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How much cbd oil vape should i take for anxiety

How To Use CBD To Help Alleviate Anxiety

Dr. Bindiya Gandhi is an integrative medicine physician with expertise in functional and holistic medicine based in Atlanta, Georgia.

Commissions we earn from partner links on this page do not affect our opinions or evaluations. Our editorial content is based on thorough research and guidance from the Forbes Health Advisory Board.

Table of Contents

  • CBD for Anxiety
  • How to Use CBD for Anxiety
  • CBD Dosage for Anxiety
  • Potential Risks and Side Effects

While delta-9-tetrahydrocannabinol (THC) can have a bad rap for being intoxicating and anxiety-inducing, cannabidiol (CBD) can actually be used to relieve anxiety. Research supports this benefit, with several studies reinforcing the positive effects CBD can have on various anxiety conditions. In fact, 51% of U.S. adults who use CBD do so to help alleviate their anxiety, according to a recent Forbes Health survey of 2,000 U.S. adults conducted by OnePoll.

CBD isn’t yet legally cleared as an anxiolytic, or anxiety relief medication. Therefore, it’s up to you—and, ideally, a doctor who specializes in cannabis administration—to determine whether CBD is a safe treatment for your anxiety.

Here’s what the science says regarding CBD’s anxiolytic properties, along with experts’ dosage guidelines and advice on how to take CBD safely.

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CBD for Anxiety

The Food and Drug Administration (FDA) has yet to approve any CBD-based medications for anxiety. However, many studies indicate the substance can be an effective anxiolytic.

CBD for Generalized Anxiety

In 2011, a small trial-tested CBD on participants with generalized social anxiety disorder (SAD) and healthy control patients undergoing a simulated public speaking test (SPST), which is a common anxiety testing method [1] Bergamaschi MM, Queiroz RH, Chagas MH, et al. Cannabidiol reduces the anxiety induced by simulated public speaking in treatment-naïve social phobia patients. Neuropsychopharmacology. 2011;36(6):1219-1226. . Compared to a placebo, CBD significantly reduced anxiety and discomfort in the participants with SAD. In fact, their reduced anxiety levels were comparable to those of the control participants.

Eight years later, a 2019 test compared the efficacy of three CBD doses (150 milligrams, 300 milligrams and 600 milligrams) and a placebo in men taking an SPST [2] Linares IM, Zuardi AW, Pereira LC, et al. Cannabidiol presents an inverted U-shaped dose-response curve in a simulated public speaking test. Revista brasileira de psiquiatria (Sao Paulo, Brazil : 1999). 2019;41(1):9-14. . Compared to a placebo, 300 milligrams of CBD significantly reduced participants’ anxiety during the speech, but the 150-milligram and 600-milligram doses did not. These results highlight how dosage can be highly variable and that more CBD isn’t necessarily more effective.

Meanwhile, another 2019 study tested CBD in much lower doses than most other clinical studies—some participants consumed 25 milligrams a day while others consumed 50 milligrams or 75 milligrams a day [3] Shannon S, Lewis N, Lee H, Hughes S. Cannabidiol in Anxiety and Sleep: A Large Case Series. Perm J. 2019;23:18-041. . Researchers thought higher doses might be too expensive for participants to maintain in their normal lives and that low doses would still prove effective. Indeed, anxiety decreased within the first month for most participants and remained low. Sleep quality also improved, although it fluctuated more than anxiety. Only three patients reported side effects.

CBD for Anxiety and Depression

In 2020, researchers tested the effects of CBD oil at varying doses across 397 patients with a variety of ailments [4] Gulbransen G, Xu W, Arroll B. Cannabidiol prescription in clinical practice: an audit on the first 400 patients in New Zealand. BJGP Open. 2020;4(1):bjgpopen20X101010. . Participants with non-cancer pain or mental health-related symptoms experienced significant improvement in anxiety and depression, as well as in their abilities to complete their usual activities. The use of CBD oil suggested significant pain relief in these groups as well.

CBD for PTSD and Phobia Therapy

A small 2019 study of 11 patients found that, when consumed orally and administered alongside routine psychiatric care, CBD decreased patients’ posttraumatic stress disorder (PTSD) symptom severity [5] Elms L, Shannon S, Hughes S, Lewis N. Cannabidiol in the Treatment of Post-Traumatic Stress Disorder: A Case Series. J Altern Complement Med. 2019;25(4):392-397. .

