In the past few years, a popular treatment for anxiety and nervousness has arisen in the form of CBD. CBD or cannabidiol is a derivative of the cannabis plant that contains many healing, but no psychoactive or euphoric properties.
In the United States, nearly 50 million people suffer from some type of anxiety disorder. Nearly 1/3rd of these people go untreated. For those who do seek treatment, doctors can prescribe different types of medications, many that are “off label” to treat anxiety.
An off-label drug is a drug that’s prescribed to a patient for a condition or illness (or to a group of patients, such as children) that the US Food and Drug Administration hasn’t approved the drug for.
What Is Anxiety?
The dictionary’s definition of anxiety is a feeling of worry, nervousness, or unease, typically about an imminent event or something with an uncertain outcome. It’s a normal human emotion. At some time or another everyone has experienced it.
In the case of an anxiety disorder, the person often finds themselves experiencing frequent bouts of anxiety. These episodes can manifest as physical symptoms, such as a fast heart rate and/or shakiness.
Often people have more than one anxiety disorder. The most common disorders are:
- Generalized anxiety disorder (GAD) – The most common form of anxiety disorder, this is a form of anxiety isn’t focused on a single event or object. It is usually defined as worry accompanied by the following symptoms: restlessness, fatigue, concentration problems, irritability, muscle tension, and/or sleep disturbance.
- Specific phobia – The opposite of GAD, anxiety brought on with specific phobias are focused on a single event or an object. Physical manifestations of this type of anxiety may be trembling, shortness of breath, or rapid heartbeat. Among the most common types of specific phobias are flying, blood, water, highway driving, and tunnels.
- Social anxiety disorder – Social anxiety disorder is an intense fear and avoidance of negative public scrutiny, public embarrassment, humiliation, or social interaction. It’s often characterized by physical symptoms such as blushing, sweating, and difficulty speaking.
- Separation anxiety disorder – Separation anxiety is the feeling of excessive and inappropriate levels of fear over being separated from a person or place. This is often seen in young children but can affect adults as well.
- Agoraphobia – Agoraphobia is the fear of being in a place or situation where escape is difficult or where help may be unavailable. Many people who experience this must have a door or exit in line of sight to help reduce their anxiety.
- Panic disorder – Panic disorder, or panic attacks are brief bouts of fear that’s usually accompanied by trembling, shaking, confusion, dizziness, nausea, and/or difficulty breathing. They can last from a few minutes to several hours. And while these attacks can be triggered by stress, irrational thoughts, general fear or fear of the unknown, or even exercise, many times, there isn’t any trigger and can affect a person without warning.
- Obsessive-compulsive disorder (OCD) – OCD is a subject for debate among physician and scientist. Some classify it as anxiety (such as the International Classification of Diseases) but others don’t (such as the American Psychiatric Association’s Diagnostic and Statistical Manual of Mental Disorders). Either way, it is when a person feels the uncontrollable need to perform certain routines or has certain uncontrollable thoughts repeatedly. Some common compulsions include hand washing, counting of things, hoarding and checking to see if a door is locked.
- Selective mutism – Selective mutism occurs when a person who is normally capable of speech does not speak in specific situations or to specific people.
In addition to medication, to effectively treat anxiety, counseling and lifestyle changes are recommended. Without treatment, anxiety disorders usually don’t subside.
Current Anxiety Prescription Medications
According to the Anxiety and Depression Association of America (ADAA), doctors have several options for prescribing medication to patients that suffer from anxiety. Each of these classes of medications works differently to treat the issue and have many side effects.
Selective Serotonin Reuptake Inhibitors (SSRI)
The most common type of medications prescribed for anxiety is SSRIs. Doctors like to prescribe these medications because the likelihood of addiction to them is extremely low, so they can be taken for long periods of time.
These medications weren’t designed to treat anxiety originally. SSRIs are actually antidepressants block certain nerve cells in the brain from reabsorbing serotonin. This leaves more serotonin available for the sending of nerve impulses. With more serotonin available, the person’s mood improves, making him or her less susceptible to bouts of anxiety.
