Ingesting cannabidiol (CBD) before diagnostic scans can reduce anxiety in women with advanced breast cancer, according to research published December 16 in JAMA Network Open.
A team led by Ilana Braun, MD, from the Dana-Farber Cancer Institute in Boston, MA, found that anxiety levels significantly decreased two to four hours after ingesting CBD in patients and that orally ingested CBD is safe. However, anxiety scores did not significantly differ between women who ingested CBD and those who ingested a placebo.
“We believe these signals are sufficiently intriguing to justify continued exploration of CBD as a safe and possibly effective therapy for cancer-related anxiety,” the Braun team wrote.
One in four or five adults experience anxiety in oncologic settings. And while benzodiazepines are typically given to patients experiencing anxiety related to scans measuring tumor burden, they can leave patients with undesirable side effects such as confusion, amnesia, and addiction, among others.
CBD is derived from the hemp plant, a botanic cousin of marijuana. However, it is not impairing since it doesn’t contain tetrahydrocannabinol (THC), the psychoactive ingredient found in marijuana that produces a high. Medically speaking, CBD has several uses. These include serving as an anticonvulsant for epilepsy and as an anti-anxiety supplement for patients undergoing MRI scans. Furthermore, CBD does not have addictive properties, the researchers noted.
However, data are few and far between on CBD’s potential. Braun and co-authors in a randomized clinical trial studied whether a single 400-mg oral dose of CBD that has been approved by the U.S. Food and Drug Administration (FDA) improves clinical anxiety among women undergoing diagnostic CT and/or PET scans for advanced breast cancer.
The study enrolled 50 women. Of these, 25 were given CBD while the remaining 25 ingested a placebo pill. The researchers stratified the women by baseline anxiety levels and randomized them at a 1:1 ratio to receive CBD or the placebo within 48 hours before their CT or PET scans.
The researchers also compared change scores on the afraid subscale of the Visual Analog Mood Scale (VAMS) before and two to four hours after drug ingestion. They converted VAMS scores to T-scores to better measure mood change. T-scores greater than 20 indicated reliable change while scores greater than 30 meant both reliable and clinically significant change.
While women who took the CBD pill experienced less anxiety than those who ingested the placebo, the findings did not achieve statistical significance. The CBD arm demonstrated a VAMS score change of -19.1 while the placebo arm had a score change of -15 (p = 0.37).
The researchers wrote that these results may have fallen short of statistical significance due to a small sample size, the slight differences in averages between both groups at baseline, and the low correlation between VAMS afraid subscale scores before and after study drug ingestion.
However, the CBD arm experienced significantly less anxiety than the placebo arm between two and four hours after drug ingestion. These included T-scores of 51.5 for women who took CBD and 58.0 for women who ingested the placebo (p = 0.02).
Finally, the team reported no grade 3 or 4 toxic effects among the study population, indicating CBD’s safety.
The study authors highlighted that their findings add to literature suggesting that 400 mg of oral CBD can be used safely in cancer patients.
“This finding may provide important learning for other CBD clinical trialists as well as those advising adults with cancer in the clinic,” they wrote.
The authors also called for future longitudinal trials that incorporate the following: anxiety score trajectories on repeated measures, wearable devices to measure anxiety, patients with moderate to severe levels of anxiety, and the Patient Global Impressions Scale.
“Such a study may allow the scientific community to truly assess whether oral CBD, which we show can be used safely in a medically ill population, benefits adults with cancer and acute clinical anxiety,” they added.
The full study can be found here.