Cannabis containing equivalent concentrations of delta-9-tetrahydrocannabinol (THC) and cannabidiol (CBD) induces less state anxiety than THC-dominant cannabis
Nadia R. P. W. Hutten, Thomas R. Arkell, Frederick Vinckenbosch, Jan Schepers, Richard C. Kevin, Eef L. Theunissen, Kim P. C. Kuypers, Iain S. Mcgregor, Johannes G. Ramaekers
Psychopharmacology October 13, 2022 DOI: 10.1007/s00213-022-06248-9 via OpenAlex
Summary
Vaporized cannabis containing both THC and cannabidiol (CBD) produces less anxiety than THC alone, but this effect depends on a person's baseline anxiety level. In a placebo-controlled trial with 26 healthy recreational cannabis users, THC-dominant cannabis (13.75 mg THC) and THC/CBD-equivalent cannabis (13.75 mg each) both increased self-rated state anxiety compared to placebo, though the combination caused significantly less anxiety than THC alone. When baseline anxiety was low, CBD completely counteracted THC-induced anxiety; when baseline anxiety was high, CBD did not counteract it. Trait anxiety did not influence the results, and objective measures of attention bias showed no effects.
Study at a glance
| Characteristics | Randomized controlled trial, within-subjects Placebo-controlled Peer reviewed |
|---|---|
| Sample size | 26 |
| Population | Healthy recreational cannabis users |
| Interventions | THC-dominant cannabis CBD-dominant cannabis THC/CBD-equivalent cannabis placebo cannabis |
| Dose | 13.75 mg THC, 13.75 mg CBD, 13.75 mg THC/13.75 mg CBD |
| Topics | Anxiety Cannabis |
| Keywords | Tetrahydrocannabinol Anxiolytic |
| Citations | 36 |
| Key finding | THC/CBD-equivalent cannabis induces less state anxiety than THC-dominant cannabis, but CBD's anxiety-counteracting effect is absent in individuals with high baseline anxiety. |
Abstract
RATIONALE: Delta-9-tetrahydrocannabinol (THC), an active component of cannabis, can cause anxiety in some users during intoxication. Cannabidiol (CBD), another constituent of cannabis, has anxiolytic properties suggesting that cannabis products containing CBD in addition to THC may produce less anxiety than THC-only products. Findings to date around this issue have been inconclusive and could conceivably depend on moderating factors such as baseline anxiety levels in users. OBJECTIVE: The present study examined whether anxiety following single doses of vaporised THC, CBD and THC/CBD might be explained by state and trait anxiety levels at baseline. METHODS: A placebo-controlled, randomised, within-subjects study including 26 healthy recreational cannabis users tested the effects of vaporised THC-dominant cannabis (13.75 mg THC), CBD-dominant cannabis (13.75 mg CBD), THC/CBD-equivalent cannabis (13.75 mg THC/13.75 mg CBD) and placebo cannabis on anxiety. Self-rated trait anxiety was assessed with the State-Trait Anxiety Inventory (STAI). State levels of anxiety were objectively assessed with a computer-based emotional Stroop task (EST) and subjectively rated with the STAI-state questionnaire and a visual analogue scale. RESULTS: Both THC and THC/CBD significantly increased self-rated state anxiety compared to placebo. State anxiety after THC/CBD was significantly lower than after THC alone. THC-induced anxiety was independent of anxiety at baseline. When baseline anxiety was low, CBD completely counteracted THC-induced anxiety; however, when baseline anxiety was high, CBD did not counteract THC-induced anxiety. There were no effects of any treatment condition on the EST. CONCLUSION: Overall, the study demonstrated that the THC/CBD-equivalent cannabis induces less state anxiety than THC-dominant cannabis.