Common SSRIs include (generic names are in parentheses):
- Celexa (citalopram)
- Lexapro (escitalopram)
- Prozac (fluoxetine)
- Luvox (fluvoxamine)
- Paxil (paroxetine)
- Pexeva (paroxetine)
- Zoloft (sertraline)
SSRIs, while they can be effective, are designed to be prescribed for no longer than 12 months. After this time they’ll usually become ineffective. In addition, they can take up to a month to start working.
Also, they’re not without any side effects. Among the most common side effects that patients experience are:
- blurry vision
- constipation
- diarrhea
- dizziness
- drowsiness or fatigue
- dry mouth
- feeling agitated or restless
- gaining weight
- headaches
- nausea
- sexual problems
- sleep problems
Serotonin-Norepinephrine Reuptake Inhibitors (SNRI)
SNRIs also are antidepressants that affect serotonin. With this class of drugs, the levels of both serotonin and norepinephrine are increased by reducing the absorption of them into the brain. Norepinephrine mobilizes the brain and body for action. It affects many emotions and body processes such as anxiety, alertness, glucose production, blood pressure, and more.
Among the common SNRIs prescribed are Cymbalta (duloxetine) and Effexor XR (venlafaxine). The side effects of these medications include:
- constipation
- dizziness
- drowsiness
- dry mouth
- fatigue
- headaches
- increased blood pressure
- loss of appetite
- nausea
- profuse sweating
- sexual problems
- sleep problems
- upset stomach
- weight gain
Tricyclic Antidepressants (TCA)
TCA drugs have been around since the 1950s and have mostly been replaced by SSRIs and SNRIs. But they’re still around. Many doctors use this class of drugs when SSRIs and SNRIs fail to work on a patient because of the many side effects and the propensity for addiction.
TCAs work similarly to SNRIs as they also reduce the brain’s absorption of serotonin and norepinephrine into the brain.
Common TCA drugs include:
- Elavil (amitriptyline)
- Tofranil (imipramine)
- Pamelor (nortriptyline)
Common side effects of TCAs are:
- addiction
- blurry vision
- constipation
- difficulty urinating
- dry mouth
- drowsiness
- increase in appetite
- lightheadedness
- low blood pressure
- sexual problems
- sweating more than usual
- tremors
- weight loss or gain
Benzodiazepines
Benzodiazepines are used as a short term anxiety medication for some patients. This class of drugs is highly addictive, so the recommended prescription length is rarely longer than 1 month. They also can have severe withdrawal symptoms if the user stops taking them abruptly.
Benzodiazepines work less on the brain than they do the physical symptoms associated with anxiety by acting as a reduce tension and relax muscles.
Common benzodiazepines include:
- Xanax (alprazolam)
- Librium (chlordiazepoxide)
- Valium (diazepam)
- Ativan (lorazepam)
The side effects of benzodiazepines include:
- addiction
- balance issues
- blurry vision
- bone density issues
- cognitive decline
- confusion
- dizziness
- drowsiness
- fatigue
- headaches
- loss of coordination
- loss of memory or concentration
- slurred speech
- upset stomach
Monoamine Oxidase Inhibitors (MAOI)
Monoamine oxidase inhibitors, like TCAs, were developed in the 1950s. These are rarely prescribed for anything but the most severe anxiety issues as they’re among the most powerful antidepressants available.
They work by inhibiting the activity of one or both of the enzymes monoamine oxidase A (MAO-A) and monoamine oxidase B (MAO-B), both of which regulate different neurotransmitters in the brain.
Common MAOIs include:
- Marplan (isocarboxazid)
- Nardil (phenelzine)
- Emsam (selegiline)
- Parnate (tranylcypromine)
MAOIs have lots of hazards. Among them are interactions with other drugs. It’s important that physicians take note of any other medications that the patient takes as well as their use of illicit drugs or alcohol before prescribing an MAOI.
