Clinical evidence shows the Endocannabinoid System (ECS) modulates synaptic transmission processes (Castillo et al., 2012; Katona et al., 2012) and a large amount of data points to the ECS playing a crucial role in the behavioral regulation of fear, anxiety, and stress (Peng et al., 2022; Lutz et al., 2015; Lafenêtre et al., 2007; McLaughlin et al., 2014).

CBD and other cannabinoids ser ve as ligands, binding to the receptors of the ECS. Numerous pharmacological studies show that these ECS receptors, specifically CB1 and CB2, are influenced by these exogenous cannabinoids that, with low and high doses, can exert both anxiolytic and anxiog enic states on humans and animals (Moreira et al., 2009).

Neuroimaging and biochemical studies indicate that anxiety disorders pathophysiology is related to specific neurotra nsmitters, including DA (Dunlop et al., 2007), norepinephrine (NE) (Goddard et al., 2010), γ-aminobutyric acid (GABA) (Nemeroff et al. 2003), and serotonin (5-HT) (Ressler et. al, 2000).

While the exact mechanisms by which CBD mitigates anxiety remain undefined, clinical evidence demonstrates its anxiolytic effects, and research suggests the main anti - anxiety activity may result from CBD inhibiting the inactivation of AEA, a neurotransmitter (Peng et al. 2022; Murrough et al., 2015; Blessing et. al, 2015) and/or CBD interacting with 5-HT1A receptors (Campos et al., 2012; Patel et al., 2016).

More double - blind placebo - controlled clinical trials need to take place to further evaluate CBD’s anxiety - modulating effects, but current studies support CBD as a promising solution.

For example, studies on stimulated public speaking demonstrated that CB D significantly decreased participants’ general social anxiety and reduced cognitive impairment, suggesting CBD could be beneficial for people in stressful situations (Zuardi et al., 1993, Bergamaschi et. al., 2011, Zuardi et. al., 2017; Zuardi et al., 2019).

The ad ministration of oral CBD in addition to routine psychiatric care was associated with PTSD symptom reduction in adults. CBD also appeared to offer relief in a subset of patients who reported frequent nightmares as a symptom of their PTSD (Lucas Elms at al., 2019).