Cannabinoid treatments for anxiety: A systematic review and consideration of the impact of sleep disturbance

Andrea J Narayan; Luke A Downey; Brooke Manning; Amie C Hayley

doi:10.1016/j.neubiorev.2022.104941

Cannabinoid treatments for anxiety: A systematic review and consideration of the impact of sleep disturbance

Neurosci Biobehav Rev. 2022 Dec:143:104941. doi: 10.1016/j.neubiorev.2022.104941. Epub 2022 Nov 9.

Authors

Andrea J Narayan¹, Luke A Downey², Brooke Manning¹, Amie C Hayley³

Affiliations

¹ Centre for Human Psychopharmacology, Swinburne University of Technology, Hawthorn, Australia.
² Centre for Human Psychopharmacology, Swinburne University of Technology, Hawthorn, Australia; Institute for Breathing and Sleep, Austin Hospital, Melbourne, Australia.
³ Centre for Human Psychopharmacology, Swinburne University of Technology, Hawthorn, Australia; Institute for Breathing and Sleep, Austin Hospital, Melbourne, Australia. Electronic address: ahayley@swin.edu.au.

PMID: 36370842
DOI: 10.1016/j.neubiorev.2022.104941

Abstract

Cannabidiol's (CBD) safety profile and broad action has made it a popular treatment option for anxiety and co-occurring sleep disturbance. However, its efficacy in healthy and clinical populations, treatment duration, formulation and doses for optimal therapeutic benefits remains unclear. Selected databases were examined from inception to October 2022. Study selection, data extraction and Cochrane Risk of Bias assessments were conducted according to PRISMA guidelines and registered on the PROSPERO database (CRD42021247476) with 58 full-text studies meeting the eligibility criteria and administered CBD only or with Δ-9-tetrahydrocannabinol (THC) across healthy and clinical populations. In healthy populations and certain non-cannabis using clinical populations, CBD had greater anxiolytic effects without prominent effects on sleep. An inverted U-shaped dose relationship, and CBD ratio to THC in combined treatments likely moderated these effects. Mechanistically, observed CBD effects occurred via primary modulation of the endocannabinoid system and secondary regulation of neuroendocrine function. Additional research is needed to understand CBD mechanisms of action across diverse groups.

Keywords: Anxiety; Cannabidiol; Cannabinoids; Sleep disturbance.

Publication types

Systematic Review
Review
Research Support, Non-U.S. Gov't

MeSH terms

Anxiety / drug therapy
Cannabidiol* / pharmacology
Cannabidiol* / therapeutic use
Cannabinoids* / pharmacology
Cannabinoids* / therapeutic use
Dronabinol
Humans
Sleep
Sleep Wake Disorders* / drug therapy

Substances

Cannabinoids
Dronabinol
Cannabidiol