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Cannabidiol CBD is one of many cannabinoid compounds found in cannabis. Evidence points toward a calming effect for CBD in the central nervous system. Interest in CBD as a treatment of a wide range of disorders has exploded, yet few clinical studies of CBD exist in the psychiatric literature.
A large retrospective case series at a psychiatric clinic involving clinical application of CBD for anxiety and sleep complaints as an adjunct to usual treatment. The retrospective chart review included monthly documentation of anxiety and sleep quality in adult patients.
Sleep and anxiety scores, using validated instruments, at baseline and after CBD treatment. Anxiety scores decreased within the first month in 57 patients Sleep scores improved within the first month in 48 patients In this chart review, CBD was well tolerated in all but 3 patients. Cannabidiol may hold benefit for anxiety-related disorders.
Controlled clinical studies are needed. The Cannabis plant has been cultivated and used for its medicinal and industrial benefits dating back to ancient times. Cannabis sativa and Cannabis indica are the 2 main species.
The most abundant cannabinoid, tetrahydrocannabinol THC , is well known for its psychoactive properties, whereas cannabidiol CBD is the second-most abundant and is nonpsychoactive.
Hemp plants are grown for their fibers and high levels of CBD that can be extracted to make oil, but marijuana plants grown for recreational use have higher concentrations of THC compared with CBD. Many different cultures have used the Cannabis plant to treat a plethora of ailments.
Practitioners in ancient China targeted malaria, menstrual symptoms, gout, and constipation. During medieval times, cannabis was used for pain, epilepsy, nausea, and vomiting, and in Western medicine it was commonly used as an analgesic. California was the first state to go against the federal ban and legalize medical marijuana in CBD has demonstrated preliminary efficacy for a range of physical and mental health care problems. In the decade before , there were only 9 published studies on the use of cannabinoids for medicinal treatment of pain; since then, 30 articles have been published on this topic, according to a PubMed search conducted in December Finally, the most notable benefit of cannabis as a form of treatment is safety.
There have been no reports of lethal overdose with either of the cannabinoids and, outside of concerns over abuse, major complications are very limited.
Given the promising biochemical, physiologic, and preclinical data on CBD, a remarkable lack of randomized clinical trials and other formal clinical studies exist in the psychiatric arena.
The present study describes a series of patients using CBD for treatment of anxiety or sleep disturbances in a clinical practice setting. Given the paucity of data in this area, clinical observations can be quite useful to advance the knowledge base and to offer questions for further investigation.
Given the novel nature of this treatment, our study also focused on tolerability and safety concerns. As a part of the evolving legal status of cannabis, our investigation also looked at patient acceptance. A retrospective chart review was conducted of adult psychiatric patients treated with CBD for anxiety or sleep as an adjunct to treatment as usual at a large psychiatric outpatient clinic. Any current psychiatric patient with a diagnosis by a mental health professional psychiatrist, psychiatric nurse practitioner, or physician assistant of a sleep or anxiety disorder was considered.
Diagnosis was made by clinical evaluation followed by baseline psychologic measures. These measures were repeated monthly. Comorbid psychiatric illnesses were not a basis for exclusion. Accordingly, other psychiatric medications were administered as per routine patient care. Selection for the case series was contingent on informed consent to be treated with CBD for 1 of these 2 disorders and at least 1 month of active treatment with CBD.
Patients treated with CBD were provided with psychiatric care and medications as usual. Most patients continued to receive their psychiatric medications. The patient population mirrored the clinic population at large with the exception that it was younger. If anxiety complaints predominated, the dosing was every morning, after breakfast.
If sleep complaints predominated, the dosing was every evening, after dinner. Often CBD was employed as a method to avoid or to reduce psychiatric medications. Informed consent was obtained for each patient who was treated and considered for this study. CBD was added to care, dropped from care, or refused as per individual patient and practitioner preference. Wholeness Center is a large mental health clinic in Fort Collins, CO, that focuses on integrative medicine and psychiatry. Practitioners from a range of disciplines psychiatry, naturopathy, acupuncture, neurofeedback, yoga, etc work together in a collaborative and cross-disciplinary environment.
CBD had been widely incorporated into clinical care at Wholeness Center a few years before this study, on the basis of existing research and patient experience. The sampling frame consisted of adult patients who were consecutively treated with CBD at our psychiatric outpatient clinic.
Eighty-two Patients with sole or primary diagnoses of schizophrenia, posttraumatic stress disorder, and agitated depression were excluded. Ten patients were further excluded because they had only 1 documented visit, with no follow-up assessment. The final sample consisted of 72 adult patients presenting with primary concerns of anxiety Sleep and anxiety were the targets of this descriptive report.
Sleep concerns were tracked at monthly visits using the Pittsburg Sleep Quality Index. Anxiety levels were monitored at monthly visits using the Hamilton Anxiety Rating Scale. Both scales are nonproprietary. The Hamilton Anxiety Rating Scale is a widely used and validated anxiety measure with 14 individual questions.
It was first used in and covers a wide range of anxiety-related concerns. The score ranges from 0 to A score under 17 indicates mild anxiety, and a score above 25 indicates severe anxiety. The Pittsburg Sleep Quality Index is a self-report measure that assesses the quality of sleep during a 1-month period. It consists of 19 items that have been found to be reliable and valid in the assessment of a range of sleep-related problems.
