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How to use cbd oil for panic attack

How to Use CBD Oil for Panic Attacks

This article was co-authored by Aimée Shunney, ND. Dr. Aimée Gould Shunney is a Licensed Naturopathic Doctor at Santa Cruz Integrative Medicine in Santa Cruz, California where she specializes in women’s health and hormone balancing. She also consults with various companies in the natural products industry including CV Sciences, makers of PlusCBD Oil. Dr. Aimée educates consumers, retailers, and healthcare providers about CBD oil through written articles, webinars, podcasts, and conferences nationwide. Her work has been featured at the American Academy for Anti-Aging Medicine, the American Association of Naturopathic Physicians Conference, and on Fox News. She earned her ND from the National College of Naturopathic Medicine in 2001.

There are 12 references cited in this article, which can be found at the bottom of the page.

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Cannabidiol, also known as CBD oil, is a non-psychoactive (non-high producing) extract of marijuana and hemp plants. There is some evidence that taking CBD oil can help with anxiety and panic attacks, although more research is needed to confirm this. If you’re considering taking CBD oil to help you cope with panic attacks, talk with your doctor first to find out if this is a safe option for you. Certain medications can interact with CBD oil and some adverse effects are possible. If you decide to try taking CBD oil for panic attacks, choose the delivery route that best suits your needs and follow up with your doctor regularly.

How To Use CBD To Help Alleviate Anxiety

Dr. Bindiya Gandhi is an integrative medicine physician with expertise in functional and holistic medicine based in Atlanta, Georgia.

Commissions we earn from partner links on this page do not affect our opinions or evaluations. Our editorial content is based on thorough research and guidance from the Forbes Health Advisory Board.

Table of Contents

  • CBD for Anxiety
  • How to Use CBD for Anxiety
  • CBD Dosage for Anxiety
  • Potential Risks and Side Effects

While delta-9-tetrahydrocannabinol (THC) can have a bad rap for being intoxicating and anxiety-inducing, cannabidiol (CBD) can actually be used to relieve anxiety. Research supports this benefit, with several studies reinforcing the positive effects CBD can have on various anxiety conditions. In fact, 51% of U.S. adults who use CBD do so to help alleviate their anxiety, according to a recent Forbes Health survey of 2,000 U.S. adults conducted by OnePoll.

CBD isn’t yet legally cleared as an anxiolytic, or anxiety relief medication. Therefore, it’s up to you—and, ideally, a doctor who specializes in cannabis administration—to determine whether CBD is a safe treatment for your anxiety.

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Here’s what the science says regarding CBD’s anxiolytic properties, along with experts’ dosage guidelines and advice on how to take CBD safely.

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CBD for Anxiety

The Food and Drug Administration (FDA) has yet to approve any CBD-based medications for anxiety. However, many studies indicate the substance can be an effective anxiolytic.

CBD for Generalized Anxiety

In 2011, a small trial-tested CBD on participants with generalized social anxiety disorder (SAD) and healthy control patients undergoing a simulated public speaking test (SPST), which is a common anxiety testing method [1] Bergamaschi MM, Queiroz RH, Chagas MH, et al. Cannabidiol reduces the anxiety induced by simulated public speaking in treatment-naïve social phobia patients. Neuropsychopharmacology. 2011;36(6):1219-1226. . Compared to a placebo, CBD significantly reduced anxiety and discomfort in the participants with SAD. In fact, their reduced anxiety levels were comparable to those of the control participants.

Eight years later, a 2019 test compared the efficacy of three CBD doses (150 milligrams, 300 milligrams and 600 milligrams) and a placebo in men taking an SPST [2] Linares IM, Zuardi AW, Pereira LC, et al. Cannabidiol presents an inverted U-shaped dose-response curve in a simulated public speaking test. Revista brasileira de psiquiatria (Sao Paulo, Brazil : 1999). 2019;41(1):9-14. . Compared to a placebo, 300 milligrams of CBD significantly reduced participants’ anxiety during the speech, but the 150-milligram and 600-milligram doses did not. These results highlight how dosage can be highly variable and that more CBD isn’t necessarily more effective.

Meanwhile, another 2019 study tested CBD in much lower doses than most other clinical studies—some participants consumed 25 milligrams a day while others consumed 50 milligrams or 75 milligrams a day [3] Shannon S, Lewis N, Lee H, Hughes S. Cannabidiol in Anxiety and Sleep: A Large Case Series. Perm J. 2019;23:18-041. . Researchers thought higher doses might be too expensive for participants to maintain in their normal lives and that low doses would still prove effective. Indeed, anxiety decreased within the first month for most participants and remained low. Sleep quality also improved, although it fluctuated more than anxiety. Only three patients reported side effects.

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CBD for Anxiety and Depression

In 2020, researchers tested the effects of CBD oil at varying doses across 397 patients with a variety of ailments [4] Gulbransen G, Xu W, Arroll B. Cannabidiol prescription in clinical practice: an audit on the first 400 patients in New Zealand. BJGP Open. 2020;4(1):bjgpopen20X101010. . Participants with non-cancer pain or mental health-related symptoms experienced significant improvement in anxiety and depression, as well as in their abilities to complete their usual activities. The use of CBD oil suggested significant pain relief in these groups as well.

