cbd oil dosage for depression

Cannabidiol for Treatment Resistant Depression (CBD)

With this study, the investigators will address the following scientific aims:

  1. Demonstrate the antidepressant effects of CBD in human adults with treatment refractory MDD as measured by standard rating scales.
  2. Confirm CBD’s safety profile in human adult patients with MDD.

Condition or disease Intervention/treatment Phase
Treatment Resistant Depression Drug: Active study drug ( oral CBD) Drug: matching placebo Phase 4

Participants will be medically stable and historically failed to respond to one or more adequate trials of commercially available antidepressant drugs during the current depressive episodes. We plan to administer Epidiolex (CBD) or placebo in double blind, randomized, cross-over fashion to 10 depressed adults with MDD over 16 weeks. The study will use a cross-over design so that each participant serves as their own control. The dosage of CBD or placebo CBD will automatically be titrated up and down during the dosing period. Participants first randomized to CBD will automatically be tapered from CBD and switched to placebo CBD after eight weeks. Participants first randomized to placebo CBD will automatically have an equivalent reduction in placebo CBD and be switched to CBD after eight weeks. During the first week after randomization, participants will receive 125mg of CBD or placebo CBD taken twice daily (250mg/day). During the second week after randomization, the dosage will be increased to 250mg of CBD or placebo CBD taken twice daily (500mg/day) for one week. During the third week after randomization, the dosage will be increased to 500mg of CBD or placebo CBD taken twice daily (1000mg/day). Participants will remain on 1000mg/day of CBD or placebo CBD for four more weeks, at which point they will be stepped down to 500mg/day of CBD or placebo CBD for one week, followed by 250mg/day of CBD or placebo CBD for one week.

Study drug and matching placebo will be prepared by the UAB Investigational Pharmacy. Sesame oil will be used to create the placebo. Both the placebo and the active CBD will be flavored with strawberry flavoring. Study medications will be dispensed at weekly visits and each participant will be given 14 single dose syringes to be taken orally twice a day.

At screening participants will undergo a MINI interview, physical examination, and ECG, vital signs, HDRS-17, MADRS, CSSR-S, ATRQ, SF-36 and CGI-S. Laboratory assessment including CBC with differential, TSH with reflex T4, CMP, UA, and UDS will be done at screening.. At screening, the investigators will also administer the following self-report questionnaires to characterize reward sensitivity and other personality features relevant to anhedonia: Social Anhedonia Scale, the Motivation and Energy Inventory and the Physical Anhedonia Scale. The screening period will last up to one week, at which point subjects will present for a baseline randomization visit.

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Participants will be seen on site weekly during the study. Drug effect will be measured using standard rating scales including the HDRS-17, MADRS, SF36, CSSR-S, CGI-I, CGI-S, which will be completed at each visit. The following scales will be completed at every other visit following the screening visit: Social Anhedonia Scale, the Motivation and Energy Inventory and the Physical Anhedonia Scale. At each study visit safety assessments including vital sign assessment and adverse event assessment will be completed. Subjects will also undergo physical examination and an ECG for safety during screening, after 8 weeks of treatment and at the end of 16 weeks of treatment. Laboratory assessment including CBD with differential, CMP, and UA will be done at the 8 week and 16 week visit.

To assess potential changes in cognition while on the study drug/placebo, three computerized tests of cognition will the administered at baseline, Week 8, and Week 16. The Relational & Item Specific Encoding task (RISE) will probe any potential neural abnormalities. The Probabilistic Learning Task will be used to examine neural circuits related to reward processing in major depression disorder. For the working memory task, participants will be shown two images with objects and asked to decide whether the two images differ or not.

Treating Anxiety & Depression Naturally with CBD

Anxiety disorders and depression can be crippling mental health conditions that impact every aspect of your life. It can be especially difficult for patients who are struggling to find a medication that provides them with more benefits than side effects, or those who simply do not want to use medication to manage their condition. Now that medical marijuana is legal in Florida, CBD, or cannabidiol, has become a natural and attractive alternative in the state. Board-certified psychiatrist Dr. Daniel Bober may recommend CBD for anxiety and depression at his Hollywood, FL, practice, to help patients achieve a better quality of life.

Do Patients Find the Treatment to Be Effective?

What Is CBD?

Cannabidiol is a non-psychotomimetic constituent of Cannabis sativa. While CBD is a component of marijuana, it can be derived from both the marijuana and hemp plant which is a cousin of the marijuana plant [1] .While there is limited research on patients, some studies have also shown that CBD can have anti-anxiety and antidepressant effects [2] .

Is CBD Legal?

