This question comes up often but usually from two different directions.
The first one centers around whether there is a rebound anxiety effect when CBD wears off.
The second deals with using CBD for rebound anxiety from other medications.
There's good news on both fronts!
We're also going to look at an important aspect of how CBD works with anxiety for short term and long term results.
This is very important to address rebound anxiety as well as the core driver of anxiety.
While working on our CBD versus anxiety medications articles, it was very interesting to see how the most addictive benzodiazepines were the shortest lived ones.
The shorter the half-life of the medication, the worst the rebound anxiety.
Xanax was a major example of this effect.
Also, the benzo's that did not have metabolites...small, trailing chemicals that also had longer lasting anti-anxiety effects, had the hardest anxiety rebound.
Again, Xanax, Valium, and Ativan have this issue.
We'll cover these topics
- Will CBD cause rebound anxiety
- What is the half-life of CBD
- Does CBD help with anxiety rebounds from other meds
- Does CBD normalize or become habit forming
- Short term versus long term effects of CBD for anxiety
- How much CBD for anxiety
- Best type of CBD for anxiety
Let's get started!
Will CBD cause rebound anxiety
The first and most common question.
Let's walk through a situation.
Anxiety is one of the most common reasons that people take CBD.
You can read all about the benefits of CBD for anxiety here.
Most people with anxiety have either used benzos or are trying get off of them.
The trouble is that you can experience a really nasty anxiety rebound effect when they wear off.
These can be excruciating...even worse than the original anxiety the person was using the benzo to treat.
In fact, it's hard to tell how much was the underlying anxiety issue (which benzo's just hide) or the side effect of benzo addiction (which can be anxiety).
Either way, this is part of the addiction process where people will continue to use a drug to avoid the withdrawal symptoms.
Does CBD do this?
CBD is not habit forming or normalizing.
It does not hit the dopamine system in the same way that benzos do.
Our dopamine system is called the "reward" circuit of the brain
Almost all addiction centers around this pathway.
There is much research on CBD to see if is addictive.
Good news there!
- CBD does not have withdrawal symptoms
- It does not normalize (need more and more for the same effect)
- It does not cause addiction via the dopamine system
CBD is non-rewarding, and acts on a number of receptor systems including the opioid (101), serotonergic (102, 103), and cannabinoid (22) systems
The key word there is "non-rewarding". This references the dopamine system, the key system in almost all addiction.
In fact, CBD is gaining quite a bit of attention to help with addiction (even to THC, the other active chemical in cannabis).
Systemically administered CBD has also been demonstrated to regulate mesolimbic DA activity (114), and potentially attenuate substance-induced dysregulation of the mesolimbic circuitry (115, 116), suggesting its utility against SUDs.
The mesolimbic DA is key part of the brain tied to addiction.
All the referenced studies showed that CBD help to re-balance that circuit after being altered by drug use and addiction. SUD is "substance use disorder".
Take a look at this chart here on the effects of CBD across a range of different drugs including alcohol, nicotine, THC, opiates, and more:
Keep in mind that anxiety drugs like benzos pump up the levels of GABA and also cause a rush of dopamine (hence the high addiction risk).
This is action in one direction!
GABA is the key lever for anxiety in the brain.
It acts as the calming agent both within the brain and for our mood.
Like with anything in the body, if you create a surge of a chemical, it tends to crash until it is replenished.
Think of the crash after a sugar rush.
CBD does not directly pump up GABA but helps to normalize GABA signaling (along with its counterbalances: Glutamate and Histamine).
Learn all about how CBD helps to balance GABA signalling in the brain.
One of the reasons that drugs like benzos have rebound anxiety has to do with how long they stay in the system.
This is call the half-life.
Xanax, the most prescribed with arguably the most significant rebound anxiety (the two are intimately related) has the shortest half life.
It comes on fast and drops off fast!
Check our CBD versus benzos comparison here.
What about the half-life of CBD?
What is the half-life of CBD
This is important for the the short term rebound of anxiety.
The terminal half-life of CBD in humans is estimated at 18–32 hour
Peak blood levels of CBD are generally found around 4-6 hours after use.
Compare this to Xanax at peak blood levels between 1-2 h hours and half-life of 8-10 hours.
Most rebound anxiety can start as early as 4-6 hours with Xanax due to a severe drop in its level.
That's the short term look at rebound anxiety from CBD.
More important is the long term effect of CBD on the pathways of anxiety.
Anxiety generally isn't just a deficiency in GABA levels.
What is drawing down GABA levels?
- Elevated glutamate and histamine
- Brain circuit imbalance
- Brain mass reduction from immune attack
- Gut bacteria imbalance
- Genetic pathways
The long term change of anxiety rebound is what we really want to look at.
- Benzos just pump GABA levels (and dopamine).
- SSRI's pump serotonin levels with a little neurogenesis
CBD is a powerful agent for
- Balancing stress hormones
- Reducing neuroinflammation
- Normalizing neurotransmitter and hormone levels
- Normalizing brain circuit firing
- Neurogenesis in key areas tied to anxiety such as the hippocampus
If anxiety is the result of a specific situation (loss of family member, stressful job, etc), that's more of short term concern.
If the anxiety is more a function of how our brain processes stress, that's longer term.
If we don't address the underlying cause, there will always be rebound anxiety when a chemical is stopped such as with benzos and SSRI's.
The interesting research on CBD deals with how it bolsters the endocannabinoid system to help balance key systems.
You can learn all about these long term facets her:
- How CBD works with Anxiety
- CBD and inflammation for anxiety
- CBD and GABA levels for anxiety
- Comparing CBD and anxiety medications
- CBD versus Benzos for anxiety
- CBD versus SSRI's for anxiety
We'll leave with this.
