CBD (Cannabidiol)
Cannabidiol (CBD) is a non-intoxicating cannabinoid; in humans it shows clear benefits in epilepsy, mixed findings in pain and sleep, and in anxiety mostly no difference from placebo.
We evaluated 327 human studies on CBD (cannabidiol), including 183 randomised controlled trials and 55 meta-analyses or systematic reviews; the controlled studies include 12,663 participants in total. As of 10 October 2026.
1. What Is CBD (Cannabidiol)? Occurrence, Origin and Forms
Cannabidiol, or CBD for short, is a cannabinoid from the hemp plant (Cannabis sativa, family Cannabaceae). Unlike THC, it is not intoxicating. It is the active substance in approved medicines for certain forms of epilepsy and is also sold in oils, capsules and skin products; it is studied for anxiety, sleep and pain, among other uses.
Cannabidiol forms in the flowers and resin of the hemp plant, especially in cultivated varieties with a low THC content, known as industrial hemp.
It is obtained by extraction from hemp flowers, usually with supercritical carbon dioxide or alcohol; the extract is diluted in edible oil or further purified into pure cannabidiol. In human studies, the forms examined are mainly the oral solution, capsules, oils taken by mouth, topical products and inhaled forms.
Forms and Preparations Studied
- Oral solution
- Capsules and tablets
- Oil taken by mouth (drops)
- Topical product
- Inhaled form (vaporised)
- Purified cannabidiol (isolate)
Not covered on this page:
- THC and cannabis flowers with intoxicating effects
- Synthetic cannabinoid drugs with a different mechanism of action
- Hemp seed oil, an edible oil from the seeds that contains virtually no cannabidiol
- Other cannabinoids such as CBG or CBN
2. What Does CBD (Cannabidiol) Do? Results by Area
| Area | Result in controlled studies | Strength of evidence | Studies | Participants |
|---|---|---|---|---|
| Pain | mostly no difference | high | 2 meta-analyses · 37 controlled · 30 other | 2,014 |
| Anxiety | mostly no difference | high | 7 meta-analyses · 19 controlled · 22 other | 1,036 |
| Epilepsy | mixed | high | 13 meta-analyses · 4 controlled · 32 other | 835 |
| Addiction | mostly no difference | high | 2 meta-analyses · 9 controlled · 10 other | 323 |
| Psychosis | mostly no difference | moderate | 4 meta-analyses · 3 controlled · 7 other | 98 |
| Skin | mostly improved | moderate | 0 meta-analyses · 2 controlled · 2 other | 47 |
| Sleep | mostly no difference | low | 1 meta-analyses · 12 controlled · 19 other | 2,410 |
| Other investigations | mostly no difference | high | 11 meta-analyses · 85 controlled · 70 other | 3,706 |
How to read the table: counted are human studies whose results concern the area. “High” means at least one meta-analysis and two controlled studies showing improvement, or at least three controlled studies of which three quarters show improvement, with at least 300 participants in total. “Moderate” means at least two controlled studies showing improvement, as a majority, or one meta-analysis alongside controlled studies. “Low” means one controlled study showing improvement. Where an area has no controlled study, the strength of evidence is at most “low” (result “reviews only” or “observational data only”). Everything else is “unclear”. A study counts as showing improvement when at least half of its outcomes in this area improved. Reviews of combination products do not count as meta-analyses; results that only describe side effects or shares of users do not count as an effect. The same study is counted only once.
3. What the Studies Show in Detail
CBD (Cannabidiol) and Pain: Human Studies
For pain, the picture is mixed: in acute toothache, a single oral dose relieved pain more than placebo in one randomized controlled trial 90. After shoulder surgery, pain was lower only on the first day, and opioid consumption did not differ 73. For knee osteoarthritis, after ureteral stenting and for nerve damage caused by chemotherapy, there was no advantage over placebo 7576107. Small studies with preparations for topical application reported less pain in jaw muscle pain and nerve pain in the legs 9394128. Muscle soreness and pain thresholds remained without difference in several controlled studies 130139154181. Robust statements on dose, duration and long-term benefit are lacking.
