CBD for PTSD: Benefits, Dosage, & Side-Effects
Learn how it works, how much to take, and what CBD oils are most effective.
PTSD affects at least 10% of people at some stage in their life .
Most of us have experienced trauma in some way. It can come from many places — abuse, war, accidents, disasters, or traumatic loss. It can overwhelm and affect our ability to cope. Response to trauma can have devastating consequences.
If someone is feeling distressed, disconnected, or isolated after experiencing or witnessing a life-threatening event, they may have PTSD. Current treatment methods are often unsuccessful and some have unwanted side effects.
Recently, studies have confirmed the ability of cannabidiol (CBD), a component of Cannabis sativa to be extremely beneficial in improving PTSD symptoms.
Here, we discuss PTSD, its symptoms, and how high-quality CBD oil products can help to support trauma recovery.
Let’s get started.
MEDICALLY REVIEWED BY
Updated on November 13, 2021
Table of Contents
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Can CBD Oil Help With Post Traumatic Stress Disorder (PTSD)?
Researchers have discovered many promising benefits of CBD to alleviate the symptoms associated with the disorder — especially in people that haven’t responded well to conventional therapies.
The benefits of CBD oil for PTSD include:
- May prevent nightmares
- may prevent the formation of “fear memories”
- Alleviates symptoms of anxiety & depression
- Alleviates insomnia
1. It Stops Nightmares
Clinical Trials have shown that CBD ceased or significantly reduced flashbacks, nightmares, and persistent memories in patients with PTSD .
2. It Prevents The Formation of Fear Memories
CBD disrupts the feelings of long-term fear memory processing, consequently reducing stress and anxiety .
3. It Reduces Anxiety and Depression Symptoms
CBD has a range of calming effects that reduce anxiety, panic attacks, compulsiveness, and the long-term effects of stress .
4. It Helps With Insomnia
CBD improves the quantity and quality of sleep and reduces night sweats. 
What’s The Dose of CBD Oil For PTSD
If you’re considering trying CBD oil for the first time, it’s important to start with a small dose and increase gradually.
Dosage recommendations vary and depend on the product you choose. Use our CBD dosage calculator below to find the best dose based on your weight and desired strength.
The most common method of taking CBD oil is in the form of drops. Place the dose under your tongue where it’s easily absorbed and swallow after 30 seconds to a minute.
Studies have shown high dosage ranges from 12 mg to 25 mg of CBD can significantly decrease anxiety symptoms, taking effect within 1-2 hours after taking the oil .
The key is to start low and go slow.
Be patient. Keep a daily journal of dosage and track your symptoms. You’ll know you’ve reached the ideal dose when your symptoms start to improve.
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Endocannabinoid Dysfunction & PTSD
The two major cannabinoids found in Cannabis, tetrahydrocannabinol (THC) and cannabidiol (CBD), are both compounds that influence the body’s endocannabinoid system (ECS) but have very different effects.
Recently, researchers have focused on the importance of the endocannabinoid system as an essential emotional regulating system the body uses to maintain homeostasis — or support ‘balance’ in the internal environment despite changes in the external environment.
The ECS plays a crucial role in brain and nervous system function and is involved in modulating other factors such as appetite, sleep, pain, and cognitive function .
Researchers believe that chronic stress, or a traumatic event, can impair the ECS signaling in the brain, therefore, leading to a host of symptoms described above.
For those with PTSD, the ECS system is integral to the regulation of emotional behavior, learning, and responses to traumatic events.
To break it down, CB1 and CB2 are receptors that cannabinoids like CBD target.
The CB1 Receptors: Regulating the Brain & Nervous System
These are found in the brain and the nervous system. CB1 receptors play a role in fear memory formation, appetite, pain tolerance, and mood. The mood enhancing neurotransmitter anandamide activates CB1, and when anandamide levels are low, it creates a deficiency of CB1 receptors leading to increased levels of stress and anxiety.
The CB2 Receptors: Regulating Pain & Inflammation
The CB2 receptors regulate inflammation, a primary cause of many diseases.
High concentrations of CB2 receptors are found in the immune and gastrointestinal system. CB2 receptors bind with CBD and regulate appetite, immunity, inflammation, and pain.
It’s thought that in people with PTSD, ECS signaling is disrupted due to endocannabinoid deficiencies or excess — resulting in increased anxiety, fear, and unpleasant memories.