Other studies suggest CBD can reduce PTSD symptoms when consumed with THC [6] Bitencourt RM, Takahashi RN. Cannabidiol as a Therapeutic Alternative for Post-traumatic Stress Disorder: From Bench Research to Confirmation in Human Trials. Front Neurosci. 2018;12:502. . When taken together, the two compounds create what’s known as the “entourage effect,” where THC enhances the effects of CBD as CBD tempers the effects of THC, resulting in a more well-rounded experience [7] Ferber SG, Namdar D, Hen-Shoval D, et al. The “Entourage Effect”. Terpenes Coupled with Cannabinoids for the Treatment of Mood Disorders and Anxiety Disorders. Curr Neuropharmacol. 2020;18(2):87-96. .

Some studies also suggest CBD can enhance the effects of exposure therapy—which assists patients in dissociating certain cues with a fear response—and cognitive behavioral therapy [8] Das RK, Kamboj SK, Ramadas M, et al. Cannabidiol enhances consolidation of explicit fear extinction in humans. Psychopharmacology (Berl). 2013;226(4):781-792. [9] Blessing EM, Steenkamp MM, Manzanares J, Marmar CR. Cannabidiol as a Potential Treatment for Anxiety Disorders. Neurotherapeutics. 2015;12(4):825-836. .

How to Use CBD for Anxiety

Without clear FDA guidance, optimal CBD use for anxiety varies from person to person. You may find one method works better for you over another. You can consume CBD in the following forms:

  • Oils and tinctures, which come in dropper bottles and are consumed by mouth
  • Gummies, which are chewable, sweet and often fruit-flavored
  • Sprays, which come in bottles with a nozzle to be sprayed in the mouth
  • Capsules, softgels or tablets, which are taken individually by mouth like a pill
  • Vapes, which heat CBD oil without igniting it, resulting in an inhalable vapor
  • Flowers, which are dried hemp plants that are typically ignited and smoked
  • Creams and gels, which introduce CBD topically (through the skin) as a more localized treatment

You may have to try different forms to determine what works best in addressing your anxiety. For instance, when it comes to the absorption of CBD in your bloodstream, vaping and smoking are more effective than edibles like gummies.

CBD Dosage for Anxiety

You also have to find the right CBD dosage for your anxiety. Experts suggest starting small and working your way up depending on how your body reacts.

Many clinical trials jump right to testing high doses. Successful doses evaluated for anxiety relief specifically include:

  • 600 milligrams in patients with SAD in a speech simulation [10] Bergamaschi MM, Queiroz RH, Chagas MH, et al. Cannabidiol reduces the anxiety induced by simulated public speaking in treatment-naïve social phobia patients. Neuropsychopharmacology. 2011;36(6):1219-1226.
  • 300 milligrams in male patients in a speech simulation [11] Linares IM, Zuardi AW, Pereira LC, et al. Cannabidiol presents an inverted U-shaped dose-response curve in a simulated public speaking test. Revista brasileira de psiquiatria (Sao Paulo, Brazil : 1999). 2019;41(1):9-14.

However, other trials suggest much lower doses are also quite effective in treating anxiety.

  • 25 to 75 milligrams for generalized anxiety and/or sleep problems [12] Shannon S, Lewis N, Lee H, Hughes S. Cannabidiol in Anxiety and Sleep: A Large Case Series. Perm J. 2019;23:18-041.
  • 33 to 49 milligrams a day for PTSD, in addition to routine psychiatric treatment [13] Elms L, Shannon S, Hughes S, Lewis N. Cannabidiol in the Treatment of Post-Traumatic Stress Disorder: A Case Series. J Altern Complement Med. 2019;25(4):392-397.

Another study involving hundreds of patients noted success with doses from 40 milligrams to 300 milligrams a day, further supporting the idea that CBD dosage varies significantly, depending on a person’s symptoms and physiology.

Potential Risks and Side Effects

The World Health Organization deems CBD a safe and generally well-tolerated substance. Studies report very few adverse effects, if any.

However, taking CBD while on other medications may pose a risk, as these substances may interact and cause unwanted effects, such as weight gain, drowsiness, upset stomach and change in appetite.

Cheryl Bugailiskis, M.D., a cannabis specialist at Heally, a telehealth platform for alternative medicine, also warns people with preexisting liver injuries and people taking medications that can cause liver injuries should practice caution when using CBD.

CBD Dosage: How Much Should You Take?

Commissions we earn from partner links on this page do not affect our opinions or evaluations. Our editorial content is based on thorough research and guidance from the Forbes Health Advisory Board.

Table of Contents

  • Determining the Best CBD Dosage for You
  • How to Calculate CBD Dosage
  • How to Take CBD

Cannabidiol (CBD) is growing increasingly popular, thanks to its many purported health benefits and non-intoxicating properties (most CBD products contain less than 0.3% tetrahydrocannabinol, or THC). In fact, 60% of U.S. adults have tried CBD at some point and believe it has medicinal benefits, according to a recent Forbes Health survey of 2,000 U.S. adults conducted by OnePoll. As research evolves and sheds light on CBD’s efficacy, especially for pain relief, more and more people are adding it to their daily wellness regimens.