CBD for PTSD and Phobia Therapy

A small 2019 study of 11 patients found that, when consumed orally and administered alongside routine psychiatric care, CBD decreased patients’ posttraumatic stress disorder (PTSD) symptom severity [5] Elms L, Shannon S, Hughes S, Lewis N. Cannabidiol in the Treatment of Post-Traumatic Stress Disorder: A Case Series. J Altern Complement Med. 2019;25(4):392-397. .

Other studies suggest CBD can reduce PTSD symptoms when consumed with THC [6] Bitencourt RM, Takahashi RN. Cannabidiol as a Therapeutic Alternative for Post-traumatic Stress Disorder: From Bench Research to Confirmation in Human Trials. Front Neurosci. 2018;12:502. . When taken together, the two compounds create what’s known as the “entourage effect,” where THC enhances the effects of CBD as CBD tempers the effects of THC, resulting in a more well-rounded experience [7] Ferber SG, Namdar D, Hen-Shoval D, et al. The “Entourage Effect”. Terpenes Coupled with Cannabinoids for the Treatment of Mood Disorders and Anxiety Disorders. Curr Neuropharmacol. 2020;18(2):87-96. .

Some studies also suggest CBD can enhance the effects of exposure therapy—which assists patients in dissociating certain cues with a fear response—and cognitive behavioral therapy [8] Das RK, Kamboj SK, Ramadas M, et al. Cannabidiol enhances consolidation of explicit fear extinction in humans. Psychopharmacology (Berl). 2013;226(4):781-792. [9] Blessing EM, Steenkamp MM, Manzanares J, Marmar CR. Cannabidiol as a Potential Treatment for Anxiety Disorders. Neurotherapeutics. 2015;12(4):825-836. .

How to Use CBD for Anxiety

Without clear FDA guidance, optimal CBD use for anxiety varies from person to person. You may find one method works better for you over another. You can consume CBD in the following forms:

  • Oils and tinctures, which come in dropper bottles and are consumed by mouth
  • Gummies, which are chewable, sweet and often fruit-flavored
  • Sprays, which come in bottles with a nozzle to be sprayed in the mouth
  • Capsules, softgels or tablets, which are taken individually by mouth like a pill
  • Vapes, which heat CBD oil without igniting it, resulting in an inhalable vapor
  • Flowers, which are dried hemp plants that are typically ignited and smoked
  • Creams and gels, which introduce CBD topically (through the skin) as a more localized treatment
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You may have to try different forms to determine what works best in addressing your anxiety. For instance, when it comes to the absorption of CBD in your bloodstream, vaping and smoking are more effective than edibles like gummies.

CBD Dosage for Anxiety

You also have to find the right CBD dosage for your anxiety. Experts suggest starting small and working your way up depending on how your body reacts.

Many clinical trials jump right to testing high doses. Successful doses evaluated for anxiety relief specifically include:

  • 600 milligrams in patients with SAD in a speech simulation [10] Bergamaschi MM, Queiroz RH, Chagas MH, et al. Cannabidiol reduces the anxiety induced by simulated public speaking in treatment-naïve social phobia patients. Neuropsychopharmacology. 2011;36(6):1219-1226.
  • 300 milligrams in male patients in a speech simulation [11] Linares IM, Zuardi AW, Pereira LC, et al. Cannabidiol presents an inverted U-shaped dose-response curve in a simulated public speaking test. Revista brasileira de psiquiatria (Sao Paulo, Brazil : 1999). 2019;41(1):9-14.

However, other trials suggest much lower doses are also quite effective in treating anxiety.

  • 25 to 75 milligrams for generalized anxiety and/or sleep problems [12] Shannon S, Lewis N, Lee H, Hughes S. Cannabidiol in Anxiety and Sleep: A Large Case Series. Perm J. 2019;23:18-041.
  • 33 to 49 milligrams a day for PTSD, in addition to routine psychiatric treatment [13] Elms L, Shannon S, Hughes S, Lewis N. Cannabidiol in the Treatment of Post-Traumatic Stress Disorder: A Case Series. J Altern Complement Med. 2019;25(4):392-397.

Another study involving hundreds of patients noted success with doses from 40 milligrams to 300 milligrams a day, further supporting the idea that CBD dosage varies significantly, depending on a person’s symptoms and physiology.

Potential Risks and Side Effects

The World Health Organization deems CBD a safe and generally well-tolerated substance. Studies report very few adverse effects, if any.

However, taking CBD while on other medications may pose a risk, as these substances may interact and cause unwanted effects, such as weight gain, drowsiness, upset stomach and change in appetite.

Cheryl Bugailiskis, M.D., a cannabis specialist at Heally, a telehealth platform for alternative medicine, also warns people with preexisting liver injuries and people taking medications that can cause liver injuries should practice caution when using CBD.