Among the common side effects of MAOIs are:
- constipation
- diarrhea
- difficulty urinating
- dizziness
- drowsiness
- dry mouth
- headaches
- low blood pressure
- nausea
- sexual dysfunction
- sleep problems
- sweating
- weight gain
Beta Blockers
Beta blockers are usually written as an off-label alternative to antidepressants for anxiety. Originally approved by the FDA for blood pressure and heart-related conditions, beta blockers were found to have reduced the absorption of norepinephrine into the brain, alleviating some of a patient’s anxiety issues.
The most common beta blockers prescribed for anxiety are Tenormin (tenolol) and Inderal (propranolol).
Common side effects of beta blockers include:
- cold hands and feet
- depression
- extreme tiredness
- low blood pressure
- shortness of breath
- sleep problems
- weight gain
Buspirone
Buspirone has been widely available since the 1980s, although it was invented in the 1960s. It has been shown to be effective as a short term treatment for anxiety. It interrupts serotonin absorption in the brain.
Buspirone is a popular treatment for short term anxiety due to the costs for the patient. The average cost for a 1 month supply is less than $3.
Unlike other medications previously mentioned, this isn’t a class of drugs, but a specific drug. Buspirone is the generic name, it is also sold under the brand name Buspar.
Side effects of buspirone include:
- blurry vision
- diarrhea
- dizziness
- drowsiness
- dry mouth
- fatigue
- headaches
- muscle pains
- nausea
- nervousness
- paresthesia (a tingling, pricking, chilling, burning, or numb sensation on the skin)
- poor concentration
- profuse sweating
- sleep issues
- weakness
CBD for Anxiety
Over the past few years, many people have been turning to CBD to treat their anxiety disorders. Many have turned to this as a result of years using anti-anxiety medications. They find that these medications may only have a positive effect on them for a short period of time before they have to be changed.
In addition, many people choose CBD for anxiety because of the side effects of prescription medications.
People who’ve studied CBD as an alternative to anti-anxiety medications know that CBD has anti-inflammatory, antibacterial, analgesic, and neuroprotective properties.
In a 2016 study on CBD and serotonin levels in mice, researchers found that CBD works faster than SSRIs and helps enhance serotonin levels. The study, titled Cannabidiol induces rapid-acting antidepressant-like effects and enhances cortical 5-HT/glutamate neurotransmission: role of 5-HT1A receptors found that “Both antidepressant-like effect and enhanced cortical 5-HT/glutamate neurotransmission induced by CBD were prevented by 5-HT1A receptor blockade. Moreover, adaptive changes in pre- and post-synaptic 5-HT1A receptor functionality were also found after chronic CBD. In conclusion, our findings indicate that CBD could represent a novel fast antidepressant drug, via enhancing both serotonergic and glutamate cortical signaling through a 5-HT1A receptor-dependent mechanism.” https://www.ncbi.nlm.nih.gov/pubmed/26711860
The fact that the study shows that CBD can be effective along with the lack of any side effects other than sleepiness has put CBD in the mix as an effective treatment for anxiety.
Conclusion
Given the choice, most people would want to choose a natural remedy for an affliction than a synthetic solution. CBD is an all-natural choice that’s been used for thousands of years (in the form of cannabis) to treat pain, seizures, headaches, tremors, burns, arthritis, and a host of other issues.
The CBD works with the body’s natural endocannabinoid system (ECS) to send the CBD directly to the central nervous system where it’s sent out through the bloodstream to various parts of the body.
Because of the interaction on CBD and the body’s ECS, it can make CBD a more effective choice than some medications.
Of course, CBD, just like prescription medications, won’t combat anxiety alone. Many people need intensive therapy, usually Cognitive Behavioral Therapy, or CBT, as well as lifestyle modifications to overcome the issue.
The lifestyle changes may be a slight change, for example, eliminating caffeine from your diet. Or they may be major, such as removing yourself from your current living conditions. Whatever the case, a doctor and therapist can help you come up with a plan to combat your anxiety and can incorporate CBD.
It is recommended that before starting a course of CBD for anxiety that you consult your physician. This is especially true if you’re currently on any anti-anxiety medications as you don’t want to go “cold turkey” off of a prescription as you may suffer severe withdrawal symptoms. You’ll also want to be sure that the CBD won’t affect any other medications that you may be taking.
