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cbd oil dosage for ptsd

Clinical Studies and Case Reports

On this site you will find clinical studies with cannabis or single cannabinoids in different diseases and case reports on the use of cannabis by patients.
You may search for diseases (indications), authors, medication, study design (controlled study, open trial, case report etc.) and other criteria.

Introduction: Posttraumatic stress disorder (PTSD) is a pervasive and devastating anxiety disorder, the lifetime prevalence of which, as assessed in several community-based studies, is reach up to 8%. Frequently, PTSD is associated with other mental and somatic conditions such as depression (in up to 70% cases) and severe pain of various origins. Many PTSD patients frequently use marijuana as “a emotional regulation strategy to reduce or to manage perceived aversive psychological or mood states”. Meanwhile, the optimal treatment for PTSD and its comorbid conditions is still in development and the effectiveness and safety of Cannabis (Medical marijuana) use in such patients is not clear.

Methods: As a part of our routine consulting work, we assessed the mental condition of 79 adult PTSD patients, who applied to the Ministry of Health in order to obtain a license for the Medical Cannabis. The group consisted of patients with “pure” PTSD (18 patients), PTSD patients with clinical depression (27 patients) and patients suffering from PTSD/chronic pain comorbidity (34 patients). Clinician-Administered PTSD scale (CAPS) was used for traumatic symptoms assessment and Quality of Life Scale was filled out. The changes in Clinical Global Impression-Improvement scale (CGI-I) were registered. The data on their somatic conditions and pain level was provided by their treating physicians. Only part of them (about 50%) got Medical Cannabis licenses (study group). We followed up them (periodical evaluation) for a period of about two years.

Results: Majority of PTSD patients used also the conventional medications (such as antidepressants and sedatives, pain killers etc), prescribed them by their treating physicians. Medical Cannabis (as sativa and/or indica species) was provided by several companies. The Cannabis daily dosage was in range 2-3 gr/day (containing about 20% of cannabioids active compounds THC/CBD). In most cases a significant improvement in Quality of Life and pain scores, with some positive changes in CAPS scores was observed. Under this combine (Cannabis + conventional medications) treatment, the patients reported a discontinuation or lowering the dosage of pain killers and sedative pharmacological agents. The majority of improved PTSD patients belonged to groups with either pain and/or depression comorbidity. No exacerbations or serious adverse events were reported.

Conclusion: This naturalistic observational study represents a first attempt to assess and to monitor the effectiveness and safety of the Medical Cannabis use in PTSD patients. The results show good tolerability and other benefits (especially in the quality of life & on CGI-I) of such flexible combine approach, particularly, in the patients with either pain and/or depression comorbidity. Further large-scale investigations are needed to substantiate our observations and to elaborate the most effective and safe therapeutic approaches to these difficult-to-treat group.

Clinical Studies and Case Reports On this site you will find clinical studies with cannabis or single cannabinoids in different diseases and case reports on the use of cannabis by patients. You

What Dosage of CBD Should You Take?

Steven Gans, MD is board-certified in psychiatry and is an active supervisor, teacher, and mentor at Massachusetts General Hospital.

A bottle of CBD oil and a medicine dropper

Iryna Veklich / Getty Images

CBD is available in a number of different formulations including creams, tablets, oils, and gummies. These can vary in terms of their ingredients as well as dosages, and there is not a great deal of research available on what dose might be beneficial or safe to treat certain conditions.

Cannabidiol (CBD) is the second most abundant cannabinoid found in marijuana. Unlike tetrahydrocannabinol (THC), CBD does not have psychoactive effects. Interest in the use of CBD for health purposes has grown tremendously in the last few years.

CBD is believed to have a range of positive physical and mental health effects. Because of this, it has become increasingly popular as a way to alleviate everything from anxiety to sleep disorders.

In order to determine if CBD is right for you, it is important to consider its potential benefits, side effects, and available research on safe dosages.

Possible Benefits

CBD is just one of hundreds of different compounds found in the cannabis plant. While cannabis has been used in holistic medicine for many years, only recently have researchers begun to explore some of the medicinal purposes for CBD and other cannabinoids.