Consumers can choose from a variety of CBD products, from oils to gummies to vapes to capsules. But figuring out the safe and effective CBD dose for an individual is a complex decision.

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Here’s how to find the right CBD dosage for you and how to consume it safely.

Determining the Best CBD Dosage for You

With the exception of one CBD product, a prescription drug used to treat seizures associated with particular syndromes, the Food and Drug Administration (FDA) doesn’t regulate the use of CBD. (In fact, it’s illegal to market CBD as a supplement or add it to food.) Therefore, it’s best to consult a doctor with experience in CBD administration to determine your ideal dosage.

Expressed in milligrams (mg), CBD dosage largely depends on the conditions and symptoms you’re trying to treat and your unique endocannabinoid system, which is associated with motor control, behavior, emotions, the nervous system and homeostasis. CBD dosage remains an area of active research—more large, high-quality studies are needed in different populations to determine appropriate dosing, efficacy and safety guidelines.

“It’s best to start small and gradually increase your dose up to a level that gives you the desired effect,” says Cheryl Bugailiskis, M.D., a cannabis specialist at Heally, a telehealth platform for alternative medicine. Your starting point might look like half a CBD gummy or a drop of oil. Ideally, navigate this process under the guidance of a qualified physician.

If you’re still not sure where to start, mydosage.com offers a questionnaire and CBD calculator to help you based on your specific symptoms and usage goals.

How to Calculate CBD Dosage

When you consume CBD gummies, capsules or softgels, dosage is typically expressed per unit. For example, there may be 50 milligrams of CBD in each individual gummy. These products don’t offer much dosage flexibility since you can’t split up capsules easily. For instance, if one softgel capsule didn’t provide your desired result, you would have to take another full capsule, doubling the total dose.

CBD oil, on the other hand, makes it easier, to begin with a small dose. But calculating CBD oil dosage can be less straightforward. Oils and tinctures tend to come in a dropper bottle and, typically, only the total liquid volume and CBD contents are listed on the label. For example, the label might simply state there’s 1,500 milligrams of CBD in the 30-milliliter bottle.

But what does 1 milliliter look like? Due to the current lack of regulation of CBD, this calculation can be tricky. Start by figuring out the volume of a single drop in your dropper, which is usually 0.05 milliliters, according to Dr. Bugailiskis. If you’re unsure, ask the company.

Here’s where math comes in. Let’s continue with the 30-milliliter bottle with 1,500 milligrams of CBD and 0.05 milliliters in a single drop as our example.

1500mg÷30mL = 50 mg/mL

This bottle contains 50 milligrams of CBD per milliliter. Let’s see how many milligrams are in a drop:

50mg/mL ×0.05mL/drop = 2.5mg/drop

Each drop contains 2.5 milligrams of CBD.

Next, you can calculate how many drops you need to reach your goal dosage. Let’s say you want to consume 25 milligrams each day.

25mg÷2.5mg/drop = 10 drops
10 drops ×2.5mg = 0.5mL

With this CBD oil dosage calculator as your guide, you would find that you needed to consume 10 drops, or 0.5 milliliters, to reach 25 milligrams. And if you intend to consume 25 milligrams daily, you can expect this particular bottle to serve as a 60-day supply.

Some CBD products do some of this math for you and illustrate how many milligrams are in a milliliter, some even marking these points on the dropper so you know exactly what you’re taking.

CBD Dosage for Different Ailments

Without FDA approval, there is little guidance in the U.S. on how much CBD a person should consume for various conditions.

In many medical studies on CBD, you see administered doses reach hundreds of milligrams a day, which sounds severe compared to our starting dosage example of 25 milligrams. However, Steven Phan, founder of Come Back Daily, a CBD dispensary in New York, points out that patients in these studies are often dealing with serious flare-ups and pain-inducing conditions compared to everyday dispensary customers.

Below are clinically-studied CBD dosages based on different ailments and conditions. Note: Some of the formulations studied contained THC as well—not all available dosage research sticks strictly to CBD.

