Updated on August 26, 2020.
Medical content reviewed by Dr. Joseph Rosado, MD, M.B.A, Chief Medical Officer
Having an anxiety disorder can be stressful enough without having to navigate mental health care. Many folks with anxiety find they have to try all sorts of prescriptions from their doctors to find the right medication. Not to mention, you can build up a tolerance to the anti-anxiety drug, forcing you to add even more medicine to your daily dosage. You might be starting to think enough is enough.
When you compare medical cannabis with anti-anxiety pharmaceuticals, how does each medication help? While everyone’s reaction to a medication varies, they work more similarly than you think. They both work with the same chemicals in your brain.
Doctors commonly prescribe benzodiazepines for people with anxiety disorders. These medications manage the levels of a neurotransmitter called GABA, which balances your anxiety levels. Early studies show medical marijuana can also impact your GABA levels. So, you can get the same results from benzodiazepines and cannabis.
Medical cannabis and anti-anxiety medication have different side effects, tolerance and risks. Many patients quickly build a tolerance to their benzodiazepines, forcing them to take higher doses. In extreme cases, anti-anxiety medication can cause an overdose. Every year, thousands of people die from overdosing on benzodiazepine medication.
Meanwhile, zero people have died from a marijuana overdose. Some folks do build up a tolerance to marijuana and others may have side effects when overdosing on the herb, but taking too much of it doesn’t have lethal effects.
Pros of Medical Marijuana
Cannabis has been used for centuries both recreationally and medicinally with positive effects. Many people in the U.S. view the legalization of medical marijuana favorably, including members of Congress and the medical community. While many benefits of medical marijuana exist, some of the more prominent ones include:
Alleviate nausea and vomiting. Some studies found medical marijuana can decrease chemotherapy-related nausea which often comes when treating cancer. The herb almost eliminates vomiting.
Relieve muscle spasticity often linked with paralysis and multiple sclerosis.
Combat different forms of chronic pain like neuropathic pain.
Help with loss of appetite associated with certain types of cancer, HIV/AIDS and other conditions.
Be a safer option compared to some other medicines prescribed to treat the same symptoms. For instance, you can use medical weed instead of opioids for managing pain. Not to mention, opioids are typically not used long-term to treat chronic pain because they are highly addictive.
Be taken in other forms other than smoking cannabis to benefit from it medically. Products like topical pain relief treatments, cannabidiol (CBD) oils, edibles and other applications you don’t smoke are now available. However, smoking cannabis alone — without using it along with tobacco — doesn’t increase lung disease risk.
As researchers conduct studies, more of marijuana’s compounds are being found to be medically beneficial. By itself, CBD could lead to further medical treatment advancement options without producing the “high” associated with the compound tetrahydrocannabinol (THC).
Additional Pros of Medical Marijuana for Anxiety Treatment
As we continue learning more about medical cannabis, we’re continually finding new ways it serves as a pharmaceutical and natural alternative medicine. There’s increasing evidence that shows medical weed can effectively treat anxiety disorders.
Marijuana has more consumption methods than anti-anxiety medications. You have a variety of delivery method choices to choose from with each one producing slightly different effects. Some cannabis consumption methods include:
Methods That Take Effect Quickly
Slower Consumption Methods
Capsules or pills
Marijuana’s side effects are also much milder and more manageable than the side effects you may experience with certain prescription medicines. Moreover, opioids and other narcotics and pain relievers put you at risk for addiction. And, there haven’t been any recorded deaths from marijuana overdose like there have been with prescription medication.
Cons of Medical Marijuana
For each person who advocates for the legalization of cannabis for medicinal purposes, there’s another who will argue against it. Some arguments regarding medical cannabis are:
Using marijuana frequently can affect your short-term memory seriously.
Smoked cannabis contains compounds that can cause cancer.
Frequent cannabis use can impair your cognitive ability.
Workplace and automobile accidents have involved cannabis.
Cannabis carries the risk of addiction and abuse.
Marijuana is a Schedule I drug under the Controlled Substances Act and is illegal under federal law.
Anxiety is a general term for a family of different diagnoses and classifications. The most common are:
General Anxiety Disorder
Separation Anxiety Disorder
Social Anxiety Disorder
Obsessive Compulsive Disorder (OCD)
Posttraumatic Stress Disorder (PTSD)
To treat these anxiety disorders and others, doctors can prescribe a variety of medications. Medication, however, is most beneficial when it’s combined with therapy that addresses the anxiety’s underlying psychological triggers. Treatment can include cognitive behavioral therapy, exposure therapy and desensitization therapy. If you’re thinking about pursuing some anxiety treatment, there are some things you should know about the medication options available to you. Some anti-anxiety medications your doctor may prescribe to you could include:
Benzodiazepines, often called benzos for short, are a widely used type of medication for treating anxiety and has the highest usage worldwide. But, they’re also one of the most abused. When you use benzos as instructed by your physician, they can offer substantial anxiety relief, but they’re extremely dangerous when you combine them with alcohol and other depressants and contain physically addictive qualities.
