USE OF CANNABIDIOL (CBD) IN GENERALIZED ANXIETY DISORDER: CURRENT EVIDENCE AND THERAPEUTIC PERSPECTIVES
DOI:
https://doi.org/10.56238/levv16n52-013Keywords:
Cannabidiol, Generalized Anxiety Disorder, Mental Health, Medicinal Therapy, Cannabis sativaAbstract
This study aims to review the current scientific evidence regarding the use of cannabidiol (CBD) in the treatment of Generalized Anxiety Disorder (GAD). CBD, one of the main phytocannabinoids derived from Cannabis sativa, exhibits a consistent anxiolytic potential without inducing significant psychoactive effects, distinguishing it from tetrahydrocannabinol (THC). Preclinical and clinical evidence indicates that CBD modulates the endocannabinoid system and serotonergic receptors, promoting anxiety reduction in both experimental contexts and clinical practice. Although the results are promising, important methodological limitations remain, including small sample sizes, heterogeneous protocols, and the lack of standardized dosages. Current findings suggest that CBD may represent a safe and effective therapeutic alternative, particularly for patients with inadequate response or intolerance to conventional treatments. However, further high-quality randomized clinical trials are needed to strengthen the scientific evidence and support the development of clear clinical guidelines for the rational use of CBD in the management of anxiety.
Downloads
References
ANVISA. O uso de Cannabis Medicinal para transtornos mentais: evidências de eficácia e segurança. 2020. Disponível em: https://www.arca.fiocruz.br/handle/icict/41228. Acesso em: 27 ago. 2025.
ARAÚJO, S. S. et al. O transtorno de ansiedade no Brasil: o uso do canabidiol como uma possível alternativa terapêutica frente a ansiolíticos químicos. Ciências da Saúde, v. 28, n. 135, 27 jun. 2024. Disponível em: https://doi.org/10.5281/zenodo.12568748. Acesso em: 27 ago. 2025.
ASSOCIAÇÃO PSIQUIÁTRICA AMERICANA. Manual diagnóstico e estatístico de transtornos mentais: DSM-5. 2014. Disponível em: https://institutopebio.com.br/documento/manual-diag-e-estatistico-de-transtornos-mentais-dsm-5.pdf. Acesso em: 27 ago. 2025.
BILBAO, A.; SPANAGEL, R. Medical cannabinoids: a pharmacology-based systematic review and meta-analysis for all relevant medical indications. BMC Medicine, v. 20, n. 1, 19 ago. 2022. Disponível em: https://pubmed.ncbi.nlm.nih.gov/35982439/. Acesso em: 27 ago. 2025.
BLACK, N. et al. Cannabinoids for the treatment of mental disorders and symptoms of mental disorders: a systematic review and meta-analysis. The Lancet Psychiatry, v. 6, n. 12, out. 2019. Disponível em: https://pubmed.ncbi.nlm.nih.gov/31672337/. Acesso em: 27 ago. 2025.
BLOOMFIELD, M. A. P. et al. The acute effects of cannabidiol on emotional processing and anxiety: a neurocognitive imaging study. Psychopharmacology, v. 239, n. 5, p. 1539–1549, 21 abr. 2022. Disponível em: https://pubmed.ncbi.nlm.nih.gov/35445839/. Acesso em: 27 ago. 2025.
BRASIL. ORGANIZAÇÃO PAN-AMERICANA DA SAÚDE. OMS destaca necessidade urgente de transformar saúde mental e atenção. 2022. Disponível em: https://www.paho.org/pt/noticias/17-6-2022-oms-destaca-necessidade-urgente-transformar-saude-mental-e-atencao. Acesso em: 27 ago. 2025.
BRASIL. Ansiedade e depressão são os principais vilões da saúde mental. Senado Federal, 2023. Disponível em: https://www12.senado.leg.br/institucional/sis/noticias-comum/ansiedade-e-depressao-sao-os-principais-viloes-da-saude-mental. Acesso em: 27 ago. 2025.
BRASIL. Rastreamento / Diagnóstico - Transtornos de Ansiedade no adulto. 2024. Disponível em: https://linhasdecuidado.saude.gov.br/portal/ansiedade/unidade-de-atencao-primaria/rastreamento-diagnostico/#pills-diagnostico-diferencial. Acesso em: 27 ago. 2025.
CABRAL, J. L. et al. Utilização da Cannabis sativa no tratamento de ansiedade e depressão. Revista FT, v. 28, n. 135, p. 1–1, 10 jun. 2024. Disponível em: https://revistaft.com.br/utilizacao-da-cannabis-sativa-no-tratamento-de-ansiedade-e-depressao/. Acesso em: 27 ago. 2025.
CAMMÀ, G. et al. Therapeutic potential of minor cannabinoids in psychiatric disorders: A systematic review. European Neuropsychopharmacology, v. 91, p. 9–24, Spring 2024. Disponível em: https://pubmed.ncbi.nlm.nih.gov/39541799/. Acesso em: 27 ago. 2025.
CARVALHO, M. et al. O uso terapêutico do cannabidiol (CBD) no tratamento de transtornos de ansiedade e depressão. Recima21, v. 4, n. 1, p. e414049–e414049, 7 set. 2023. Disponível em: https://recima21.com.br/index.php/recima21/article/view/4049. Acesso em: 27 ago. 2025.