Inflammation, infection, and our body's immune response to these things can cause tremendous damage in the brain.
It's the driver behind autoimmune diseases and the effect is very common in the brain as well.
Anxiety and depression may be a result of inflammation in the nervous system and brain.
The key to eliminating rebound anxiety is to help repair the neuronal connections in the brain that respond to stress.
How does CBD impact this effect called neurogenesis?
The anxiolytic effect of cannabidiol on chronically stressed mice depends on hippocampal neurogenesis: involvement of the endocannabinoid system.
Anxiolytic just means anti-anxiety.
In fact, the benefit of SSRIs which more directly affect the level for depression appear to have some of their effects through this same process.
Albeit, with some nasty potential side effects (see CBD versus SSRI's here).
Again, there's more on this and other important considerations for reducing anxiety rebound.
What about the anxiety rebounds from other medications or drug?
Does CBD help with anxiety rebounds from other meds
This is usually the second meaning people have when research CBD and rebound anxiety.
Can CBD help reduce anxiety rebound from benzos, opiates, and a host of different drugs.
One of the reasons for the intense addiction of benzos is the rebound anxiety that comes when its levels drop.
Not only do we have the underlying cause of anxiety that the benzo was taken to mask, but an additional layer of withdrawal anxiety can be added.
This can be unbearable and causes many people to fall back on the benzos which just furthers the cycle.
In fact, benzos are known to "potentiate" dopamine neurons to react more strongly over time.
The main rebound effect of benzos is anxiety.
There is more research on CBD's effect for opiate withdrawal currently than for benzos.
Anxiety and irritability are key symptoms of opiate withdrawal.
Because CBD is neither intoxicating nor rewarding and has an extremely large therapeutic window and impressive safety profile, the use of CBD to inhibit opioid craving has great therapeutic potential.
Learn all about CBD and addiction here.
Ultimately, the real question is whether CBD will help with rebound anxiety from other medications such as benzos.
If you look at the pathways of both at our CBD versus benzo comparison, the research is very positive.
Also check out CBD and GABA here.
Does CBD normalize or become habit forming?
There are three key concerns for CBD causing rebound anxiety:
- Is CBD hedonic?
- Does CBD normalize?
- Is CBD habit forming?
If it it has any of these qualities, rebound anxiety is a possibility.
Hedonic means that a substance causes pleasure.
Opiates, alcohol, and other additive drugs are hedonic.
What about CBD?
CBD, which is nonhedonic, can reduce heroin-seeking behavior after, for example, cue-induced reinstatement
What about normalization...the ability to build up a tolerance where the chemical has less and less effect?
They also conclude from their survey, that none of the studies reported tolerance to CBD.
As for addiction, the news is even better.
Where benzos create a rush of dopamine (key circuit for addition), CBD is actually showing much promise to offset addiction.
This is especially true for THC addiction (yes, it's addictive for a percentage of the population) and opiates.
Check out this study and the resulting effect of CBD on rebound anxiety from cannabis withdrawal:
CBD treatment resulted in a fast and progressive reduction in withdrawal, dissociative and anxiety symptoms, as measured with the Withdrawal Discomfort Score, the Marijuana Withdrawal Symptom Checklist, Beck Anxiety Inventory, and Beck Depression Inventory (BDI). Hepatic enzymes were also measured daily, but no effect was reported.
So...how much CBD should we look at to avoid anxiety rebounds?
How much CBD for anxiety rebounds?
This is where the research gets interesting.
We'll look break it up into two categories:
- Short term anxiety rebounds
- Long term anxiety rebounds
There's the immediate issue of reducing short term anxiety.
Many study have found anxiety effects across a range of levels of CBD.
This can be anywhere from 50 to 600 mg of CBD depending on the severity of the anxiety rebound in the research.
That's an immediate effect and as we mentioned above, the half life will generally be around 1-2 days per dose.
Most people break up the dosage into 2-3 blocks (after meals, at least 2 hours away from medication).
This deals with the 4-6 hours peak levels in the blood.
Now...where it gets interesting.
The long term neurogenesis benefit for rebound anxiety that we mentioned above is in a bell curve.
This means that it peaks around 300 mg but goes down until it goes away around 600 mg.
This may be key to offsetting damage and inflammation in the brain and nervous system (critical to anxiety, PTSD, depression, and other issues).
Neurogenesis helps with the long term potential for anxiety rebounds.
Check out CBD and neurogenesis here.
Of course, it's important to start low and test how your body responds.
A wellness or introductory CBD level for rebound anxiety is usually around 25-30 mgs.
Now we know that going over 300 mg may reduce the neurogenesis needed for long term anxiety relief.
Check out the how many mg of CBD for anxiety article here for more.
Let's look at one more important consideration.
Best type of CBD for anxiety
There are two main types of CBD on the market.
- Full spectrum
- CBD Isolate
Full spectrum will have lots of plant material and potentially up to .3% THC.
This is not great news for people with histamine issues.
That's roughly 40-60% of the population.
Women are higher on that scale are as people over age 40.
That's why we focus on CBD Isolate.
More importantly, all the research (dozens of studies) are for CBD by itself.
Not full spectrum. Not CBC. Not CGN. Not hemp oil.
CBD by itself.
We crafted IndigoNaturals based on what research was showing for anxiety.
Our story is here but we found out the hard way after 3-4 bottles of full spectrum CBD caused lots of histamine issues.
THC can actually cause anxiety in the research so there's no reason to have that there as well.
Let know us know how CBD works for you for anxiety rebounds.