Most cannabinoids act on both CB1 and CB2 receptors, helping them to regain normal function.
As a result, CBD may be useful for PTSD patients.
CBD vs. THC for PTSD
CBD is the primary non-psychoactive component of cannabis and has anti-inflammatory, neuroprotective, anxiolytic and antipsychotic actions— it’s different to THC— which produces the mind-altering effects you may commonly hear about, also known as causing a ‘high’.
CBD doesn’t make you ‘high’— hence its popularity as a therapeutic agent.
Another advantage over other agents (such as THC) is CBD has fewer complications at high doses .
Research Supports CBD for PTSD
Promising research shows that CBD is effective in attenuating some of the major symptoms of PTSD— such as preventing the consolidation of fear memories, reducing anxiety and improving sleep.
In a recent 2018 review, researchers found that CBD offers a safe, therapeutic alternative for treating PTSD— with significant improvements in these symptoms, particularly in reducing the retention of unpleasant memories .
Other research has confirmed that nabilone, a synthetic cannabinoid, is effective in blocking trauma-related nightmares in patients that did not respond to traditional therapies .
As acceptance of CBD widens, more countries have approved the use of medical-grade cannabis for the treatment of PTSD. CBD is recognized as a suitable treatment option with its ability to reduce anxiety and depression, improve sleep, and eliminate flashbacks — all without risk of serious side-effects.
What is PTSD?
PTSD is a chronic psychological condition that can develop after experiencing a traumatic event.
You may be wondering if you or someone you care about has PTSD.
Often, people don’t believe they meet the criteria or have the ‘right’ to have PTSD, because it’s regularly associated with first responders and military veterans.
However, PTSD can affect anyone.
What is a Traumatic Event?
Traumatic events can mean experiencing or witnessing life-threatening events that cause intense fear or threat to safety.
Some Examples of Traumatic Events Include:
- Domestic violence or abuse
- Witnessing someone being killed or seriously injured
- Surviving a car/train/bus accident or plane crash
- Surviving a heart attack or receiving a serious medical diagnosis
- Being a victim of rape or sexual assault
- Victim of a crime, kidnapping, stalking or torture
- Experiencing a life-changing event, such as divorce, unemployment or the death of a loved one
- Experiencing a natural disaster like bushfires, earthquakes, floods
- Experience in war or civil conflict or terrorist attack
What Are The Symptoms of PTSD?
People living with PTSD often experience multiple symptoms as the body and mind try to cope with the stressful event.
PTSD can manifest in many ways — developing into anxiety and depression or reckless behavior. Gut issues, migraines, headaches, and reduced immunity are common symptoms associated with PTSD.
Signs & Symptoms of PTSD (According to The Anxiety and Depression Association of America):
- Flashbacks of the trauma
- Physical symptoms (such as racing heartbeat, sweating, brain fog)
- Trouble sleeping
- Overly emotional, mood alterations (such as rage, shame, blame, negativity)
- Emotional detachment
- Negative beliefs and feelings
- Intrusive thoughts and memories
- Living in fear
- Nightmares and strange dreams
- Difficulty maintaining employment
- Difficulty concentrating
- Avoidance and Social isolation
- Substance abuse
PTSD symptoms can last between a few months to many years after the event — sometimes leading to chronic illness.
Sufferers often feel like they’re on guard, or something’s always about to go wrong, and they’re left feeling exhausted and in fear — which can continue for many years after the event.
Bodily symptoms of shortness of breath, tremors, increased heart rate, memory loss, and poor concentration can hijack our ability to lead a healthy life.
Risk Factors for PTSD
Anxiety and fear are normal adaptive responses that help us cope with threats to our survival. Not everyone who experiences a traumatic event will develop PTSD, but some factors can influence their likelihood of developing it.
Some risk factors of PTSD include:
- A long-lasting or intense trauma (such as childhood abuse or domestic violence)
- First responders and military personnel where there is greater exposure to traumatic events
- Having existing anxiety and depression
- A family history of anxiety and depression
For survivors of trauma, it can be extremely difficult and frustrating to try to understand the psychological and physical changes occurring — and what can be done to ease them.
How Is PTSD Diagnosed?
A doctor may perform a physical exam and a psychological assessment, using the Diagnostic and Statistical Manual of Mental Disorders (DSM-5).