| Study | Design · participants | Preparation · dose · duration · comparison | Result |
|---|---|---|---|
| 23 Warren et al. 2026 | systematic review | Low-dose oral cannabidiol (≤2.5 mg/kg or ≤175 mg/day); ≤2.5 mg/kg or ≤175 mg/day; PK studies ≤150 mg; single doses 10–160 mg; vs. Placebo or control in randomized controlled trials | Timed walk test and pain in MS: improved (80 mg/day) |
| 26 Walczyńska-Dragon et al. 2025 | systematic review | Cannabidiol, topical or intraoral, sometimes with opioids/NSAIDs; highly heterogeneous, not standardized; vs. various controls, inconsistent | Analgesic effect in chronic myofascial TMD and bruxism: improved; Acute nociceptive pain (pulpitis, third molar surgery): unclear (inconsistent results); Enhancement of conventional analgesics (opioids, NSAIDs): unclear |
| 27 de et al. 2025 | systematic review | Topical and intraoral CBD formulations; vs. Control in 6 randomized and 1 nonrandomized study | Pain reduction: improved |
| 28 Almuntashiri et al. 2025 | systematic review | Cannabis-based medicines including CBD, THC, THC+CBD, CT-3, cannabidivarin; personalized and adjusted, exact dose not reported; study duration not reported; vs. placebo | pain reduction: improved (15 studies); no significant pain relief: no difference (seven RCTs) |
| 30 Reechaye et al. 2024 | systematic review | Cannabinoids, including CBD and THC; vs. Placebo | Pain relief (visual analog scale): improved (33% vs 15%); Reduction in sharp pain (neuropathic pain scale): improved |
| 34 El-Mourad et al. 2024 | systematic review | THC/CBD combination, CBD-rich extract, nabilone, dronabinol; THC/CBD 17/15 mg/day; CBD-rich extract 31.4 mg/day; nabilone 1.7 mg/day; dronabinol 5-10 mg/day; Dronabinol four days; otherwise not reported; vs. no uniform comparator; observational and RCT data | Opioid use in chronic non-cancer pain: improved (significant reduction in opioid use); Opioid use in cancer patients (nabilone): improved (significant reduction in opioid use); Opioid use in acute pain (dronabinol): improved (significant reduction in opioid use) |
| 35 Lewis et al. 2024 | systematic review | Phytocannabinoid preparations incl. CBD, THC, THC/CBD, cannabidivarin; short duration of CBD studies; vs. Placebo | Pain relief with CBD: no difference (no analgesic effect over placebo) |
| 48 Stephens et al. 2022 | systematic review | oral or topical CBD; vs. control groups in included studies | pain relief: improved (early positive results); side effects (limited minor side effects) |
Further studies in this area: 61 67 69 71 72 73 75 76 77 80 85 90 91 93 94 96 97 99 101 106 107 110 112 118 128 130 133 135 138 139 142 146 154 162 164 171 181 184 187 189 199 201 203 206 208 210 211 217 220 221 223 226 232 233 238 240 241 244 246 247 253
CBD (Cannabidiol) and Anxiety: Human Studies
For anxiety, the picture is mixed: one systematic review considers anxiety reduction compared with placebo possible, but the individual results contradict each other 33. Another describes anxiolytic effects mainly after a single dose, for example in social anxiety disorder 11. One study with various doses, but without a placebo group, saw less anxiety in menstruation-related complaints than before the start of treatment 172. Several randomized controlled trials, by contrast, found no difference from placebo in test anxiety, cancer, alcohol or opioid dependence and bipolar depression 6695114117123. In highly stressed students, low-dose full-spectrum CBD oil did not differ from placebo oil in any outcome, including anxiety 63. In women with advanced breast cancer, a single dose before an examination missed the primary endpoint, but a few hours later anxiety was lower than with placebo 100. Two reviews included CBD-rich extracts or partly THC-containing preparations; there, the effect cannot be attributed to cannabidiol alone 1725. Mainly oral solutions, capsules and oils for ingestion were investigated; it remains open which dose, purity and treatment duration are decisive for a possible benefit.
