A Double-Blind, Randomized, Placebo-Controlled Test of the Effects of Cannabidiol on Experiences of Test Anxiety Among College Students

Cannabidiol usage, efficacy, and side effects: analyzing the impact of health conditions, medications, and cannabis use in a cross-sectional online pilot study

Background

Products containing cannabidiol (CBD) are attracting attention because of their potential therapeutic benefits and positive impacts on well-being and mental health. Although additional research is needed to understand their effectiveness in treating mental disorders, cross-sectional studies may help identify the factors influencing CBD use patterns. This study examined the impact of variables such as health status, medication use, medical supervision, gender, age, and cannabis use on CBD consumption patterns.

Materials and methods

A self-selected sample (n =267) of current or former CBD users was recruited via social media and participated in an online survey designed to collect data on basic demographics, health status, cannabis use, and CBD usage patterns.

Results

The sample (n = 267) consisted of 68.5% women with an average age of 30.21 years, of which 25.8% reported diagnosed psychiatric disorders and 49.4% reported cannabis use. The top five reasons for using CBD were self-reported stress (65.3%), sleep problems (51.7%), overall improvement in well-being (52.5%), improved mood (44.9%), and anxiety relief (40.9%). Our findings suggest that individuals with psychiatric disorders and those taking psychotropic medications are more likely to use CBD to relieve stress and anxiety. Overall, nearly 70% of the individuals found CBD products to be effective. Sublingual administration was more popular among non-cannabis users, while cannabis users preferred smoking and vaping to CBD administration.

Conclusion

Our results indicate that individuals using CBD for health and wellness reasons believe that it has potential health benefits. Further research using rigorous longitudinal designs is needed to delve deeper into the effectiveness of low-dose CBD and to better understand the therapeutic potential of CBD.

The impact of cannabidiol placebo on responses to an acute stressor: A replication and proof of concept study

BACKGROUND

Our group has previously reported that cannabidiol (CBD) expectancy alone blunts markers of stress, particularly during anticipation, but it is not clear the extent to which such findings were specific to the methods utilized.

AIMS

To examine CBD-related placebo effects on stress reactivity and anticipation and to validate a protocol to be used in a neuroimaging study.

METHODS

Forty-eight healthy adults (24 female) were randomly assigned to be informed that they ingested a CBD-containing oil or a CBD-free oil despite receiving the same oil (CBD-free). Following oil administration, participants engaged in a laboratory stressor and were then incorrectly informed that they would engage in a second more difficult task following a waiting period. Subjective state (sedation, energy, stress, anxiety) and heart rate were assessed at baseline, post-oil administration, immediately following the first stressor, and while anticipating the second stressor.

RESULTS

Subjective stress and anxiety were significantly elevated immediately following the stressor (p-values < 0.001). CBD expectancy was associated with increased subjective sedation (p < 0.01) and tended to be associated with blunted subjective stress (p = 0.053). Post hoc within-condition pairwise compassions suggested a return to pre-stressor levels during the anticipation period in the CBD condition for subjective stress and anxiety (p = 0.784, 0.845), but not the CBD-free condition (p = 0.025, 0.045).

CONCLUSION

Results replicate and extend previous findings that CBD expectancy alone can impact stress- and anxiety-relevant responses in the laboratory context.

Effects of auricular acupressure on test anxiety in medical students: a randomized parallel-group trial

BACKGROUND

Test anxiety is a prevalent issue among students, including those in the medical field. The present study aims to examine the impact of auricular acupressure on reducing test anxiety specifically among medical students.

METHODS

In this single-blind randomized parallel-group trial, a total of 114 medical students from Kermanshah, Iran, were allocated into two groups: intervention and control. Each group consisted of 57 students. The data collection instruments included a demographic information form and the Sarason Anxiety Inventory. In the intervention group, bilateral auricular acupressure was administered on the Shen Men point for a duration of 10 min. On the other hand, the control group received bilateral auricular acupressure on the Sham point, located in the earlobe, as a placebo, also for 10 min.

RESULTS

The mean test anxiety scores in the Shen Men acupressure group exhibited a significant reduction from 18.4 ± 5.3 before the intervention to 13.3 ± 4.8 after the intervention (P = 0.001). Conversely, in the Sham acupressure group, the mean test anxiety scores showed no significant change, with values of 16.36 ± 6.4 before the intervention and 16.4 ± 6.1 after the intervention (P = 0.963). Prior to the intervention, the majority of participants in both the intervention group (87.7%) and control group (86.0%) exhibited moderate to severe levels of test anxiety. Following acupressure, a significant improvement was observed in the intervention group, with 52.6% of participants experiencing a reduction to mild anxiety levels (P = 0.001); however, no notable change in anxiety levels was observed in the control group. Furthermore, a statistically significant difference in anxiety intensity after the intervention was found between the two groups (P = 0.001).

CONCLUSION

Shen Men auricular acupressure demonstrates efficacy in reducing test anxiety among medical students. However, to validate its effectiveness, further research using objective measures is warranted.

