Clinical and functional outcomes of cannabis use among individuals with anxiety disorders: A 3‐year population‐based longitudinal study

Feingold, Daniel L.; Rehm, Jürgen; Factor, Hagai; Redler, Avigayil; Lev‐Ran, Shaul

doi:10.1002/da.22735

Cited by 19 publications

(9 citation statements)

References 85 publications

(104 reference statements)

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“… 2409 participants N/A Almost 62% of CBD users reported using CBD to treat a medical condition. The top three medical conditions were pain, anxiety, and depression Feingold et al 2018 [ 58 ] Data was drawn from Waves 1 and 2 of the National Epidemiologic survey on Alcohol and Related Conditions 3723 participants N/A Remission rates for non-users: 66.0% Remission rates for users: 52.8%) Cuttler et al 2018 [ 57 ] Data from the cannabis tracking app Strainprint TM 5085 tracking sessions Inhalation (smoking, vaping, concentrates, dab bubbler, dab portable) 93.5% of sessions recorded decrease in anxiety …”

Section: Resultsmentioning

confidence: 99%

“…In a 3-year longitudinal survey of cannabis use by patients with a primary anxiety disorder diagnosis (N = 3723), it was found that remission rates from anxiety disorders were higher among cannabis nonusers (Table 2). However, these differences were not statistically significant in adjusted models [58]. Discrepancies in responses are further highlighted as men reported experiencing greater headache/migraine relief from medical cannabis than women, despite a larger proportion of women reporting using it for this reason.…”

Section: Epidemiological Datamentioning

confidence: 91%

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Cannabis, a cause for anxiety? A critical appraisal of the anxiogenic and anxiolytic properties

et al. 2020

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Background Cannabis has been documented for use in alleviating anxiety. However, certain research has also shown that it can produce feelings of anxiety, panic, paranoia and psychosis. In humans, Δ9-tetrahydrocannabinol (THC) has been associated with an anxiogenic response, while anxiolytic activity has been attributed mainly to cannabidiol (CBD). In animal studies, the effects of THC are highly dose-dependent, and biphasic effects of cannabinoids on anxiety-related responses have been extensively documented. A more precise assessment is required of both the anxiolytic and anxiogenic potentials of phytocannabinoids, with an aim towards the development of the ‘holy grail’ in cannabis research, a medicinally-active formulation which may assist in the treatment of anxiety or mood disorders without eliciting any anxiogenic effects. Objectives To systematically review studies assessing cannabinoid interventions (e.g. THC or CBD or whole cannabis interventions) both in animals and humans, as well as recent epidemiological studies reporting on anxiolytic or anxiogenic effects from cannabis consumption. Method The articles selected for this review were identified up to January 2020 through searches in the electronic databases OVID MEDLINE, Cochrane Central Register of Controlled Trials, PubMed, and PsycINFO. Results Acute doses of CBD were found to reduce anxiety both in animals and humans, without having an anxiogenic effect at higher doses. Epidemiological studies tend to support an anxiolytic effect from the consumption of either CBD or THC, as well as whole plant cannabis. Conversely, the available human clinical studies demonstrate a common anxiogenic response to THC (especially at higher doses). Conclusion Based on current data, cannabinoid therapies (containing primarily CBD) may provide a more suitable treatment for people with pre-existing anxiety or as a potential adjunctive role in managing anxiety or stress-related disorders. However, further research is needed to explore other cannabinoids and phytochemical constituents present in cannabis (e.g. terpenes) as anxiolytic interventions. Future clinical trials involving patients with anxiety disorders are warranted due to the small number of available human studies.

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Section: Resultsmentioning

confidence: 99%

Section: Epidemiological Datamentioning

confidence: 91%

Cannabis, a cause for anxiety? A critical appraisal of the anxiogenic and anxiolytic properties

et al. 2020

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“…However, a stronger positive association was revealed between anxiety and cannabis use disorder. Other longitudinal data involving the USA-based National Epidemiologic survey on Alcohol and Related Conditions [37] confirms there is no obvious causal inference. The study included individuals with a diagnosis of any anxiety disorder during the initial 4-year data collection period, comparing cannabis nonusers to users, and also individuals with cannabis use disorder at a later time point on a range of psychosocial measures.…”