| Study | Design · participants | Preparation · dose · duration · comparison | Result |
|---|---|---|---|
| 11 Larsen et al. 2020 | systematic review · 927 participants | Cannabidiol formulations; form and purity not reported; Dose and dosing schemes varied significantly between studies; vs. 22 controlled trials (833 patients), 3 observational studies (94 patients) | Anxiolytic effects with acute administration: improved; Effect on social anxiety disorder: improved |
| 17 Pereira et al. 2025 | systematic review · 494 participants | CBD-rich formulations (mixture with other cannabinoids); vs. placebo in some studies | anxiety symptoms: improved (reduction in anxiety symptoms) |
| 20 Rutledge et al. 2026 | systematic review · 146 participants | Cannabidiol (form not reported); acute effects; vs. Placebo | Brain activation/perfusion in cortical and subcortical regions: unclear; Certainty of evidence (GRADE) (low to very low) |
| 25 Singh et al. 2025 | systematic review | Cannabidiol in various formulations; 75–1000 mg, variable; acute dosing, duration not reported; vs. placebo or control, not uniform | Subjective anxiety in psychiatric patients: improved (Decreases in subjective anxiety) |
| 33 Coelho et al. 2024 | systematic review | Cannabidiol (CBD); varied dosages; continuous administration (duration not reported); vs. placebo or conventional pharmaceutical treatments | anxiety symptoms: improved |
| 36 Yndart et al. 2024 | systematic review | Cannabidiol, oral or vaporized, sometimes with THC; oral 200-1,500 mg single dose or vaporized 13.75 mg; vs. varied trial designs and controls | anxiety and cognition: improved (9 out of 16 analyzed trials) |
| 43 Tang et al. 2022 | systematic review | cannabidiol from Cannabis sativa with <3% THC, prescription or non-prescription; 400 µg to 6000 mg; vs. randomized clinical trials, controls not reported | anxiolytic effect: improved |
| 45 Oikonomou et al. 2022 | systematic review | Cannabidiol (CBD) or cannabinoid preparations, including nabilone; vs. Placebo or other cannabis formulations | Anxiety and anxiety-induced tremor: improved |
Further studies in this area: 49 50 52 63 64 66 86 89 95 97 99 100 105 114 117 123 126 149 157 171 172 173 184 187 188 197 200 201 205 207 212 213 218 223 225 227 241 244 250 255
CBD (Cannabidiol) and Epilepsy: Human Studies
For epilepsy the situation is clearest: with cannabidiol as an oral solution, seizures were halved in more patients than with placebo 91638; reviews confirm this for other severe childhood epilepsies 213. Seizure frequency also decreased compared with placebo 7951. Liposomal preparations showed a modest benefit 7; in a small controlled study in frontal lobe epilepsy, more patients improved with liposomal cannabidiol than with placebo, while seizure severity remained the same 179. Slightly more patients became seizure-free with cannabidiol than with placebo 29, and in Lennox-Gastaut syndrome the number of seizure-free days increased more 56. The strength of evidence is high because controlled studies and numerous meta-analyses agree. What was studied above all was a highly purified oral solution as add-on therapy to standard treatment (Epidiolex, in Europe Epidyolex), which is approved for Dravet syndrome, Lennox-Gastaut syndrome and tuberous sclerosis. A transdermal preparation for application, by contrast, showed no difference in seizure frequency in a controlled study 62. In Dravet syndrome, cannabidiol performed worse in indirect comparisons than stiripentol and fenfluramine 3146. Adverse events, including serious ones, were more frequent than with placebo 163839; elevated liver values and drowsiness occurred mainly together with valproate or clobazam 7. For mixed preparations with CBDV, THC or combinations, only one review with limited informative value is available 22.
| Study | Design · participants | Preparation · dose · duration · comparison | Result |
|---|---|---|---|
| 1 Bilbao et al. 2022 | meta-analysis · 12,123 participants | Cannabidiol (CBD) compared with dronabinol, nabilone, nabiximols; vs. Placebo or other cannabinoids or comparator groups | Standardized mean difference (SMD): improved (SMD - 0.5[CI - 0.62, - 0.38] high grade) |
| 2 de et al. 2026 | systematic review · 2,592 participants | pharmaceutical-grade cannabidiol; vs. Add-on or monotherapy; subgroups by syndrome, age, dose, clobazam | Proportion achieving ≥ 50% seizure reduction: improved (49.9% (95% CI 44.9-55.0)); Proportion achieving ≥ 75% seizure reduction: improved (26.7% (95% CI 22.0-32.0)); Seizure freedom: improved (5.7% (95% CI 4.0-8.0)) |
| 4 Peacock et al. 2022 | meta-analysis · 1,912 participants | Cannabidiol as novel antiseizure medication; vs. other novel antiseizure medications or placebo | Risk of movement disorders |
