Cannabidiol (CBD) shows promise for treatment‑resistant anxiety in young people — pilot study

Summary: A pilot study led by Orygen found that cannabidiol (CBD) treatment produced an average 42.6% reduction in anxiety severity and impairment among young people with treatment‑resistant anxiety.

Source: Orygen

Key finding: Cannabidiol may substantially reduce the severity and functional impact of long‑standing anxiety in young people. In a small open‑label pilot study, young participants with treatment‑resistant anxiety experienced meaningful improvements in symptoms and everyday functioning after 12 weeks of CBD treatment.

The Cannabidiol Youth Anxiety Pilot Study, led by Professor Paul Amminger at Orygen, Australia’s centre of excellence in youth mental health, enrolled 31 young people aged 12–25 who had persistent anxiety despite prior treatment. Across the group, self‑reported anxiety severity and impairment fell by an average of 42.6% on the Overall Anxiety Severity and Impairment Scale after 12 weeks of cannabidiol treatment. A clinician‑rated measure, the Hamilton Anxiety Rating Scale, showed a 50.7% reduction in clinician‑assessed anxiety severity.

Professor Amminger described the clinical significance of these changes: participants reported fewer panic attacks and regained abilities they had previously lost, such as leaving the house, attending school, engaging in social situations, dining out, using public transport and keeping appointments alone. For a group characterised as having treatment‑resistant, long‑standing severe to very severe anxiety, these functional gains were notable.

Professor Patrick McGorry, Orygen’s Executive Director and a study co‑investigator, emphasised the wider relevance of the findings given the rising prevalence of anxiety in young people. Recent Australian Bureau of Statistics data cited by the researchers indicate nearly one in three people aged 16–24 reported anxiety (31.5%), making anxiety the most common form of mental ill‑health in that age group—almost double the rate seen across the general population. New, effective and well‑tolerated treatment options are therefore urgently needed.

Study participants were recruited through Orygen’s primary care services. All had a diagnosed anxiety disorder and had not shown significant improvement after at least five sessions of cognitive behavioural therapy (CBT). The researchers note that frontline treatments such as CBT and selective serotonin reuptake inhibitors (SSRIs) are effective for many, but only about half of people respond adequately, leaving many young people with ongoing symptoms and risk of secondary conditions such as depression or substance use disorders.

In this pilot, cannabidiol dosing started at one 200 mg capsule daily and was increased to 400 mg after one week. Participants who did not show meaningful improvement were offered dose increases in 200 mg increments up to a maximum of 800 mg per day. All participants were also offered biweekly CBT across the 12‑week study period (five sessions).

The treatment was generally well tolerated. The most common adverse effects reported were transient mild sedation and fatigue, typically occurring around dose increases and usually resolving within a few days. The investigators did not observe side effects often associated with some antidepressant medications, such as emergent suicidal thoughts, marked irritability or significant sleep disturbance. The research team highlighted that cannabidiol is non‑intoxicating, does not contain tetrahydrocannabinol (THC), does not produce a “high” and is not considered addictive. They also noted that cannabidiol has been investigated in other research contexts for reducing addictive behaviours and for attenuating some of THC’s adverse effects.

Regulatory context mentioned by the authors: in Australia the Therapeutic Goods Administration has approved cannabidiol for certain rare paediatric epilepsies (Dravet syndrome and Lennox‑Gastaut syndrome) and has permitted clinical trials of cannabidiol for conditions such as Tourette syndrome, Fragile X syndrome, autism spectrum disorder and intellectual disability.

The investigators were careful to stress the limitations of the current work. As an open‑label pilot study without a placebo control, the observed benefits could reflect placebo effects or other confounding factors. To establish whether cannabidiol truly provides a reliable treatment effect for young people with treatment‑resistant anxiety, the authors recommend a larger randomized controlled trial. They estimate a definitive trial would need roughly 200–250 young people to determine with confidence whether cannabidiol delivers real clinical benefits and to characterise its safety profile more precisely.

About this psychopharmacology research news

Author: Press Office
Source: Orygen
Contact: Press Office – Orygen
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Original Research: The findings will appear in Journal of Clinical Psychiatry