While further research is still needed, there is some evidence that CBD may have some beneficial mental health effects. These include:

  • Alleviating depression: Some research also indicates that CBD may be useful as a treatment for depression. Studies suggest that the cannabinoid might have an influence on how the brain responds to serotonin, a neurotransmitter that plays a key role in mood.   People with depression sometimes have a low level of serotonin, so CBD may help the brain use available serotonin more effectively.
  • Improving sleep: While the reasons are not entirely understood and require further research, CBD also appears to have potential as a treatment for sleep problems. For example, one study found that people who took CBD also reported improvements in the quality of their sleep.  
  • Reducing anxiety: Anxiety is one of the most common types of mental health conditions, affecting almost 20% of American adults each year. Research suggests that CBD may help alleviate acute symptoms of a number of anxiety-related conditions including generalized anxiety disorder, obsessive-compulsive disorder, and social anxiety disorder.  

In addition to the mental health benefits, CBD may also have therapeutic benefits for a range of other conditions. The World Health Organization suggests that CBD may have beneficial effects in the treatment of:  

  • Alzheimer’s disease
  • Arthritis
  • Cardiovascular disease
  • Diabetes
  • Infection
  • Inflammation
  • Multiple sclerosis
  • Nausea
  • Pain
  • Psychosis

It is important to remember that these benefits have not yet been conclusively proven. More research is needed to determine the role that CBD might play in the treatment of different disorders and health conditions.

Research

There have been a number of studies that suggest that CBD may have a number of different physical and mental health uses. However, more research is still needed to better understand the substance’s potential applications and possible long-term side effects.

A 2019 comprehensive review published in The Lancet Psychiatry looked at previously published studies.   The review ultimately concluded that there was little evidence to support the use of CBD for mental health purposes and suggested that more research is needed in order to substantiate its use to treat symptoms of conditions such as anxiety, depression, and insomnia.

It is important to remember that this doesn’t mean that CBD isn’t effective. Many of the studies that were included in the review were small, had few participants, and were not randomized controlled trials.

This suggests that more research involving more participants and well-designed studies is needed in order to better understand if, how, and why CBD works.

While its effectiveness is still up for debate, one 2017 review found that it was a relatively safe option.   While it is important to remember that there is still a great deal we don’t yet know about CBD and its effects, it is something that you might opt to try to see if you experience any benefits.

How Much Should You Take?

The dosages used in research studies vary and there is no consensus on how much should be used for specific conditions. If you do decide to try CBD, it is also important to note that there is no universally agreed upon dose. Research also suggests that people may respond differently to various dosages, so the amount that is right for your needs might vary.

CBD Dosages

Some dosages that have been used in research studies for different conditions include:

  • Anxiety: 300 to 600 mg  
  • Bowel disease: 10 mg per day  
  • Cancer-related pain: 50 to 600 mg per day  
  • Parkinson’s disease: 75 to 300 mg per day  
  • Poor sleep: 25 mg per day  
  • Psychosis: 600 mg per day  

One 2020 review of studies found that participants showed improvements in anxiety levels after single doses of CBD ranging from 300 to 600 mg.   Such results indicate that the CBD may hold promise as a treatment to alleviate symptoms of acute anxiety.

It is important to remember that you should always talk to your doctor before using CBD if you have symptoms of a serious mental or physical health condition. CBD could potentially worsen symptoms or interact with other medications you are taking.

Looking at the dosage information for the CBD product that has been FDA approved can also be helpful. For Epidiolex, an FDA-approved cannabis-derived medication used to treat seizures in people with certain types of epilepsy, the starting dosage is 5 milligrams per kilogram of body weight. This dose can later be increased to 5 mg per kilogram of body weight twice a day.

Other CBD products are not FDA regulated and do not have officially recommended dosages. This can make it difficult to determine how much you might need, but there are some things you can consider that might help.

  • Assess your sensitivity to CBD: Your individual ability to tolerate CBD can also play a role in determining how much you need. If you are very sensitive to the effects of CBD, you should take a small dose. Some people may find that they are not as affected by the substance, so they may need to take a larger dose to notice any beneficial effects.
  • Consider individual factors: When you are trying to decide how much CBD to take, there are a number of factors you should consider. These include the formulation and concentration of the capsule, oil drops, or gummies you are taking, the symptoms you are treating, and your age, sex, weight, and overall health. Generally, people with heavier bodies need to take a little more to achieve the same effects. Men may need a larger dose, while older people may need less.
  • Consider the symptoms you’re treating: The symptoms you are trying to alleviate can also play a role in the CBD dosage you need to take to see results. In one study, participants who took 25mg of CBD each day had improved sleep quality, although the results were not consistent.   However, you might find that you need a lower or higher dose if you are treating another type of condition.
  • Try a dosage calculator: Researchers note that while the variety of dosing strategies and formulations make it difficult to determine efficacy, there are a number of online “dose-calculators” available online (such as mydosage.com) that are designed to help people choose the correct dose.   The accuracy of such calculators is difficult to assess, but it may be a good place to start.