The use of CBD and its legality is complex as the government considers it in the same class as marijuana but does not typically enforce the same restrictive laws [1] . However, since CBD can be extracted from hemp plants, which do not qualify as marijuana in the state of Florida, many patients easily acquire low-THC CBD products online without a license.

For many patients, a combination of CBD treatment and therapy can be especially beneficial.

CBD is currently marketed as a supplement, so it is not regulated by the U.S Food and Drug Administration (FDA) [1] . As such, it can be nearly impossible to know which other active ingredients manufacturers are including. It is important to only use CBD provided by a trusted source.

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Prevalence of Anxiety & Depression

While 40 million adults in the U.S. are affected by anxiety disorders each year, only 36.9 percent seek treatment [3] . Similarly, 173 million American adults have experienced at least one major depressive episode but 35 percent did not receive treatment [4] . It is alarming that a significant number of patients who are suffering from these serious conditions are not receiving the help they need.

Barriers to Treatment

Patients may be hesitant to seek treatment for several reasons including:

  • Personal choice
  • Financial restrictions
  • Lack of awareness
  • Shame

Dr. Bober is dedicated to erasing the stigma of mental health disorders and helping patients find an effective solution for their condition. CBD may the answer for you or your loved one.

How Does CBD Help Improve Anxiety & Depression?

By helping regulate the endocannabinoid system (ECS) [5] , CBD can improve [6] :

  • Ability to cope with stressors
  • Overall mood
  • State of mind
  • Muscular tension
  • Difficulties concentrating
  • Fatigue

Additionally, CBD may be able to help reduce social anxiety in patients [6] . In reality, CBD products are being used by individuals for widespread uses, from addressing specific conditions to improving overall well-being.

Are CBD Products an Effective Treatment Method?

CBD has been used for everything from anxiety, sleep, chronic pain, depression, and many other conditions. Despite the growing popularity of CBD, there is very little evidence that it works for most conditions. Several studies have found CBD to be harmless, which is to say safe, but that’s very different from proving its effectiveness. According to a study published in 2018, 62 percent of participants reported they were using CBD to treat a medical condition, primarily pain, anxiety, and depression [7] . Additionally, 36 percent reported that CBD was treating their medical condition “very well by itself” [7] .

Important Factors to Consider

To date, the FDA has approved only one drug for previously uncontrollable pediatric seizures. So why all the hype? Well for many, it’s financial motivation. CBD is becoming a multi-billion dollar Industry.

The other problem is a lack of reliability and consistency within the industry. In a 2017 study, Marcel Bonn-Miller, an adjunct assistant professor in the psychiatry department at the University of Pennsylvania’s Perelman School of Medicine, said his team found that nearly 70 percent of the CBD products they analyzed were mislabeled. Many of these products contained less than the reported amount of CBD. Furthermore, because research has been limited to date, there is no consensus on what dose of CBD to use for what conditions.

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Anyone who decides to use CBD should do so with products that have been independent laboratory third-party tested to ensure the vendor’s label and advertising are accurate. All this being said, CBD has shown promise (albeit anecdotally) for a number of conditions and the absence of evidence is not the evidence of absence. More studies are needed to separate these purported benefits from placebo effect and until then, patients must proceed with caution and with skepticism.

Is There a Risk of Marijuana Addiction?

Many patients and loved ones are concerned about marijuana addiction and safety when considering CBD treatment. However, the World Health Organization (WHO) Expert Committee on Drug Dependence (ECDD) found that “CBD exhibits no effects indicative of any abuse or dependence potential”, including signs of withdrawal. This is especially true since many CBD products are available with such low quantities of THC that they provide no intoxicating effects [6] .

Additionally, the WHO reports that CBD is “generally well tolerated with a good safety profile” [6] . However, some negative effects may be experienced when CBD is taken in combination with certain medications. As such, your treatment and CDB usage should be closely managed by a professional.

Your Treatment

As a board-certified psychiatrist, Dr. Bober can prescribe the proper dosage of CBD to safely manage your anxiety disorder or depression. The ratio of CBD to THC is important and varies from patient to patient. Typically, he will start off with a lower dosage and, if that is not effective, it can easily be increased to provide the relief you need. It is important to note that using CBD for anxiety or depression does not mean you should stop therapy. For many patients, a combination of CBD treatment and therapy can be especially beneficial.

With over a decade of experience, Dr. Bober is extensively knowledgable in the treatment of anxiety and depressive disorders. His patients’ health and safety are his primary concerns and he will only recommend CBD if he believes it is the very best solution for your needs or can complement other treatment methods. He can also work in collaboration with your therapist and doctors.

Find Relief with CBD

If you or a loved one are suffering from anxiety or depression, do not let medication deter you. CBD may be an alternative that can change your life. Call (954) 994-1115 to schedule your consultation with Dr. Bober at his Hollywood practice.