Medicinal cannabis in the management of anxiety disorders: A systematic review

Leah Roberts¹, Elizabeth Sorial², Charley A Budgeon³, Kenneth Lee⁴, David B Preen⁵, Craig Cumming⁶

Affiliations

¹ School of Population and Global Health, 35 Stirling Hwy, Crawley WA 6009, Australia; NHMRC Centre of Research Excellence in Medicines Intelligence, University of South Australia, University of New South Wales, University of Sydney, University of Western Australia, Australia. Electronic address: leah.roberts@uwa.edu.au.
² School of Population and Global Health, 35 Stirling Hwy, Crawley WA 6009, Australia. Electronic address: elizabeth.sorial@research.uwa.edu.au.
³ School of Population and Global Health, Cardiovascular Epidemiology Research Centre, University of Western Australia, 35 Stirling Hwy, Crawley WA 6009, Australia. Electronic address: charley.budgeon@uwa.edu.au.
⁴ Department of Pharmacy, School of Allied Health, 35 Stirling Hwy, Crawley WA 6009, Australia. Electronic address: kenneth.lee@uwa.edu.au.
⁵ School of Population and Global Health, 35 Stirling Hwy, Crawley WA 6009, Australia; NHMRC Centre of Research Excellence in Medicines Intelligence, University of South Australia, University of New South Wales, University of Sydney, University of Western Australia, Australia. Electronic address: david.preen@uwa.edu.au.
⁶ School of Population and Global Health, 35 Stirling Hwy, Crawley WA 6009, Australia; NHMRC Centre of Research Excellence in Medicines Intelligence, University of South Australia, University of New South Wales, University of Sydney, University of Western Australia, Australia. Electronic address: craig.cumming@uwa.edu.au.

PMID: 40413923
DOI: 10.1016/j.psychres.2025.116552

Free article

Medicinal cannabis in the management of anxiety disorders: A systematic review

Leah Roberts et al. Psychiatry Res. 2025 Aug.

Free article

. 2025 Aug:350:116552.

doi: 10.1016/j.psychres.2025.116552. Epub 2025 May 17.

Authors

Leah Roberts¹, Elizabeth Sorial², Charley A Budgeon³, Kenneth Lee⁴, David B Preen⁵, Craig Cumming⁶

Affiliations

¹ School of Population and Global Health, 35 Stirling Hwy, Crawley WA 6009, Australia; NHMRC Centre of Research Excellence in Medicines Intelligence, University of South Australia, University of New South Wales, University of Sydney, University of Western Australia, Australia. Electronic address: leah.roberts@uwa.edu.au.
² School of Population and Global Health, 35 Stirling Hwy, Crawley WA 6009, Australia. Electronic address: elizabeth.sorial@research.uwa.edu.au.
³ School of Population and Global Health, Cardiovascular Epidemiology Research Centre, University of Western Australia, 35 Stirling Hwy, Crawley WA 6009, Australia. Electronic address: charley.budgeon@uwa.edu.au.
⁴ Department of Pharmacy, School of Allied Health, 35 Stirling Hwy, Crawley WA 6009, Australia. Electronic address: kenneth.lee@uwa.edu.au.
⁵ School of Population and Global Health, 35 Stirling Hwy, Crawley WA 6009, Australia; NHMRC Centre of Research Excellence in Medicines Intelligence, University of South Australia, University of New South Wales, University of Sydney, University of Western Australia, Australia. Electronic address: david.preen@uwa.edu.au.
⁶ School of Population and Global Health, 35 Stirling Hwy, Crawley WA 6009, Australia; NHMRC Centre of Research Excellence in Medicines Intelligence, University of South Australia, University of New South Wales, University of Sydney, University of Western Australia, Australia. Electronic address: craig.cumming@uwa.edu.au.

PMID: 40413923
DOI: 10.1016/j.psychres.2025.116552

Abstract

Background: With rising anxiety disorder diagnoses, many individuals are seeking alternatives to standard pharmacotherapies, like medicinal cannabis. This systematic review focuses exclusively on anxiety-related disorders and examines a wide range of cannabis-based preparations and interventions.

Method: We searched MEDLINE, EMBASE, CINAHL, and PsycInfo (October-December 2023) for peer-reviewed empirical studies, excluding case series, case studies, and review papers. Inclusion criteria were studies on adults (18+ years) diagnosed with anxiety-related disorders, examining the efficacy or effectiveness of medicinal cannabis. Studies on recreational cannabis or cannabis-use-disorder were excluded. The MASTER and QualSyst tools were used to assess bias.

Results: Fifty-seven studies met the inclusion criteria: 40 % cohort (n = 23), 30 % randomised controlled trials (n = 17), 18 % cross-sectional (n = 10), 12 % qualitative or other designs (n = 7). The MASTER scale revealed a high risk of bias, with a mean score of 62.9 (out of 100) due to inadequate reporting. Among the 13 highest-quality studies, 70 % (n = 9) reported a positive improvement for disorders including generalised anxiety disorder (GAD), social anxiety disorder (SAD), and post-traumatic stress disorder (PTSD). 30 % (n = 4) reported a negative result for conditions like obsessive-compulsive disorder, trichotillomania, test anxiety and SAD. Over 90 % of all studies, including lower quality studies, reported positive outcomes for CBD and THC-based cannabis. However, 53 % (n = 30) either omitted, or included self-reported data on either form and/or dosage.

Conclusion: Medicinal cannabis demonstrates potential in reducing anxiety symptoms, but the long-term benefits and overall impact on quality of life remain unclear. Further high-quality, longitudinal research with standardised dosing is needed.

Keywords: Anxiety; Medicinal cannabis; Post-traumatic stress disorder; Review.

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Conflict of interest statement

Declaration of competing interest The authors declare that they have no known competing financial interests or personal relationships that could have appeared to influence the work reported in this paper.

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Medicinal cannabis in the management of anxiety disorders: A systematic review

Affiliations

Medicinal cannabis in the management of anxiety disorders: A systematic review

Authors

Affiliations

Abstract

Conflict of interest statement

Publication types

MeSH terms

Substances

LinkOut - more resources

Full Text Sources

Medical

Miscellaneous