Before you try CBD, discuss your plan with your doctor. They may be able to recommend a dose and help you better understand any potential risks, complications, side effects, or interactions you might experience.

Start With a Low Dose

Unless your doctor recommends a specific dose, start by taking 10 to 20 mg a day. Take this for a week to ensure that it is well-tolerated and that you don’t experience any unwanted effects or an allergic reaction.

If this dose does not have the desired effect, try increasing in increments of 5mg each week until the desired amount is reached.

In studies, amounts vary from as low as 20 milligrams per day to up to 1,500 milligrams (mg) per day. The World Health Organization reports that dosages in clinical research studies typically range between 100 and 800 milligrams per day.  

Is It Possible to Take Too Much?

So what is the maximum amount of CBD you should take? Researchers have found that 600 mg per day appears to be safe, but one study suggested that doses of up to 1,500 mg a day are safe and tolerated well.  

However, it’s important to remember that research is still in its infancy and experts do not yet fully understand the potential long-term impacts of CBD usage. For that reason, you should always discuss your CBD use with your doctor.

Starting at a lower dose and working your way up to the amount you need may be the best ways to avoid taking too much.

How to Take CBD

The amount of CBD found in a product may depend on different factors, including the formulation and method of administration. CBD products are available in a number of different forms including oils, capsules, tablets, nasal sprays, and gummies.

One of the most popular ways to take CBD is as an oil. Such products are made by combining CBD with some type of carrier oil, such as coconut oil. Some more recently developed products include dietary supplements, foods, beverages, lotions, salves, and cosmetics.

The type of CBD product you choose may depend on what you are trying to treat. If you are looking for general mood improvements, a dietary supplement might be a good option.

If you are targeting specific symptoms of a condition, taking an oil, capsule, or gummy might be a better way to obtain a higher, more concentrated dose.

Topical applications may produce localized effects, but they are unlike to have any mental health benefits.

What Kind Should You Take?

It’s also important to remember that many products don’t contain just CBD on its own. There are three types of CBD available:

  • Isolate contains CBD and only CBD.
  • Broad-spectrum contains CBD and other cannabinoids, but not THC.
  • Full-spectrum contains CBD, THC, and other cannabinoids.

It may be helpful to take a broad-spectrum product since research suggests that CBD’s effects may be most beneficial when taken in conjunction with other cannabinoids, a phenomenon known as the entourage effect. CBD may also help mitigate some of the effects of THC.

Side Effects

While CBD is generally well-tolerated, this does not mean that you won’t experience any side effects.

Some of the most common side effects that people experience when taking CBD include:

  • Appetite changes
  • Diarrhea
  • Nausea
  • Dizziness
  • Stomach upset
  • Weight changes

Some recent research has generated concerns over the safety and potential long term effects of CBD. One study involved giving mice an equivalent of the maximum dose of the CBD medication Epidiolex, which is used to treat certain forms of epilepsy. The results indicated an increased risk for liver damage as well as concerns over its interaction with other medications.  

Safety

It is also important to remember that CBD products are not regulated by the U.S. Food and Drug Administration (FDA). Some manufacturers make unproven claims about the uses and efficacy of their products. There is also concern about the quality and safety of the products themselves.

One report by the Centers for Disease Control and Prevention (CDC) indicated that a number of people experienced negative unwanted side effects due to CBD products that contained synthetic CBD, although the products were not labeled as containing such ingredients.  

Mislabeling appears to be a fairly common problem with CBD products. In one study, 70% of the CBD products that were sold online contained significantly more of the psychoactive ingredient THC than the label indicated.  

Federal law prohibits the sale of products that contain more than 0.3% THC. States laws also vary, so you should always check with your state before buying CBD products online.

A Word From Verywell

If you do decide to take CBD to alleviate an acute or chronic condition, remember that the amount that you take will depend on a variety of factors. Finding the right dosage often takes some experimentation and adjustments. Starting with a low dose and then gradually increasing the amount you take until you achieve the desired effects is the best approach.

CBD holds promise as a treatment for a range of conditions, but how much should you take? Learn more about CBD dosages for different purposes.