PTSD is identified by signs and symptoms in the following three categories for a period extending from 1 month :
- Reminders of the Exposure — Flashbacks, nightmares, intrusive thoughts
- Activation — Hyperarousal, agitation, insomnia, irritability, aggression, impulsiveness
- Deactivation — Numbing, isolation, avoidance, confusion, anxiety, depression
How Trauma Affects The Nervous System
The nervous system is a complex system that involves nerves and cells, known as neurons, which transmit signals from the brain to various parts of the body.
When the brain experiences any event that has negative consequences from a stressful or dangerous situation, the hormone adrenaline kicks in via the sympathetic nervous system. This is commonly known as ‘fight or flight’ which is a natural, built-in stress response.
However, in PTSD, the stress response is heightened, and instead of returning to normal soon after the threat is over, it’s pushed beyond its limits, and becomes ‘stuck’.
The nervous system loses its ability to self-regulate, leading to psychological and physical distress.
This state is known as hypervigilance. The body is continuously alert in order to avoid danger. As a result, people can startle easily, have increased sweating, a rapid heartbeat, and quick breathing.
Conventional Treatments for PTSD
Conventional treatment usually involves psychotherapy, and can also include medications, such as antidepressants to improve symptoms.
The Mayo Clinic explains the symptoms, causes, current diagnosis, and treatment to treat both children and adults with PTSD.
Those suffering PTSD symptoms often feel their only option is a life relegated to pharmaceutical drugs and therapy. Medications have their place and can be life-saving — but are often ineffective.
Unfortunately, remission in PTSD patients is relatively low. These medications can also have unwanted side effects , including:
Opioids are also prescribed to patients with PTSD, however, they’re highly addictive medications and patients with PTSD may be at a higher risk of developing opioid use disorder compared to patients without PTSD.
Thankfully CBD offers a safer treatment option for people with PTSD without the side effects. However, CBD interacts with many medications.
If you’re thinking about trying CBD oil, it’s important you speak with your doctor before stopping other medications.
When combined with conventional treatment, natural therapies can be beneficial in recovery from PTSD in addition to lifestyle modifications such as:
1. Yoga & Meditation
Research has shown yoga improves emotional regulation, heart rate variability and reduces anxiety and stress .
2. Good Sleep & Hygiene
Ensure enough quality sleep and rest by adopting healthy sleeping habits. Relaxation exercises and improving your sleeping environment so it feels restful and comfortable will help.
In addition to getting enough sleep, showering and taking good care of your hygiene goes a long way to maintain your mental health.
3. Leverage Social Connection & Close Relationships
Use support networks such as family and friends or organizations in your local area. Depending on where you live, there are likely support groups where you can connect with others who have PTSD. Meetup is another excellent way to bond with like-minded people.
A natural and inexpensive way to improve mood, appetite, and sleep is by finding an enjoyable way to get movement into your day — even if it’s simply going for a walk, preferably in nature.
5. Eating a Well-balanced & Clean Diet
Limit caffeine and alcohol can decrease anxiety symptoms . A poor diet high in sugar and processed type foods can lead to low mood, fatigue, increased anxiety, and weight gain.
Although PTSD is not curable, it doesn’t have to run your life.
Key Takeaways: Using CBD For PTSD
Living with PTSD can be difficult. There is no cure but there is hope.
Used in addition to therapies, CBD may relieve many of the symptoms related to PTSD — such as anxiety, depression, insomnia, and prevent nightmares and flashbacks.
CBD Oil offers a safe and effective treatment to reduce symptoms and improve quality of life.
Use of CBD Oil in the Treatment of Posttraumatic Stress Disorder
The overarching objective of the proposed project is to test the clinical efficacy of CBD in the treatment of post-traumatic stress disorder using a rigorous double-blind randomized clinical trial methodology. Participants (n=150) meeting full DSM-5 criteria for post-traumatic stress disorder (PTSD) will be randomized to one of 3 treatment arms: (a) CBD -Isolate; (b) CBD-Broad Spectrum; (c) Placebo oil.