Section: Affective Disorders Anxietymentioning

confidence: 98%

Medicinal cannabis for psychiatric disorders: a clinically-focused systematic review

et al. 2020

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Background: Medicinal cannabis has received increased research attention over recent years due to loosening global regulatory changes. Medicinal cannabis has been reported to have potential efficacy in reducing pain, muscle spasticity, chemotherapy-induced nausea and vomiting, and intractable childhood epilepsy. Yet its potential application in the field of psychiatry is lesser known. Methods: The first clinically-focused systematic review on the emerging medical application of cannabis across all major psychiatric disorders was conducted. Current evidence regarding whole plant formulations and plant-derived cannabinoid isolates in mood, anxiety, sleep, psychotic disorders and attention deficit/hyperactivity disorder (ADHD) is discussed; while also detailing clinical prescription considerations (including pharmacogenomics), occupational and public health elements, and future research recommendations. The systematic review of the literature was conducted during 2019, assessing the data from all case studies and clinical trials involving medicinal cannabis or plant-derived isolates for all major psychiatric disorders (neurological conditions and pain were omitted). Results: The present evidence in the emerging field of cannabinoid therapeutics in psychiatry is nascent, and thereby it is currently premature to recommend cannabinoid-based interventions. Isolated positive studies have, however, revealed tentative support for cannabinoids (namely cannabidiol; CBD) for reducing social anxiety; with mixed (mainly positive) evidence for adjunctive use in schizophrenia. Case studies suggest that medicinal cannabis may be beneficial for improving sleep and post-traumatic stress disorder, however evidence is currently weak. Preliminary research findings indicate no benefit for depression from high delta-9 tetrahydrocannabinol (THC) therapeutics, or for CBD in mania. One isolated study indicates some potential efficacy for an oral cannabinoid/ terpene combination in ADHD. Clinical prescriptive consideration involves caution in the use of high-THC formulations (avoidance in youth, and in people with anxiety or psychotic disorders), gradual titration, regular assessment, and caution in cardiovascular and respiratory disorders, pregnancy and breast-feeding. Conclusions: There is currently encouraging, albeit embryonic, evidence for medicinal cannabis in the treatment of a range of psychiatric disorders. Supportive findings are emerging for some key isolates, however, clinicians need to be mindful of a range of prescriptive and occupational safety considerations, especially if initiating higher dose THC formulas.

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“…However, new research in this area is limited. Only one recent article examined QOL related to substance use in anxiety, finding that individuals with anxiety disorders who used cannabis (but did not meet criteria for cannabis use disorder) reported poorer QOL than non-cannabis users in the areas of mental health and role functioning, but noncannabis users did not differ in QOL compared to those with comorbid cannabis use disorder [47]. Future research should consider substance type, frequency, and purpose of use in understanding substance use behaviors as a correlate of QOL in anxiety disorders.…”

Section: Substance Use Behaviorsmentioning

confidence: 99%

Correlates of Quality of Life in Anxiety Disorders: Review of Recent Research

Wilmer

Anderson

Reynolds

2021

Curr Psychiatry Rep

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Purpose of Review Anxiety disorders are highly prevalent conditions that have a detrimental impact on quality of life (QOL), particularly when left untreated. In the present review, we summarize recent literature, published within the last 3 years, on QOL in anxiety disorders, with a focus on factors that may play a role in the relationship between anxiety and QOL. Recent Findings We organize our findings into four categories: (1) subjective distress, (2) behavioral responses, (3) functional impairment, and (4) clinical factors. Results indicate that greater anxiety symptom severity is linked with poorer QOL, and cognitive behavioral therapies for anxiety yield positive effects on QOL. Additional transdiagnostic mechanisms are highlighted, including anxiety sensitivity, distress tolerance, emotion regulation, and avoidant coping. We examine the role of functional impairment, and we discuss factors related to treatment, including comorbidity and longitudinal effects. We also consider early research from the COVID-19 pandemic. Summary Understanding the underlying factors that contribute to QOL detriments provides important insight into the impact of anxiety disorders and identifies targets for enhancing QOL through treatment.

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Clinical and functional outcomes of cannabis use among individuals with anxiety disorders: A 3‐year population‐based longitudinal study

Abstract: These findings add to previous reports suggesting that poorer outcome of anxiety disorders among cannabis users may be attributed mainly to differences in baseline factors and not cannabis use.

Cited by 19 publications

References 85 publications

Cannabis, a cause for anxiety? A critical appraisal of the anxiogenic and anxiolytic properties

Cannabis, a cause for anxiety? A critical appraisal of the anxiogenic and anxiolytic properties

Medicinal cannabis for psychiatric disorders: a clinically-focused systematic review

Correlates of Quality of Life in Anxiety Disorders: Review of Recent Research

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