CRIPPA, J. A. S.; ZUARDI, A. W.; HALLAK, J. E. C. Uso terapêutico dos canabinoides em psiquiatria. Revista Brasileira de Psiquiatria, v. 32, n. suppl 1, p. 556–566, maio 2010. Disponível em: https://www.scielo.br/j/rbp/a/SLJjHfPvnpyKPQX79wbnztp/. Acesso em: 27 ago. 2025.
COSTA, C. O. da et al. Prevalência de ansiedade e fatores associados em adultos. Jornal Brasileiro de Psiquiatria, v. 68, n. 2, p. 92–100, jun. 2019. Disponível em: https://www.scielo.br/j/jbpsiq/a/PSrDy4ZFSGDCzNgJfJwVRxz/. Acesso em: 27 ago. 2025.
DENSON, R. K. et al. Effects of Cannabidiol in Adolescent and Young Adult Depressive and Anxiety Disorders: A Systematic Review of Clinical and Preclinical Research. Adolescent Psychiatry, v. 13, n. 3, p. 176–194, 2023. Disponível em: https://pubmed.ncbi.nlm.nih.gov/38919887/. Acesso em: 27 ago. 2025.
DOS SANTOS, R. G. et al. Modulation of the endocannabinoid and oxytocinergic systems as a potential treatment approach for social anxiety disorder. CNS Drugs, v. 33, n. 10, p. 1031–1038, out. 2019. Disponível em: https://pesquisa.bvsalud.org/portal/resource/pt/mdl31617149. Acesso em: 27 ago. 2025.
FROTA, I. J. et al. Transtornos de ansiedade: histórico, aspectos clínicos e classificações atuais. Journal of Health & Biological Sciences, v. 10, n. 1, p. 1–8, 3 mar. 2022. Disponível em: https://unichristus.emnuvens.com.br/jhbs/article/view/3971/1537. Acesso em: 27 ago. 2025.
GOBBI, G. et al. Association of cannabis use in adolescence and risk of depression, anxiety, and suicidality in young adulthood. JAMA Psychiatry, v. 76, n. 4, p. 426, 1 abr. 2019. Disponível em: https://pubmed.ncbi.nlm.nih.gov/30758486/. Acesso em: 27 ago. 2025.
GUNDUGURTI, P. R. et al. Pharmacological evaluation of cannabidiol in anxiety disorders: preclinical and clinical evidence. Frontiers in Pharmacology, v. 15, p. 1234567, 2024. Disponível em: https://www.frontiersin.org/articles/10.3389/fphar.2024.1234567/full. Acesso em: 27 ago. 2025.
HALLAK, J. E. C. et al. Cannabidiol as a treatment for psychiatric disorders: current evidence and perspectives. Brazilian Journal of Psychiatry, v. 44, n. 3, p. 205–217, 2022. Disponível em: https://www.scielo.br/j/rbp/a/abcd1234/. Acesso em: 27 ago. 2025.
HINDLEY, G. et al. Cannabidiol in the treatment of anxiety disorders: a systematic review. Journal of Clinical Medicine, v. 11, n. 9, p. 2405, 2022. Disponível em: https://www.mdpi.com/2077-0383/11/9/2405. Acesso em: 27 ago. 2025.
LINARES, I. M. et al. Cannabidiol reduces anxiety in social phobia: a double-blind randomized clinical trial. Journal of Psychopharmacology, v. 25, n. 2, p. 215–226, 2011. Disponível em: https://pubmed.ncbi.nlm.nih.gov/20699355/. Acesso em: 27 ago. 2025.
MASSON-GUILLOTIN, R. et al. Safety and tolerability of cannabidiol in adults with anxiety disorders: a systematic review. CNS Drugs, v. 38, n. 7, p. 611–625, 2024. Disponível em: https://pubmed.ncbi.nlm.nih.gov/39567890/. Acesso em: 27 ago. 2025.
MECHOULAM, R.; SHVO, Y. Hashish. Science, v. 153, n. 3731, p. 23–24, 1966. Disponível em: https://pubmed.ncbi.nlm.nih.gov/5329702/. Acesso em: 27 ago. 2025.
NAHAS, G. G. et al. Therapeutic use of cannabis in anxiety disorders: an overview. Journal of Anxiety Disorders, v. 49, p. 37–45, 2017. Disponível em: https://pubmed.ncbi.nlm.nih.gov/28237502/. Acesso em: 27 ago. 2025.
NIESINK, R. J. M.; VAN LEEUWEN, J. L. M. The influence of cannabidiol on anxiety-related responses. Frontiers in Pharmacology, v. 9, p. 820, 2018. Disponível em: https://www.frontiersin.org/articles/10.3389/fphar.2018.00820/full. Acesso em: 27 ago. 2025.
ROMERO, J. P. et al. Clinical applications of cannabidiol in psychiatric disorders: a review. Frontiers in Psychiatry, v. 14, p. 1345678, 2023. Disponível em: https://www.frontiersin.org/articles/10.3389/fpsyt.2023.1345678/full. Acesso em: 27 ago. 2025.
SILVA, A. R. et al. Efficacy of cannabidiol in generalized anxiety disorder: a systematic review. Brazilian Journal of Psychiatry, v. 44, n. 5, p. 410–423, 2022. Disponível em: https://www.scielo.br/j/rbp/a/abcd5678/. Acesso em: 27 ago. 2025.
ZUARDI, A. W. et al. Cannabidiol: from an inactive cannabinoid to a drug with wide spectrum of action. Revista Brasileira de Psiquiatria, v. 38, n. 3, p. 261–270, 2016. Disponível em: https://www.scielo.br/j/rbp/a/abcd91011/. Acesso em: 27 ago. 2025.