Clinical Takeaway
Cannabinoid formulations, particularly those containing CBD alone or in combination with THC, show measurable reductions in anxiety symptoms across multiple anxiety-related disorders, including Tourette syndrome, based on pooled clinical trial data. Effect sizes vary depending on the specific formulation, dose, and disorder being treated, meaning no single cannabinoid product fits all presentations. Clinicians should weigh this emerging evidence alongside individual patient factors, existing treatments, and local regulatory frameworks before considering cannabinoids as part of an anxiety management plan.
#24 Effects of Different Cannabinoid Formulations on Anxiety-Related Disorders, and Tourette Syndrome: A Systematic Review and Meta-Analysis.
Citation: Raminelli Adrieli Oliveira et al.. Effects of Different Cannabinoid Formulations on Anxiety-Related Disorders, and Tourette Syndrome: A Systematic Review and Meta-Analysis.. Cannabis and cannabinoid research. 2025. PMID: 40956670.
Design: 6 Journal: 1 N: 0 Recency: 2 Pop: 2 Human: 1 Risk: -2
This systematic review and meta-analysis provides clinicians with synthesized evidence to evaluate the efficacy and safety profile of specific cannabinoid formulations for anxiety disorders, enabling more informed prescribing decisions as regulatory frameworks expand access to these compounds. The analysis of different cannabinoid formulations is particularly valuable given the heterogeneity in cannabinoid compositions and delivery methods, which directly impacts clinical outcomes and allows practitioners to differentiate between evidence-supported and unproven therapeutic claims. With anxiety disorders representing a significant clinical burden and patients increasingly seeking cannabinoid-based alternatives, this evidence synthesis helps clinicians balance therapeutic potential against documented risks in shared decision-making with patients.
Quality Gate Alerts:
- Preclinical only
Abstract: Introduction: Cannabinoid formulations have been increasingly proposed as therapeutic potential options for anxiety disorders (ADs). Several countries have expanded regulatory frameworks facilitating access to these compounds due to their alleged therapeutic benefits, including their application in ADs. Given its public health significance, we evaluated existing evidence regarding the efficacy of different medical cannabinoids as interventions for ADs and related mental conditions. Methods: A comprehensive search was conducted in PubMed, Embase, PsycInfo, Web of Science, Scielo, and Lilacs databases. We included randomized controlled trials (RTCs) assessing the effects of various cannabinoid formulations on patients with ADs and related conditions. Distinct meta-analyses were performed for cannabinoid subtypes. Analyses were conducted using Jamovi software, relying on standardized mean difference (SMD) calculations of pre/post-intervention score changes for both intervention and control groups. Results: We incorporated 21 placebo-controlled RCTs, examining cannabinoid interventions in social anxiety disorder (SAD = 5), generalized anxiety disorder (GAD = 1), post-traumatic stress disorder (PTSD = 7), obsessive-compulsive disorder (OCD = 1), and Tourette syndrome (TS = 7). Data extraction indicated considerable heterogeneity across outcomes, including clinical symptoms, neuroimaging findings, well-being, psychosocial functioning, safety, and tolerability. In studies utilizing pure or enriched CBD, the meta-analytic measure indicated a nonsignificant difference (SMD = -0.40; 95% CI: -0.84/0.03). However, a subgroup analysis of pure CBD compounds yielded a moderate, statistically significant effect size (SMD: -0.61, 95% CI: -1.15/-0.07). For studies investigating pure or enriched delta-9-tetrahydrocannabinol (Δ9-THC), the meta-analytic measure was -0.65 (95% CI: -1.06/-0.24), suggesting a moderate, significant effect favoring Δ9-THC-dominant compounds. In meta-analyses
? While this systematic review addresses growing clinical interest in cannabinoids for anxiety disorders, several important limitations warrant cautious interpretation of the findings. The heterogeneity of cannabinoid formulations, dosing regimens, and study populations makes it difficult to establish clear dose-response relationships or identify which patients might benefit most, and publication bias toward positive results remains a persistent challenge in cannabis research. Additionally, most existing trials are small and short-term, leaving questions about long-term safety and efficacy unresolved, particularly regarding potential paradoxical anxiety increases or cognitive effects that some patients experience. Given these caveats, current evidence suggests cannabinoids may have a role in anxiety management for select patients, but clinicians should view them as adjunctive rather than first-line agents and maintain realistic expectations during shared decision-making conversations about the strength and durability of the evidence base.
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