Fliegel Danielle K, Lichenstein Sarah D
Department of Psychiatry, Yale School of Medicine, 1 Church St., 7th Floor, New Haven, CT, 06510, USA.
Psychiatry Res Commun. 2022 Dec;2(4). doi: 10.1016/j.psycom.2022.100074. Epub 2022 Sep 13.
The current review evaluates the potential of cannabidiol (CBD) as a promising pharmacotherapy for social anxiety disorder (SAD). Although a number of evidence-based treatments for SAD are available, less than a third of affected individuals experience symptom remission after one year of treatment. Therefore, improved treatment options are urgently needed, and CBD is one candidate medication that may have certain benefits over current pharmacotherapies, including the absence of sedating side effects, reduced abuse liability, and rapid course of action. The current review provides a brief overview of CBD's mechanisms of action, neuroimaging in SAD, and evidence for CBD's effects on the neural substrates of SAD, as well as systematically reviewing literature directly examining the efficacy of CBD for improving social anxiety among healthy volunteers and individuals with SAD. In both populations, acute CBD administration significantly decreased anxiety without co-occurring sedation. A single study has also shown chronic administration to decrease social anxiety symptoms in individuals with SAD. Collectively, the current literature suggests CBD may be a promising treatment for SAD. However, further research is needed to establish optimal dosing, assess the timecourse of CBD's anxiolytic effects, evaluate long-term CBD administration, and explore sex differences in CBD for social anxiety.
本综述评估了大麻二酚（CBD）作为社交焦虑障碍（SAD）一种有前景的药物疗法的潜力。尽管有多种基于证据的SAD治疗方法，但不到三分之一的患者在治疗一年后症状得到缓解。因此，迫切需要改进治疗方案，而CBD是一种可能比现有药物疗法具有某些优势的候选药物，包括无镇静副作用、滥用可能性降低以及起效迅速。本综述简要概述了CBD的作用机制、SAD中的神经影像学以及CBD对SAD神经基质影响的证据，并系统回顾了直接研究CBD改善健康志愿者和SAD患者社交焦虑疗效的文献。在这两个人群中，急性给予CBD均能显著降低焦虑且无同时出现的镇静作用。一项研究还表明，长期给予CBD可减轻SAD患者的社交焦虑症状。总体而言，现有文献表明CBD可能是一种有前景的SAD治疗方法。然而，需要进一步研究以确定最佳剂量、评估CBD抗焦虑作用的时间进程、评估长期给予CBD的效果，并探索CBD治疗社交焦虑的性别差异。