Each item is rated 0 to 3 and yields a total score from 0 to A higher number indicates more sleep-related concerns. Side effects and tolerability of CBD treatment were assessed through spontaneous patient self-reports and were documented in case records. Any other spontaneous comments or complaints of patients were also documented in case records and included in this analysis. Deidentified patient data were evaluated using descriptive statistics and plotted graphically for visual analysis and interpretation of trends.
Most patients with an anxiety diagnosis were men All 72 patients completed sleep and anxiety assessments at the onset of CBD treatment and at the first monthly follow-up. By the second monthly follow-up, 41 patients Table 1 provides means and standard deviations for sleep and anxiety scores at baseline and during the follow-up period for adults taking CBD.
Figure 1 graphically displays the trend in anxiety and sleep scores over the study period. On average, anxiety and sleep improved for most patients, and these improvements were sustained over time. At the first monthly assessment after the start of CBD treatment, Two months after the start of CBD treatment, Descriptive statistics for anxiety and sleep scores among adults using cannabidiol treatment. These results demonstrated a more sustained response to anxiety than for sleep over time.
Patient records displayed a larger decrease in anxiety scores than in sleep scores. The sleep scores demonstrated mild improvement. The anxiety scores decreased within the first month and then remained decreased during the study duration. CBD was well tolerated, with few patients reporting side effects. Two patients discontinued treatment within the first week because of fatigue. Three patients noted mild sedation initially that appeared to abate in the first few weeks.
One patient with a developmental disorder aged 21 years had to be taken off the CBD regimen because of increased sexually inappropriate behavior. The CBD was held, and the behavior disappeared. The behavior reappeared on redosing 2 weeks later, and the CBD regimen was formally discontinued.
One patient noted dry eyes. Reasons for patients not following-up at later assessment points are largely unknown but are probably because of standard attrition experienced in usual clinical practice.
There was no evidence to suggest patients discontinued care because of tolerability concerns. The attrition rates were similar in nature and size to those found in routinely scheduled visits in this clinic. Four patients declined CBD treatment because of religious or ethical concerns about the relation to cannabis.
Nearly all patients easily provided informed consent once the nature of the treatment was explained. Most patients appreciated the opportunity to try something natural and avoid further or initial psychiatric medication use.
In an outpatient psychiatric population, sleep scores displayed no sustained improvements during the 3-month study. Anxiety scores decreased fairly rapidly, and this decrease was sustained during the study period. These results are consistent with the existing preclinical and clinical data on CBD. CBD was well accepted and well tolerated in our patients. Side effects were minimal mainly fatigue and may be related to dosing.
The first is that in our experience lower doses appear to elicit an adequate clinical response. These results must be interpreted cautiously because this was a naturalistic study, all patients were receiving open-label treatment, and there was no comparison group.
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It seems to be popping up in all sorts of trendy products, from supplements and skin-care creams to lattes served at local coffee shops. Short for cannabidiol, CBD is one of the many compounds found in cannabis and hemp plants. Supporters of the stuff anecdotally say that it causes a state of calmness and relaxation. Skeptical, I recently set out to see whether CBD could help me chill the eff out. They offered me a one-month supply of the gummies, each with 10 mg of CBD extract, so that I could stress test the benefits for myself. I enjoy working on multiple projects and tend to work well under pressure, but I will admit that my workload lately has challenged my time management skills. Because CBD has been shown to improve focus, I decided to take one gummy every morning before work for a week. I assume this was all related to my stress response, but I definitely felt less scatterbrained by the end of the week.
Cannabidiol CBD is one of many cannabinoid compounds found in cannabis. Evidence points toward a calming effect for CBD in the central nervous system.
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There is more than one way to enjoy the health benefits of CBD oil. CBD, more formally known as cannabidiol, is a cannabinoid found in cannabis and hemp plants. When your body is introduced to the natural compounds found in cannabinoids, it activates your endocannabinoid system ECS. The endocannabinoid system can affect things like pain, mood, sleep patterns, stress levels, appetite and more. CBD products have made significant gains in popularity over the past four years, ever since the Agricultural Act of allowing the growth of industrial hemp—and the recent update. Because it contains 0—. Edibles, like gummies, are nothing more than regular gummy candy with a measured amount of CBD oil. Depending on the gummy, they also contain ingredients like sugar and other flavorings. CBD-infused edibles are different from tinctures in their method of delivery. While tinctures are absorbed into the body sublingually meaning, under the tongue , CBD infused gummie bears, and other CBD candy and edibles are digested and reach the bloodstream after being processed by the liver. The time from consumption to when you feel the effects takes longer—about one to two hours, but the effect can feel stronger than a sublingual dose. Once in the bloodstream, CBD molecules bind to cannabinoid receptors as part of the endocannabinoid system. Taking a CBD gummy is can also more easily deliver high doses of CBD rich hemp oil to the body than the same dose taken sublingually. While companies vary on how they extract their hemp oil, the end product contains zero THC and will not result in a psychological high. Not everyone is a fan of the grassy flavor of raw hemp oil, so gummies and edibles are a perfect way to dull down that flavor.
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