| 5 Zhu et al. 2025 | meta-analysis · 1,445 participants | Cannabidiol (pure cannabidiol, oral form); 10 mg/kg/day and 20 mg/kg/day; vs. Fenfluramine, clobazam, rufinamide, felbamate, lamotrigine, topiramate, deep brain stimulation, anterior corpus callosotomy | Ranking for at least 50% reduction in drop seizures (SUCRA): unclear; Ranking for median percentage reduction in drop seizure frequency (SUCRA): unclear; Likelihood of adverse events (SUCRA) |
| 7 Pratama et al. 2026 | meta-analysis · 1,154 participants | Adjunctive cannabidiol, highly purified oral; also liposomal and transdermal formulations; optimal 20 mg/kg per day; vs. Placebo in addition to standard therapy | seizure frequency: improved (pooled RR = 0.72, 95% CI 0.71-0.73; p < 0.0001); seizure frequency (liposomal CBD): improved (modest benefit); seizure frequency (transdermal CBD): no difference (no short-term efficacy) |
| 9 Silvinato et al. 2022 | meta-analysis · 1,034 participants | Cannabidiol as adjunct treatment; vs. Placebo | Frequency of convulsive seizures: improved (reduces the frequency of seizures by 33%); Patients with ≥50% seizure reduction: improved (increases the number of patients with a reduction ≥50% in the frequency of seizures by 20%); Patients with absence of seizures: improved (increases the number of patients with absence of seizures by 3%) |
| 10 Wang et al. 2024 | meta-analysis · 972 participants | oral cannabidiol (CBD); 5, 10, 20, 25 or 50 mg/kg/day; vs. placebo or another CBD dose | antiseizure efficacy: improved (RR: 1.77, 95%CI: 1.28 to 2.44); antiseizure efficacy: improved (RR: 1.91, 95%CI: 1.49 to 2.46); antiseizure efficacy: unclear (RR: 1.61, 95%CI: 0.96 to 2.70) |
| 12 Souza et al. 2022 | systematic review · 745 participants | Oral cannabidiol, partly add-on to anticonvulsants; at least one week; vs. Randomized controlled trials with repeated oral CBD administration | Seizures (1.3%) |
Further studies in this area: 13 14 16 22 31 38 39 46 51 56 58 62 179 182 183 186 190 191 192 193 194 195 196 198 202 216 219 225 228 229 230 231 234 236 239 243 248 249 251 252 254
CBD (Cannabidiol) and Addiction: Human Studies
In addiction disorders, cannabidiol brought no advantage over placebo in several randomized controlled studies regarding drinking amount and craving 95111123135. Cognition in cocaine dependence also did not improve 81. Only drug cue-induced craving decreased in a small study with a single dose in opioid dependence 161. A full-spectrum oil with traces of THC reduced alcohol craving in a pilot study, while a THC-free oil did not 103. A systematic review describes improvements in substance use disorders with inconsistent study results 11. Another review names cannabidiol alone alongside the THC-containing mouth spray nabiximols among the agents that reduced cannabis use compared with placebo 15; a third evaluated cannabidiol and nabiximols together 52. Mostly oral solutions, individual capsules, isolate, and oils were investigated; the studies are small and short, and information on dose, purity, and accompanying standard therapy is often missing.
| Study | Design · participants | Preparation · dose · duration · comparison | Result |
|---|---|---|---|
| 11 Larsen et al. 2020 | systematic review · 927 participants | Cannabidiol formulations; form and purity not reported; Dose and dosing schemes varied significantly between studies; vs. 22 controlled trials (833 patients), 3 observational studies (94 patients) | Effect on substance use disorders: improved |
| 15 Vuilleumier et al. 2022 | systematic review · 667 participants | Cannabidiol, nabiximols, dronabinol, nabilone, PF-04457845; vs. Placebo | Cannabis use and abstinence: improved; Withdrawal symptoms: unclear; Craving: unclear |
| 23 Warren et al. 2026 | systematic review | Low-dose oral cannabidiol (≤2.5 mg/kg or ≤175 mg/day); ≤2.5 mg/kg or ≤175 mg/day; PK studies ≤150 mg; single doses 10–160 mg; vs. Placebo or control in randomized controlled trials | Alcohol craving and impaired control: improved (150 mg/day CBD + 0.41 mg/day THC) |
| 25 Singh et al. 2025 | systematic review | Cannabidiol in various formulations; 75–1000 mg, variable; acute dosing, duration not reported; vs. placebo or control, not uniform | Cognition in substance use disorders: no difference (minimal effects) |
| 32 Dammann et al. 2024 | systematic review | cannabidiol (CBD), various formulations; vs. no uniform comparison due to review of various study designs | amelioration of substance use disorders: improved |
| 52 Khan et al. 2020 | systematic review | Cannabidiol and nabiximols (CBD:THC 1:1); vs. no uniform comparator; graded by levels of evidence | Cannabis withdrawal and cannabis use disorder: improved (Grade B recommendation) |