A Survey Study of Individuals Using Hexahydrocannabinol Cannabis Products: Use Patterns and Perceived Effects

Introduction: Across the cannabis market, multiple cannabinoids have seen rapid growth. Considering the differing effects between specific cannabinoids, it is critical to assess effects on an individual level. Hexahydrocannabinol (HHC) is one intoxicating cannabinoid that became more accessible due to regulatory shifts. The purpose of the current study was to provide descriptive data regarding HHC use patterns and perceived effects within a sample of participants who endorsed recent HHC use. Methods: One hundred nine individuals self-reported use of an HHC-cannabis product at least once within 6 months and completed an HHC use questionnaire via Prolific, an online crowdsourcing platform. Results: Findings suggest recent HHC users are using HHC relatively frequently (∼10 days during the past month) for various indications, including anxiety and pain. HHC was perceived to yield more good than bad effects, including relaxation and euphoria. Approximately 17% of the sample reported adverse effects, and ∼20% of those who stopped using HHC experienced some withdrawal symptoms. Few meaningful sex differences in subjective effect ratings were observed. Discussion: The current study provides critical preliminary data about consumer use patterns and perceived effects related to HHC. Such data are needed to further research on the potential therapeutic as well as detrimental effects of HHC and to better inform the consumers, health professionals, and regulators about a cannabinoid that is widely available the market.

The therapeutic potential of purified cannabidiol

The use of cannabidiol (CBD) for therapeutic purposes is receiving considerable attention, with speculation that CBD can be useful in a wide range of conditions. Only one product, a purified form of plant-derived CBD in solution (Epidiolex), is approved for the treatment of seizures in patients with Lennox-Gastaut syndrome, Dravet syndrome, or tuberous sclerosis complex. Appraisal of the therapeutic evidence base for CBD is complicated by the fact that CBD products sometimes have additional phytochemicals (like tetrahydrocannabinol (THC)) present, which can make the identification of the active pharmaceutical ingredient (API) in positive studies difficult. The aim of the present review is to critically review clinical studies using purified CBD products only, in order to establish the upcoming indications for which purified CBD might be beneficial. The areas in which there is the most clinical evidence to support the use of CBD are in the treatment of anxiety (positive data in 7 uncontrolled studies and 17 randomised controlled trials (RCTs)), psychosis and schizophrenia (positive data in 1 uncontrolled study and 8 RCTs), PTSD (positive data in 2 uncontrolled studies and 4 RCTs) and substance abuse (positive data in 2 uncontrolled studies and 3 RCTs). Seven uncontrolled studies support the use of CBD to improve sleep quality, but this has only been verified in one small RCT. Limited evidence supports the use of CBD for the treatment of Parkinson's (3 positive uncontrolled studies and 2 positive RCTs), autism (3 positive RCTs), smoking cessation (2 positive RCTs), graft-versus-host disease and intestinal permeability (1 positive RCT each). Current RCT evidence does not support the use of purified oral CBD in pain (at least as an acute analgesic) or for the treatment of COVID symptoms, cancer, Huntington's or type 2 diabetes. In conclusion, published clinical evidence does support the use of purified CBD in multiple indications beyond epilepsy. However, the evidence base is limited by the number of trials only investigating the acute effects of CBD, testing CBD in healthy volunteers, or in very small patient numbers. Large confirmatory phase 3 trials are required in all indications.

THC and CBD: Villain versus Hero? Insights into Adolescent Exposure

Cannabis is the most used drug of abuse worldwide. It is well established that the most abundant phytocannabinoids in this plant are Δ9-tetrahydrocannabinol (THC) and cannabidiol (CBD). These two compounds have remarkably similar chemical structures yet vastly different effects in the brain. By binding to the same receptors, THC is psychoactive, while CBD has anxiolytic and antipsychotic properties. Lately, a variety of hemp-based products, including CBD and THC, have become widely available in the food and health industry, and medical and recreational use of cannabis has been legalized in many states/countries. As a result, people, including youths, are consuming CBD because it is considered “safe”. An extensive literature exists evaluating the harmful effects of THC in both adults and adolescents, but little is known about the long-term effects of CBD exposure, especially in adolescence. The aim of this review is to collect preclinical and clinical evidence about the effects of cannabidiol.

THC, CBD, and Anxiety: A review of recent findings on the anxiolytic and anxiogenic effects of cannabis' primary cannabinoids

Purpose of review

In the context of ongoing decriminalization and legalization of cannabis, a better understanding of how THC and CBD impact anxiety is critical to elucidate the risks of recreational cannabis use as well as to establish the therapeutic potential of cannabis products for anxiety-related applications.

Recent findings

Recent literature supports anxiogenic effects of THC administration, which may be attenuated among regular cannabis users. Data regarding anxiolytic effects of CBD administration are mixed. Most newer studies contradict earlier findings in reporting no effects of CBD on anxiety in healthy participants, whereas inconsistent results have been reported among individuals with anxiety disorders, substance use disorders, and other clinical populations.

Summary

Future research is needed to reconcile heterogenous findings, explore sex differences in the effects of THC and CBD on anxiety, as well as to assess how effects change with extended exposure, the impact of different CBD doses, and interactions between THC, CBD, and other cannabis compounds.