We predict that patients receiving CBD isolate or CBD Broad Spectrum will show significantly greater improvements in PTSD symptoms and functional impairment at the posttreatment, one month, and three month follow-up assessments relative to patients receiving placebo oil. Additionally, we expect that patients receiving CBD Broad Spectrum will show significantly greater improvements relative to patients receiving CBD Isolate.
|Condition or disease||Intervention/treatment||Phase|
|Post Traumatic Stress Disorder||Drug: CBD Isolate Other: CBD Broad Spectrum Other: Placebo oil||Phase 2|
Background and Significance of the Proposed Project
Over 80% of Americans are exposed to a significant trauma sometime during their lifetime and approximately 7% will meet for a threshold diagnosis of posttraumatic stress disorder. PTSD is the most costly anxiety-related disorder and confers significant interference in work, social functioning, increased risk for other physical and mental health problems, and a four-fold increase in suicide rates compared to the general population.
Over the past two decades, trauma-focused psychotherapies for PTSD have been shown to outperform more traditional supportive psychotherapy or pharmacotherapy and have become the first line treatment for PTSD. Despite these advances, trauma focused treatments such as prolonged exposure therapy (PE) are associated with high rates of treatment refusal, and among those who do enter treatment, approximately 25% drop-out. These data highlight the need to develop PTSD treatment strategies that are both effective and more palatable to patients.
More recently, there’s been considerable excitement in the press over the potential therapeutic use of cannabidiol (CBD) products in the treatment of a variety of physical and mental health problems.( Delta-9-tetrahydrocannabinol (delta-9 THC) is still illegal in most states because of its psychoactive abuse potential. In contrast, cannabidiol (CBD) does not convert to THC in the body and has negligible side effects relative to main stream psychiatric drugs (benzodiazepines and antidepressants) commonly prescribed for the treatment of PTSD. Mounting evidence from studies with rodents suggests that CBD may confer significant promising health-related benefits including anti-inflammatory, pain-relieving, anti-cancer, memory enhancement, and facilitation of fear extinction (see White for a recent review).
The biggest success story for CBD use in humans to date comes from controlled randomized clinical trials demonstrating a 50% or more reduction in previously intractable seizures in children suffering from Dravet syndrome and Lennox-Gastaut syndrome. Moreover, several controlled clinical trials have shown promising findings in reducing psychotic symptoms among patients with schizophrenia and among young adults displaying THC-induced psychosis.
Preliminary Evidence that CBD may offer promise in the treatment of anxiety-related disorders has started to emerge. A small pilot trial with 24 patients presenting with social anxiety disorder found that relative to placebo, a single dose of 100 mg of CBD oil led to lower levels of anxiety, cognitive impairment, and discomfort in their actual speech performance as well as their anxiety before the speech. Unfortunately, human treatment studies for anxiety-related problems is limited almost exclusively to single dose effects on an anxiety challenge task. Studies are clearly needed to assess the effects of multi-dose CBD treatments across the full spectrum of trauma and anxiety-related disorders such as posttraumatic stress disorder.
The overarching objective of the proposed project is to test the clinical efficacy of CBD in the treatment of posttraumatic stress disorder using a rigorous double-blind randomized clinical trial methodology.
Specific aims of the project include:
Compare the efficacy of an 8-week multi-dose regimen of two CBD oil formulations (CBD Isolate (300 mg/day) and CBD Broad Spectrum) relative to placebo oil in reducing clinician and patient-rated PTSD symptoms at the posttreatment and one month follow-up assessments.
We predict that patients receiving CBD oil (CBD isolate or CBD Broad Spectrum) will show significantly greater improvement in PTSD symptoms and functional impairment at post-treatment and one month follow-up relative to patients receiving placebo oil.
We also predict that patients receiving the CBD Broad Spectrum formulation will show significantly greater improvement in PTSD symptoms and functional impairment relative to patients receiving CBD Isolate.
Examine predictors of patients’ clinical response to the various treatment combinations.
We expect that the superiority of CBD relative to placebo will be more pronounced for patients showing more severe PTSD symptoms at baseline and for those showing significant sleeping difficulties.
We expect that CBD-treated patients will show equivalent levels of side effects as those receiving placebo oil.
STUDY METHODS AND PROCEDURES
Participant Recruitment: 150 participants between the ages of 18 and older will be recruited through several outlets including notices posted on campus, announcements on our research laboratory website and national organizations related to PTSD and its treatment.
Participant Screening: Participants will undergo a two-stage screening procedure. Stage 1 will be a brief structured web-based screening interview. Stage 2 will be a telephone-administered structured clinical interview (CAPS-5). Participants meeting the following inclusion and exclusion enrollment criteria will be invited to take part in the study (see below).