| 81 Rizkallah et al. 2022 | randomised controlled · 78 participants | Cannabidiol (CBD); 800 mg; 92 days; vs. placebo, double-blind, randomized | Visual memory (PRM, correct answers): no difference (p = 0.080); Inhibition (SST, stop signal reaction time): no difference (p = 0.644); Risky decision making (CGT, quality of decision making): no difference (p = 0.994) |
| 95 Bogenschutz et al. 2026 | randomised controlled · 57 participants | Oral cannabidiol (CBD); 600 mg/day, increased to 1200 mg/day in Study 1; 4–8 weeks (Study 1), 6 weeks (Study 2); vs. Placebo | Average drinks per day: no difference; Percentage heavy drinking days: no difference; Craving: no difference |
Further studies in this area: 103 111 119 123 127 135 150 161 223 224 237 244 255
CBD (Cannabidiol) and Psychosis: Human Studies
For psychosis and schizophrenia the picture is mixed: two systematic reviews see evidence of an antipsychotic effect 1129, a third mentions promising preliminary findings 49. After a single dose, blood flow in the hippocampus in people at high risk of psychosis lay between the values with placebo and those of healthy people 116. This contrasts with results showing no advantage: a meta-analysis found no superiority of cannabidiol oil over placebo or amisulpride in schizophrenia 53, and a randomized controlled study found no difference in psychotic symptoms in bipolar depression 114. In schizophrenia with cannabis dependence, pretreatment with cannabidiol even worsened memory problems and psychotic symptoms after cannabis use 121. The controlled studies are small and short. Three reviews included various preparations, some with THC or the THC-containing mouth spray nabiximols 253252; there the effect cannot be attributed to cannabidiol alone. What was studied above all were oral solutions and cannabidiol oil; form, dose and purity are not reported in many reviews, and whether standard treatment was given alongside is often unclear.
| Study | Design · participants | Preparation · dose · duration · comparison | Result |
|---|---|---|---|
| 11 Larsen et al. 2020 | systematic review · 927 participants | Cannabidiol formulations; form and purity not reported; Dose and dosing schemes varied significantly between studies; vs. 22 controlled trials (833 patients), 3 observational studies (94 patients) | Symptomatic improvement in schizophrenia: improved; Cognitive functioning in psychotic disorders: no difference |
| 25 Singh et al. 2025 | systematic review | Cannabidiol in various formulations; 75–1000 mg, variable; acute dosing, duration not reported; vs. placebo or control, not uniform | Cognition in psychosis and paranoia: unclear (inconsistent results); Cognition in schizophrenia: no difference (minimal effects) |
| 29 Rajput et al. 2025 | systematic review | Cannabidiol (form, dose and purity not reported); vs. THC-containing cannabis or control | Antipsychotic and neuroprotective properties of CBD: improved |
| 32 Dammann et al. 2024 | systematic review | cannabidiol (CBD), various formulations; vs. no uniform comparison due to review of various study designs | amelioration of schizophrenia: improved |
| 49 Kirkland et al. 2022 | systematic review | Cannabidiol (form, dose and purity not reported); vs. Randomized controlled trials or within-subject studies | Promising preliminary findings for psychotic symptoms: improved |
| 52 Khan et al. 2020 | systematic review | Cannabidiol and nabiximols (CBD:THC 1:1); vs. no uniform comparator; graded by levels of evidence | Psychotic symptoms and cognitive impairment: improved; Schizophrenia: improved (Grade B recommendation) |
| 53 Kopelli et al. 2020 | meta-analysis | Cannabidiol oil; vs. Placebo or amisulpride | Overall symptoms of schizophrenia (monotherapy vs amisulpride): no difference (no statistically significant difference); Overall symptoms of schizophrenia (add-on vs placebo): no difference (no significant difference); Cognition (add-on vs placebo): no difference (no significant difference) |
| 114 Pinto et al. 2024 | randomised controlled · 35 participants | Cannabidiol as adjunctive treatment; 150 to 300 mg/day; 8 weeks, monitored to week 12; vs. Double-blind randomized placebo | Psychotic symptoms: no difference |
Further studies in this area: 116 121 223 227 244 255
CBD (Cannabidiol) and Skin: Human Studies
For the skin, the evidence is limited: a randomized controlled study with oral cannabidiol oil found no improvement in severity in psoriasis, but reported less itching 129. A small randomized study with nano-encapsulated cannabidiol cream showed less thickening of the epidermis and less DNA damage after UV-A irradiation than a cream without active ingredient; less redness was seen only in a subset of participants 143. A systematic review names rash as a rare serious adverse effect of oral cannabidiol 12. The studies are small and short, and for most skin conditions, robust data are lacking.