Doctors commonly prescribe these benzos for anxiety:
Rohypnol (Roofies or Flunitrazepam)
Benzos work much like many sedative drugs where they shut your neurotransmitters down and reduce the feelings of tension and anxiety.
Pros of benzos are:
No danger to life-critical body functions, unless you mix benzos with other sedatives
Effective for short-term relief
Immediate seizure prevention and useful sedative for surgery
2. SSRI Antidepressants
Antidepressants come in a wide variety of medicines used for treating depression symptoms. However, because of the way they increase the availability of dopamine, serotonin and other feel-good chemicals in the brain, they also help ease anxiety. Selective serotonin reuptake inhibitors (SSRIs) are the most common type of antidepressants.
When you compare them to benzos, SSRIs have a much lower risk of abuse and dependency. This is because they usually take several weeks of regular use before the full effects kick in. Some common SSRIs are:
Pros of SSRI antidepressants are:
Less disruptive than benzos to brain chemistry
Less potential than benzos for developing an addiction
May be used for many different types of anxiety disorders
Antidepressants are fairly effective for treating anxiety disorder symptoms. But, they shouldn’t be a sole approach.
3. Tricyclic Antidepressants
These work much like SSRIs since they also increase your brain’s feel-good chemicals. You can use these drugs when other medications haven’t worked. They work by keeping more norepinephrine and serotonin available in the brain, but they do have more drastic side effects than other antidepressants. For instance, they may cause you to experience:
Pros of tricyclic antidepressants are:
More immediate effects than SSRIs
Less disruptive than SSRIs and benzos to brain chemistry
Treats short-term anxiety effectively without too many side effects
Cons of Anti-Anxiety Medications
Medications often come with unintended adverse side effects. With anti-anxiety medicines, side effects can range from sexual dysfunction and muscle weakness to upset stomach and confusion. There are logical reasons behind side effects. First, your brain functions rely on neurotransmitters. These are chemicals that allow the communication between neurons. Your brain and body use certain neurotransmitters in various neurological processes.
So, medicines made to influence the activity of a neurotransmitter in one set of brain circuits might also influence unrelated processes. Take serotonin, for instance. This neurotransmitter is thought to be involved in a variety of brain areas that create anxiety. Medicines that increase serotonin brain levels might also affect intestinal processes since serotonin plays a substantial role in the coordination of intestinal muscle contraction. This can lead to negative side effects including diarrhea or constipation.
Since it’s challenging to impact neurotransmitter levels in a specific area without influencing other nervous system parts, individuals should expect when they take anti-anxiety medications.
Cons of benzos are:
Extremely addictive in the sense that dependence and tolerance can develop which requires more medicine to achieve the same effect.
Might cause withdrawal if you stop using them suddenly.
Can cause daytime sedation.
Can cause consciousness and respiration problems, particularly if you combine them with alcohol.
Increases your risk of confusion, falls and possibly dementia, particularly in older adults.
Can lead to memory impairment or attention issues.
Cons of antidepressants are:
Need to take these consistently and daily.
Usually take several weeks to work at a therapeutic dose.
Cons of tricyclic antidepressants are:
May impair motor function.
Not a long-term solution for anxiety.
Doesn’t reduce intense sudden panic feelings.
Won’t Medical Marijuana Make Me Feel More Anxious?
You may have heard some people who use medical marijuana experience increased anxiety as a side effect. While this is true, it’s only in response to certain kinds of medicinal cannabis. While medical professionals and patients recognize marijuana’s medicinal purposes to treat and relieve symptoms of many health-related conditions, when it comes to anxiety, there are certain strains of cannabis you might want to avoid.
Marijuana contains numerous compounds called cannabinoids that interact with receptors in your body to provide health benefits. Although it has so many components, we usually focus on the two most prevalent — THC and CBD. These two compounds are mainly responsible for marijuana’s impact on your health. CBD and THC contain distinct and valuable medicinal properties and have different effects on your body when you take them either individually or together. While THC can cause paranoia and anxiety, CBD promotes a sense of calm.
Whether cannabis medicine will make you anxious or not can highly depend on the ratio of these cannabinoids in your strain. There are two major strains of the cannabis plant — sativa and indica. These can combine to make hybrid strains. Sativa strains are higher in THC, and indica strains are higher in CBD.
Each cannabinoid’s therapeutic and medical properties are different. CBD and THC differ in how their molecules act on the brain’s cannabinoid receptors. THC binds to the CB1 receptor while CBD binds to the CB2 receptor. CBD also blocks CB1 receptors from binding with THC, meaning it reduces the effects of THC, like paranoia, anxiety and its psychoactive high.
CBD has inherent qualities for treating anxiety. It doesn’t make you “high,” but it does provide you with many medical benefits.