Condition Dose* Anxiety 300mg–600 milligrams a day [1] Linares, Ila M. et al. Cannabidiol presents an inverted U-shaped dose-response curve in a simulated public speaking test . Brazilian Journal of Psychiatry. 2019;41(1):9-14. [2] Bergamaschi MM, Queiroz RH, Chagas MH, et al. Cannabidiol reduces the anxiety induced by simulated public speaking in treatment-naïve social phobia patients . Neuropsychopharmacology. 2011;36(6):1219-1226. Select forms of epilepsy Starting at 2.5 milligrams per kilogram of the person’s body weight twice daily [3] EPIDIOLEX- cannabidiol solution. DailyMed. Accessed 7/4/2021. Central neuropathic and cancer-related pain A maximum of 30 milligrams a day (or 12 sprays) [4] Sativex Oromucosal Spray – Summary of Product Characteristics (SmPC) – (emc). Datapharm. Accessed 7/4/2021. Opioid addiction 400 or 800 milligrams a day [5] Hurd YL, Spriggs S, Alishayev J, et al. Cannabidiol for the Reduction of Cue-Induced Craving and Anxiety in Drug-Abstinent Individuals With Heroin Use Disorder: A Double-Blind Randomized Placebo-Controlled Trial. American Journal of Psychiatry. 2019;176(11):911-922. Arthritis A maximum of 30 milligrams a day (or 12 sprays), or 250 milligrams applied topically [4] Sativex Oromucosal Spray – Summary of Product Characteristics (SmPC) – (emc). Datapharm. Accessed 7/4/2021.

*Dosages are based solely on small, short-term clinical study results where CBD proved significantly successful over placebo. Much larger studies are needed to further strengthen the evidence.

FDA-approved Epidiolex administers CBD orally as a liquid to treat seizures associated with Lennox-Gastaut syndrome, Dravet syndrome and tuberous sclerosis complex. The dosage of Epidiolex is determined by taking the patient’s weight in kilograms (kg) into account.

Several countries, including Canada and those in the U.K., have approved the use of Sativex, an oral spray with equal amounts of CBD and THC, to treat pain stemming from multiple sclerosis. Canada has also approved it for treatment of cancer pain.

The medical and research community still has a long way to go before figuring out what dose works best for each condition. At an individual level, consumers can experiment with caution until they find what works best for them.

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How to Take CBD

Popular ways to take CBD include:

  • Oils and tinctures (extracts of plant material dissolved in ethanol): A liquid that comes in a bottle with a dropper
  • Gummies: A soft, chewable candy that’s often fruit-flavored
  • Sprays: A liquid that comes in a bottle with a nozzle for spraying into the mouth
  • Capsules: Tablets or softgels that are ingested by mouth
  • Vapes: CBD oil that’s heated without ignition, resulting in an inhalable vapor
  • Flower: Dried hemp plant that’s often ignited and smoked
  • Edibles: Any food that CBD oil has been added to, such as brownies or chips
  • Drinks: Any beverage that’s infused with CBD, often in the form of hemp extract

Your CBD product of choice will largely depend on your personal preferences, as well as your budget since prices vary depending on the potency of ingredients and manufacturing processes. Different mediums also offer varying levels of bioavailability—or how much of what you take is actually absorbed into your bloodstream to have an effect. For example, if you ingest 10 milligrams of CBD via 1 milliliter of liquid, your body might absorb about 60% of it, or about 6 milligrams.

Cannabinoids generally have a low bioavailability compared to other substances, according to Jordan Tishler, M.D., a physician specializing in cannabis treatment in Massachusetts. However, “products that contain emulsifiers like egg yolk (brownies) or lecithin (some gummies) do better,” he says.

With that said, ingesting CBD via gummies or other edibles may take longer to take effect since the CBD has to travel to your digestive system to be broken down and absorbed.

Can You Take Too Much CBD?

Like with any substance, you can take more CBD than your body can handle. Studies show doses up to 1,500 milligrams a day have been well-tolerated, but every person is different [7] Bergamaschi MM, Costa Queiroz RH, Zuardi AW, Crippa JAS. Safety and side effects of cannabidiol, a Cannabis sativa constituent. Current Drug Safety. 2011;6(4):237-49. . Ingesting too much CBD can cause unpleasant side effects, such as dry mouth, nausea, diarrhea, upset stomach, drowsiness, lightheadedness and general disorientation. While rare, liver damage can also occur.

What’s more, CBD can have serious interactions with certain medications. In evaluating available information on five prescription CBD-based medications, researchers found 139 medications could have a potential drug-drug interaction with CBD [8] Kocis PT, Vrana KE. Delta-9-Tetrahydrocannabinol and Cannabidiol Drug-Drug Interactions. Medical Cannabis and Cannabinoids. 2020;3:61–73. . People who take certain blood thinners, heart rhythm medications, thyroid medications and seizure medications need to be particularly careful.

At the end of the day, not all supplements are created equal, which is why it’s important to work alongside a health care provider when adding CBD to your wellness regimen and research reliable brands. And while emerging research and anecdotal evidence is promising, more large, randomized-controlled trials are needed to further understand the benefits of CBD and its dosing.