Cannabidiol (CBD) may not significantly change scan-related anxiety compared with placebo in patients with advanced breast cancer but may result in lower overall anxiety levels, according to a recent study published by Nayak et al in JAMA Network Open.
Background
Anxiety is common among adult patients receiving cancer care, with as many as 25% of patients meeting the clinical criteria for anxiety. Many patients with cancer also experience scan-related anxiety, a condition in which patients develop anxiety related to getting imaging studies to assess the potential spread of cancer, evaluate response to treatment, or investigate cancer-related symptoms.
There are not many effective options for managing anxiety outside of benzodiazepines like lorazepam or alprazolam. Although benzodiazepines have been shown to be effective, they can cause significant complications including falls and oversedation.
Study Methods and Results
In the recent study, researchers examined whether CBD could reduce anxiety levels, specifically among patients with advanced breast cancer prior to the receipt of scans assessing their tumor burden. They randomly assigned 50 patients with advanced breast cancer to receive either one 400 mg dose of U.S. Food and Drug Administration–approved CBD (n = 25) or placebo (n = 25).
Anxiety levels among participants were assessed using the Visual Analog Mood Scale prior to and 2 to 4 hours following the treatment drug ingestion. The participants who received CBD did not have a greater reduction in anxiety following ingestion compared with those who received placebo. However, while the study did not meet its primary endpoint of significant difference in anxiety change scores between the two patient groups, the researchers uncovered that anxiety levels were significantly lower 2 to 4 hours following ingestion of CBD. The treatment was also found to be safe among patients with breast cancer.
Conclusions
The findings suggested that CBD may have anxiety-reducing properties. Further investigation may be necessary to better understand the potential of CBD.
“Our results lay the groundwork for larger, more definitive trials testing CBD in patients with breast cancer and other cancers as a way of reducing anxiety,” highlighted co–lead study author Peter Chai, MD, of the Department of Emergency Medicine at Brigham and Women’s Hospital and a member of the Department of Psychosocial Oncology at Dana-Farber Cancer Institute.
“Our study also demonstrates high levels of interest in clinical trials to test treating anxiety with CBD and highlights the need to conduct follow-up studies to understand how CBD integrates into the armament of therapies to address cancer related anxiety,” emphasized senior study author Ilana Braun, MD, of the Department of Psychiatry at the Brigham and Women’s Hospital and Department of Supportive Oncology at Dana-Farber Cancer Institute. “We recruited patients at the height of the pandemic when clinical trials generally stagnated, but nearly three-quarters of potential participants expressed interest and many referred others to the study,” she concluded.
Disclosure: The research in this study was supported by the Hans and Mavis Lopater Foundation and the Gloria Spivak Faculty Advancement Fund. For full disclosures of the study authors, visit jamanetwork.com.
