What to know first
CBD (cannabidiol) may reduce anxiety for some people, but it is not risk-free. Side effects range from mild to serious. The most common include drowsiness, fatigue, dry mouth, diarrhea, and appetite changes. CBD can also interact with prescription drugs and, in rare cases, harm the liver. The FDA has not approved CBD for anxiety. Talk with a doctor before you try it, particularly if you take medications or have liver problems.
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Common side effects
- Sleepiness or grogginess, particularly at higher doses
- Dry mouth
- Diarrhea, nausea, or stomach upset
- Changes in appetite
- Dizziness or lightheadedness
- Fatigue
Some people report feeling more anxious or agitated after taking CBD. This can happen when the dose is too high or when the product contains THC. THC can trigger anxiety, paranoia, and rapid heartbeat in sensitive people.
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Serious risks
Liver injury
High doses of CBD can raise liver enzymes. Signs of liver problems include yellow skin or eyes, dark urine, nausea, and stomach pain. Stop using CBD and seek medical care if these appear. People with liver disease or those taking other liver-stressing drugs face higher risk.
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Drug interactions
CBD blocks certain liver enzymes (CYP450). This can raise blood levels of other drugs and increase side effects. Drugs that may interact include blood thinners, antiseizure medications, antidepressants, and some heart drugs. Grapefruit has a similar effect, so avoid combining CBD with grapefruit juice if you take these medications.
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Withdrawal and dependence
Daily high-dose CBD can lead to withdrawal symptoms when stopped, such as irritability, insomnia, and decreased appetite. Dependence is possible but less common than with THC.
How to use CBD safely
Prerequisites: Talk to your doctor. Start with a low dose. Choose a product with a certificate of analysis (COA).
- Ask your doctor if CBD is safe for you, given your medications and health history.
- Start with a low dose, such as 5 to 10 mg per day.
- Wait at least 2 hours to see how your body responds before taking more.
- Keep a log of your dose, time, and any side effects.
- Increase the dose slowly only if you have no side effects and your doctor agrees.
- Stop using CBD and call your doctor if you notice yellow eyes, severe stomach pain, or unusual bleeding.
When to get help
Seek immediate medical attention for signs of liver injury, severe allergic reaction (rash, swelling, trouble breathing), or a fast or irregular heartbeat. If you feel more anxious, paranoid, or confused, stop CBD and contact a healthcare provider.