders and examines a wide range of cannabis-based preparations and interventions.
Method: We searched MEDLINE, EMBASE, CINAHL, and PsycInfo (October-December 2023) for peer-reviewed empirical studies, excluding case series, case studies, and review papers. Inclusion criteria were studies on adults (18+ years) diagnosed with anxiety-related disorders, examining the efficacy or effectiveness of medicinal cannabis. Studies on recreational cannabis or cannabis-use-disorder were excluded. The MASTER and QualSyst tools were used to assess bias.
Results: Fifty-seven studies met the inclusion criteria: 40 % cohort (n = 23), 30 % randomised controlled trials (n = 17), 18 % cross-sectional (n = 10), 12 % qualitative or other designs (n = 7). The MASTER scale revealed a high risk of bias, with a mean score of 62.9 (out of 100) due to inadequate reporting. Among the 13 highest-quality studies, 70 % (n = 9) reported a positive improvement for disorders including generalised anxiety disorder (GAD), social anxiety disorder (SAD), and post-traumatic stress disorder (PTSD). 30 % (n = 4) reported a negative result for conditions like obsessive-compulsive disorder, trichotillomania, test anxiety and SAD. Over 90 % of all studies, including lower quality studies, reported positive outcomes for CBD and THC-based cannabis. However, 53 % (n = 30) either omitted, or included self-reported data on either form and/or dosage.
Conclusion: Medicinal cannabis demonstrates potential in reducing anxiety symptoms, but the long-term benefits and overall impact on quality of life remain unclear. Further high-quality, longitudinal research with standardised dosing is needed.