THC provides some physical effects of cannabis and gives all of the psychedelic effects, but it tends to induce anxiety, particularly in people who are already struggling with anxiety disorder symptoms.
THC acts as an:
Because it causes that “high” sensation, a higher ratio of CBD to THC would mean less of a “high.”
CBD provides the traits above that THC does, but it also acts as an:
And, it doesn’t cause that “high” feeling like THC. Because of this, many individuals prefer a higher CBD:THC ratio.
So, which CBD:THC ratio is best for anxiety?
The relationship between anxiety and marijuana is a complex one. For some individuals, just a small puff of the herb provides them with relief from panic, stress, worry and other anxiety-related symptoms. But, other individuals, unfortunately, experience increased paranoia and exacerbated anxiety with marijuana. This reaction is common and may be attributed to the high THC content in the strain.
Patients who take medical cannabis and find it makes them anxious shouldn’t fret. You can always work with your doctor and dispensary to try a different kind of medication that won’t make you paranoid. Medical marijuana is a versatile drug, and the side effects vary based on the strain and ingestion method you’re using.
Folks who have an anxiety disorder should ask their dispensary for medicine with high CBD and little to no THC. These high CBD to low THC strains provide many benefits to anxiety sufferers:
Grandaddy Purple (Indica-dominant hybrid)
Amnesia Haze (Indica-dominant hybrid)
Chocolate Chunk (Indica)
Harlequin (Indica-dominant hybrid)
Northern Lights (Indica)
You may want to avoid sativa strains as much as possible. However, there may be sativa strains that can help you with anxiety or indica or hybrid strains that can induce anxiety. Just experiment for yourself, work with your marijuana doctor and budtender, and see what works best for your anxiety symptoms.
Combining Medicinal Cannabis and Anti-Anxiety Medication
If the idea of switching over entirely to cannabis medicine intimidates you, you might be asking yourself, “Can I use marijuana with anti-anxiety medications?” You likely can use medical cannabis as a supplement. Many patients use medical marijuana as part of a combined treatment plan that involves pharmaceuticals and other treatments like therapy.
But, patients who do decide to use both kinds of medicine at the same time should make sure their doctor approves. Work with a doctor with experience in marijuana medicine to determine how to balance your dosages and monitor side effects.
Since anti-anxiety medication and cannabis have some overlapping side effects, taking both can exacerbate them. For instance, folks who take citalopram with medical marijuana might experience confusion, concentration problems and drowsiness. But if you and your doctor take care when adjusting your dosages and dosage time, you can minimize or eliminate these symptoms.
Replacing Your Anti-Anxiety Medication With Marijuana
On the other hand, if you want to try discontinuing your anxiety medication or don’t take any in the first place, you can opt for a cannabis-only regimen. Not only does trying medical marijuana on its own reduce the possibility of drug interactions, but you don’t have to worry about dependency on pharmaceuticals.
An early study shows promise for cannabis replacing anti-anxiety medicine for everyone if the data trends continue. Researchers looked at the cortisol levels and stress ratings of marijuana users and non-users. The group of marijuana users had lower numbers of both in stressful conditions, indicating a blunted stress response. This phenomenon could be used to lower the overactive stress response in people with anxiety disorders.
Other Factors to Consider
If you’re thinking about using medical marijuana, you should know its differences from standard medicine and consider the following factors:
Your state laws: Make sure your state lets patients with anxiety use medical marijuana. Every state has different medicinal cannabis policies.
Accessibility in your area: Even if your state allows medical marijuana treatment for anxiety disorders, you might not have a dispensary or marijuana-friendly doctor in the area. Ensure you have easy access to your medicine before paying the fees for your evaluation and application.
Your other health conditions: Do you deal with any other health problems? If you’re seeing a marijuana-trained doctor for the first time, bring them up in case there are any interactions or side effects you should know about.
Learn More About Medical Marijuana and Talk to Your Doctor About Switching
You don’t have to figure out your medical marijuana treatment alone. The medical marijuana industry has plenty of experts who can happily assist with your decision-making process.
If you’re struggling with anxiety and anxiety qualifies in your state for medical marijuana use, you can start by talking with your current doctor about making the switch to medical weed as well as any benefits and risks of therapeutically using it for your situation.
If your doctor isn’t knowledgeable on medical cannabis or doesn’t agree with CBD use as an alternative or supplemental anxiety treatment, you can search for a medical marijuana doctor and dispensary here at MarijuanaDoctors.com. Our doctors are certified and highly experienced with medical cannabis as well as its many benefits and therapeutic uses. Request a consultation with a marijuana doctor so you can have all your questions answered and any concerns validated and reassured.
Marijuana-trained physicians not only know how to evaluate you for a medical marijuana program, but they also know how to recommend medication for you. Medical dispensaries sell cannabis medicine and have staff members who can guide your purchase. Sign up for our newsletter to stay up-to-date on information about medical cannabis and book your appointment with one of our doctors today.