CBD and stress: trials used up to 300 times the EFSA dose

Stress is how the body responds to a demand, such as an exam, an interview or something unexpected, and it fades once the situation has passed. Anxiety looks ahead to a danger. According to the Inserm report on anxiety disorders, it becomes a disorder when it is strong and lasting, out of proportion to any real threat, and disrupts normal functioning.

Anxiety disorders are common. Inserm estimates that 21% of adults will have one at some point in their lives, and that 15% of people aged 18-65 have one in any given year. Women are affected twice as often as men.

Keep the distinction in mind when you read studies. Most CBD trials looked at anxiety induced in a lab, in healthy volunteers or in people with social phobia. They tell you nothing about end-of-day stress, or about an anxiety disorder that has lasted for months.

The usual protocol is the simulated public speaking test. The participant prepares and then gives a filmed speech, while researchers record self-reported anxiety, blood pressure and heart rate at several points.

In the Bergamaschi study, published in 2011 in Neuropsychopharmacology, 24 patients who had never received treatment took 600 mg of CBD or a placebo, 12 per group. The dose came an hour and a half before the test, and those on CBD reported less anxiety and discomfort during the speech.

In 2019, Linares and colleagues compared three doses in 57 healthy men. During the speech, only the 300 mg group reported less anxiety than the placebo group; 150 mg and 600 mg made no difference. The authors describe a bell-shaped curve, already observed in animals, in which a higher dose does not do more. Our article on the biphasic effect of CBD examines it in detail.

The Shannon case series, published in 2019 in The Permanente Journal, is often quoted for its 79.2% figure. It reviews the records of 72 patients who took CBD in addition to their usual care, without a placebo or a comparison group. Its own authors conclude that controlled trials are needed.

The trial that comes closest to repeated use gave the weakest result. In the Netherlands, Kwee and colleagues gave patients who had not responded to treatment either 300 mg of CBD or a placebo before each of eight exposure therapy sessions. CBD improved neither the response to therapy nor the results at the six-month follow-up. The same team reviewed 87 human and animal studies and found that in 70.3% of observations, CBD had no effect on anxiety.

Researchers keep looking because CBD slows the breakdown of anandamide, a molecule the body makes itself, which acts on the receptors of the endocannabinoid system. This is a lead for research and demonstrates nothing yet.

MILDECA states it plainly: unless they have been authorised as medicines, products containing CBD may not make therapeutic claims, on pain of criminal penalties. Epidyolex, for rare epilepsies, is the only one with that authorisation.

The rule comes from Article L5111-1 of the French Public Health Code, under which any product presented as having curative or preventive properties against human diseases is a medicine. An oil sold "against anxiety" or as "anti-stress" would therefore be an unauthorised medicine. The forbidden wordings are listed in our article on advertising CBD products.

A CBD extract that is swallowed also comes under the novel food rules, which require prior EU authorisation. The French situation is described in our overview of CBD regulation in 2026.

For severe anxiety, the French National Authority for Health (HAS) sets a sequence. Healthy habits, work on the causes of anxiety and non-drug treatments come before any benzodiazepine prescription. When these anti-anxiety drugs are prescribed, the total duration should stay within 8 to 12 weeks for most patients.

Inserm mentions cognitive behavioural therapy, which relies on gradual exposure to feared situations, and lifestyle: regular routines, sleep, diet and physical activity.

Meditation has also been studied. A meta-analysis published in 2014 in JAMA Internal Medicine pooled 47 trials with 3,515 participants. After 8 weeks, mindfulness programmes had a moderate effect on anxiety, with low-strength evidence on perceived stress, and they did no better than other active treatments. Our article on CBD and yoga covers this practice.

EFSA published on 9 February 2026 a provisional safe level of 0.0275 mg per kilo per day, which comes to about 2 mg for an adult of 70 kg. In the agency's view, the safety of CBD cannot be established under 25, during pregnancy or breastfeeding, or for people taking medication. Our article on the EFSA reference dose turns this benchmark into drops.

For an anxious person, interactions are the most concrete concern. The Epidyolex summary of product characteristics states that CBD inhibits the CYP2C19 enzyme. Taken with clobazam, a benzodiazepine, CBD multiplies the level of its active metabolite by 3 to 4. Alcohol and other nervous system depressants increase drowsiness. The mechanism is explained in our article on the grapefruit effect.

Two further points:

• ANSES proposed on 21 March 2025 classifying CBD as presumed toxic to reproduction (category 1B). The proposal has gone to the European Chemicals Agency, and it is a reason to abstain during pregnancy;
• a full-spectrum product may contain traces of THC, and Article L235-1 of the French Highway Code penalises the mere presence of THC, with no threshold. This risk is explained in our guide to saliva drug testing.

Anxiety that lasts, returns for no clear reason, disrupts work, sleep or social life, or pushes you to use a substance to cope belongs with a health professional. An over-the-counter product is no answer to it, and your GP is the first person to see.

Under the Mon soutien psy scheme, anyone aged 3 or over can have 12 sessions a year with a partner psychologist. Each session costs €50, of which French health insurance reimburses 60%, and you can book without a doctor's referral.