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Dahlgren MK, Lambros AM, Smith RT, Sagar KA, El-Abboud C, Gruber SA. Clinical and cognitive improvement following full-spectrum, high-cannabidiol treatment for anxiety: open-label data from a two-stage, phase 2 clinical trial. COMMUNICATIONS MEDICINE 2022; 2:139. [PMID: 36352103 PMCID: PMC9628346 DOI: 10.1038/s43856-022-00202-8] [Citation(s) in RCA: 15] [Impact Index Per Article: 7.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/30/2021] [Accepted: 10/18/2022] [Indexed: 12/01/2022] Open
Abstract
BACKGROUND Evidence suggests cannabidiol (CBD) has anxiolytic properties, indicating potential for novel treatment strategies. However, few clinical trials of CBD-based products have been conducted, and none thus far have examined the impact of these products on cognition. METHODS For the open-label stage of clinical trial NCT02548559, autoregressive linear modeling assessed efficacy and tolerability of four-weeks of 1 mL t.i.d. treatment with a full-spectrum, high-CBD sublingual solution (9.97 mg/mL CBD, 0.23 mg/mL Δ-9-tetrahydrocannabinol) in 14 outpatients with moderate-to-severe anxiety, defined as ≥16 on the Beck Anxiety Inventory (BAI) or ≥11 on the Overall Anxiety Severity and Impairment Scale (OASIS). RESULTS Findings suggest significant improvement on primary outcomes measuring anxiety and secondary outcomes assessing mood, sleep, quality of life, and cognition (specifically executive function) following treatment. Anxiety is significantly reduced at week 4 relative to baseline (BAI: 95% CI = [-21.03, -11.40], p < 0.001, OASIS: 95% CI = [-9.79, -6.07], p < 0.001). Clinically significant treatment response (≥15% symptom reduction) is achieved and maintained as early as week 1 in most patients (BAI = 78.6%, OASIS = 92.7%); cumulative frequency of treatment responders reached 100% by week 3. The study drug is well-tolerated, with high adherence/patient retention and no reported intoxication or serious adverse events. Minor side effects, including sleepiness/fatigue, increased energy, and dry mouth are infrequently endorsed. CONCLUSIONS Results provide preliminary evidence supporting efficacy and tolerability of a full-spectrum, high-CBD product for anxiety. Patients quickly achieve and maintain symptom reduction with few side effects. A definitive assessment of the impact of this novel treatment on clinical symptoms and cognition will be ascertained in the ongoing double-blind, placebo-controlled stage.
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Affiliation(s)
- Mary Kathryn Dahlgren
- grid.240206.20000 0000 8795 072XCognitive and Clinical Neuroimaging Core, McLean Hospital Imaging Center, 115 Mill Street, Belmont, MA 02478 USA ,grid.240206.20000 0000 8795 072XMarijuana Investigations for Neuroscientific Discovery (MIND) Program, McLean Hospital Imaging Center, 115 Mill Street, Belmont, MA 02478 USA ,grid.38142.3c000000041936754XDepartment of Psychiatry, Harvard Medical School, 25 Shattuck Street, Boston, MA 02115 USA
| | - Ashley M. Lambros
- grid.240206.20000 0000 8795 072XCognitive and Clinical Neuroimaging Core, McLean Hospital Imaging Center, 115 Mill Street, Belmont, MA 02478 USA ,grid.240206.20000 0000 8795 072XMarijuana Investigations for Neuroscientific Discovery (MIND) Program, McLean Hospital Imaging Center, 115 Mill Street, Belmont, MA 02478 USA
| | - Rosemary T. Smith
- grid.240206.20000 0000 8795 072XCognitive and Clinical Neuroimaging Core, McLean Hospital Imaging Center, 115 Mill Street, Belmont, MA 02478 USA ,grid.240206.20000 0000 8795 072XMarijuana Investigations for Neuroscientific Discovery (MIND) Program, McLean Hospital Imaging Center, 115 Mill Street, Belmont, MA 02478 USA
| | - Kelly A. Sagar
- grid.240206.20000 0000 8795 072XCognitive and Clinical Neuroimaging Core, McLean Hospital Imaging Center, 115 Mill Street, Belmont, MA 02478 USA ,grid.240206.20000 0000 8795 072XMarijuana Investigations for Neuroscientific Discovery (MIND) Program, McLean Hospital Imaging Center, 115 Mill Street, Belmont, MA 02478 USA ,grid.38142.3c000000041936754XDepartment of Psychiatry, Harvard Medical School, 25 Shattuck Street, Boston, MA 02115 USA
| | - Celine El-Abboud
- grid.240206.20000 0000 8795 072XCognitive and Clinical Neuroimaging Core, McLean Hospital Imaging Center, 115 Mill Street, Belmont, MA 02478 USA ,grid.240206.20000 0000 8795 072XMarijuana Investigations for Neuroscientific Discovery (MIND) Program, McLean Hospital Imaging Center, 115 Mill Street, Belmont, MA 02478 USA
| | - Staci A. Gruber
- grid.240206.20000 0000 8795 072XCognitive and Clinical Neuroimaging Core, McLean Hospital Imaging Center, 115 Mill Street, Belmont, MA 02478 USA ,grid.240206.20000 0000 8795 072XMarijuana Investigations for Neuroscientific Discovery (MIND) Program, McLean Hospital Imaging Center, 115 Mill Street, Belmont, MA 02478 USA ,grid.38142.3c000000041936754XDepartment of Psychiatry, Harvard Medical School, 25 Shattuck Street, Boston, MA 02115 USA
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