NOTE: ALL STUDY PROCEDURES ARE COMPLETED AT PARTICIPANTS’ HOMES. NO VISITS TO OUR RESEARCH LABORATORY ARE REQUIRED.
- Meets for a current DSM-5 diagnosis of PTSD as their “primary” mental disorder
- Age between 18 to 70
- Fluent in English
- Willingness to provide signed informed consent online
- No history of a suicide attempt in the past 6 months
- No history of psychosis with the past 6 months
9. No history of current alcohol or substance use disorder within the past 6 months.
10. No current medical problems that would preclude safe ingestion of CBD oil 11. Willingness to refrain from other forms of Cannabis use during the 8-week treatment phase of the study.
12. Has home access to the internet.
Participant Informed Consent:
All study participants will be consented by the study coordinator or a doctoral student research assistant during the screening visit conducted over the phone. The online informed consent document will provide participants with information regarding the aims of the project, what they will be asked to do, any anticipated risks or benefits associated with participating in the study, as well as a clear statement that their participation is voluntary and that they may discontinue participation at any time.
Study Design Overview: The research plan is to conduct a Phase II double-blind placebo controlled randomized clinical trial comparing the efficacy of two CBD oil (300 mg./day) versus Placebo Oil.
Nightly dosing of a hemp-derived formulation of purified CBD isolate (300 mg), CBD Broad Spectrum (300 mg.) or matching placebo oil daily for 8 weeks. Individual doses of both CBD formulations and placebo oil will be provided in identical individual plastic syringes. All patients, PI, and staff who interact with study participants will be blind to participants’ assigned treatment condition.
Clinical Assessment Schedule:
Week 0 – Pre-Treatment Screening Visit: All enrolled study participants will complete from their home a clinical assessment battery consisting of (a) self-report rating scales over the Internet (see measures); and (b) a structured clinical interview (CAPS-5).
Treatment Visits (Weeks 1 – 8) : During this phase, all study participants will (a) receive via Fed-Ex their weekly allotment of CBD/Placebo oil; (b) complete weekly clinical status assessments via the Internet (see measures).
Posttreatment Assessment Visit (Week 9): All participants will complete an online battery of clinical outcome measures identical to those administered during their pre-treatment visit (see outcome measures).
1-Month Follow-up Assessment Visit (Week 13) – All participants will be re-administered the complete battery of primary and secondary outcome measures (see outcome measures).
Primary Clinical Outcomes: The primary clinical outcomes will be (a) scores on the Clinician Administered PTSD Scale (CAPS-5) and (b) independent evaluator ratings of clinical status using the Clinical Global Improvement Scale administered at each of the three posttreatment assessment periods (Week 9, Week 13).
Secondary Clinical Outcomes: Several additional psychiatric outcomes will be assessed at each of the three follow-up assessment visits. These clinical outcomes and their respective measures appear below. Additional information on these measures is available in the accompanying cited publication for each measure.
- Patient-rated PTSD symptoms using the PCL-5
- Depression – Patient Health Questionnaire (PHQ-9)
- Life Impairment – Sheehan Disability Scale (SDS)
- Quality of Life – World Health Organization (WHOQOL-BREF)
- Substance Use Disorders – NIDA-Modified Alcohol, Smoking, and Substance Involvement Screening Test (NIDA M-ASSIST)
- Pittsburgh Sleep Quality Index (PSQI)
Data Management Data Management involves development of methods for ensuring that data collection instruments are programmed; data are properly collected; participants are tracked and monitored over the course of the study; data sets are documented and maintained; variables are created and documented; and main analyses are conducted. To enhance quality control, all data for the current study including demographic information, diagnoses, and participant and clinician rated measures will be directly entered into a HIPPA compliant electronic case report form (eCRF) using Qualtrics – a secure cloud-based platform designed exclusively for supporting HIPPA compliant data capture and storage. Qualtrics provides: (a) An intuitive interface for data entry with data validation; (b) Audit trails for tracking data manipulation and export procedures; (c) Procedures for importing data from external sources; (d) Automated export procedures for seamless data downloads to common statistical packages (SPSS, SAS, Stata, R) to facilitate data analysis; (e) automated and secure data back-up and storage to servers housed at the University of Texas Population Research Center (PRC). Dr. Telch in his role as Principal Investigator will serve as the Senior data manager and will meet bi-weekly with the biostatistician and research staff on issues related to data management.