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Journal Club: Can medical cannabis help anxiety and depression?

The Journal Club explores the latest research for the use of cannabis in anxiety and depression.



Medical cannabis and mental health - everything you need to know

The latest issue of the Journal Club explores new research around cannabis medicines in the management of anxiety and depression.

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Journal Club: Can medical cannabis help anxiety and depression?

For this edition of the Journal Club the focus is on anxiety and depression. 

Anxiety and depression are some of the most commonly cited reasons for patients taking cannabis-based medicinal products (CBMPs).

Research has shown that THC can exert anxiolytic effects at low doses, but potentially anxiogenic effects at higher doses [1]. Therefore, optimising the THC dose and counteracting its potential negative effects with CBD is likely important. CBD itself is also known to interact with serotonin receptors that are implicated in modulating anxiety and mood [2].

To date, most of the evidence has been gathered from CBMP studies focusing on chronic pain that include anxiety and depression as secondary end-points.

In this issue of the Journal Club, two recent observational clinical trials are highlighted that specifically investigate the effect of CBMPs in patients with anxiety and/or depression.

The first study is an observational trial featuring 538 patients with self-reported anxiety and/or depression, of which 368 were current cannabis users and 170 were interested in trying but had not yet started (“controls”).

Among existing cannabis users, 82 per cent reported use of CBD-dominant products, 23 per cent THC-dominant, and seven per cent balanced THC:CBD combinations.

Follow-up was offered to patients every three months. During the study period, some of the patients in the control group began taking cannabis, so comparisons could be made between those who had started cannabis and those who had not.

At baseline, cannabis users reported lower depression, better past-month sleep quality, higher quality-of-life, and lower past-month average pain than controls. There was no difference in anxiety.

Participants that either initiated medical cannabis use during the study or continued use that had been reported at baseline reported significantly reduced anxiety and depression at follow-up vs baseline.

Control group patients that did not initiate cannabis use at any stage during the trial reported no change in their anxiety or mood at follow-up. In summary, initiation of medical cannabis was associated with decreased anxiety and depression at follow-up compared to baseline. 

Read more from the Journal Club here 

The second study is a retrospective study of 7,362 adults utilising medical cannabis in a clinic in Canada. At baseline, patients completed validated questionnaires for anxiety (GAD-7) and depression (PHQ-9) and then again at follow-up.

Statistically significant improvements between baseline and follow-up scores were observed for both GAD-7 and PHQ-9. Larger improvements were seen in patients who were actively seeking medical cannabis to treat anxiety or depression.

From 12 months on, those reporting anxiety had an average decrease in GAD-7 scores that was greater than the minimum clinically important difference (MCID) of four. Likewise, from 18 months on, the average decrease in PHQ-9 scores was greater than the MCID of five.

In summary, patients receiving medical cannabis in a Canadian clinic reported improvements in anxiety and depression. 

For an up-to-date overview of CBMPs for the management of psychiatric conditions, including anxiety and depression, refer to Sarris et al [3].

If you are a doctor and would like to discuss either of the clinical papers featured in this edition of the journal club or the broader medical cannabis literature, please reach out on


1 Maldonado.R. The endocannabinoid system in modulating fear, anxiety and stress (2020). Dialogues Clin Neurosci 22(3):229-239
2 Russo.E et al. Agonistic properties of cannabidiol at 5-HT1A receptors (2005). Neurochem Res 30(8):1037-1043
3 Sarris.J et al. Medicinal cannabis for psychiatric disorders: a clinically-focused systematic review (2020). BMC Psychiatry 20:24
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