| Study | Design · participants | Preparation · dose · duration · comparison | Result |
|---|---|---|---|
| 12 Souza et al. 2022 | systematic review · 745 participants | Oral cannabidiol, partly add-on to anticonvulsants; at least one week; vs. Randomized controlled trials with repeated oral CBD administration | Rash (1.1%) |
| 129 Roongpisuthipong et al. 2026 | randomised controlled · 28 participants | oral cannabidiol oil; 60 mg/day; 8 weeks; vs. placebo | PASI score: no difference; itch score: improved (reduction in itch scores by Week 8) |
| 143 McCormick et al. 2024 | randomised controlled · 19 participants | Nanoencapsulated cannabidiol cream (nCBD) vs. vehicle cream; 14 days twice daily, then UV-A irradiation, biopsy after 24 hours; vs. Vehicle cream (VC) on contralateral skin site | erythema after UV-A: unclear (21% of participants had less observed erythema); UV-A-induced epidermal hyperplasia: improved (P = .01); cytoplasmic/nuclear 8-oxoguanine glycosylase 1 staining: improved (P < .01) |
| 177 Maghfour et al. 2021 | randomised controlled | Topical CBD and PEA formulations, CBD alone, hemp seed oil; Patch testing up to 48 h; vs. Negative control | Irritation and sensitization on patch testing; Phototoxicity at 48 h |
CBD (Cannabidiol) and Sleep: Human Studies
For sleep, many, mostly small and short studies are available; the results are mixed. Sleep quality improved in two small randomized controlled studies, with a gel for jaw muscle pain and with low-dose CBD in healthy individuals 91131. In insomnia, two randomized controlled studies found no difference from placebo in severity, time to fall asleep, and subjective sleep efficiency 125170. A meta-analysis found no effect on sleep quality for cannabidiol alone, but did for other cannabinoids 8. Also in people with a strong tendency to worry and in stressed students, CBD was not better than placebo 6388. Daytime sleepiness decreased in a small study under cannabidiol, but not under placebo 86; a single dose in healthy students did not change sleepiness 173. In insomnia, measured sleep efficiency after two weeks was better than under placebo, but self-rated sleep efficiency was not 170. In addition, the form, dose, and purity of the tested preparations vary considerably, and the observation periods are mostly short.
| Study | Design · participants | Preparation · dose · duration · comparison | Result |
|---|---|---|---|
| 6 Samanta et al. 2026 | systematic review · 1,343 participants | highly purified cannabidiol oral solution (Epidiolex/Epidyolex); vs. no comparator; change after CBD initiation | sleep: unclear (n = 2/2) |
| 8 da et al. 2025 | meta-analysis · 1,077 participants | Cannabinoids, including CBD and non-CBD cannabinoids; vs. Placebo | Sleep quality with CBD-only therapy: no difference (SMD 0.13; 95 % CI -0.38-0.65; p = 0.61) |
| 17 Pereira et al. 2025 | systematic review · 494 participants | CBD-rich formulations (mixture with other cannabinoids); vs. placebo in some studies | sleep: improved (modest benefits) |
| 23 Warren et al. 2026 | systematic review | Low-dose oral cannabidiol (≤2.5 mg/kg or ≤175 mg/day); ≤2.5 mg/kg or ≤175 mg/day; PK studies ≤150 mg; single doses 10–160 mg; vs. Placebo or control in randomized controlled trials | Sleep duration: improved (160 mg) |
| 41 Ranum et al. 2023 | systematic review | CBD-predominant therapy or nearly equal CBD:THC ratio; vs. no uniform comparison, studies with hypothesis testing | improvement in insomnia symptoms: improved (All studies reported improvement in the insomnia symptoms of at least a portion of their participants.); significant improvement in insomnia outcomes (CBD-predominant): improved (4 of 7 studies); significant improvement in insomnia outcomes (nearly equal CBD:THC): improved (12 of 16 studies) |
| 47 Velzeboer et al. 2022 | systematic review | Cannabis products containing cannabidiol and/or tetrahydrocannabinol; vs. cannabidiol versus tetrahydrocannabinol, no significant differences | sleep improvement in randomized studies: improved (7 out of 19); sleep improvement in uncontrolled trials: improved (7 out of 12); sleep architecture (diagnostic testing): no difference (no improvements in sleep architecture) |
| 52 Khan et al. 2020 | systematic review | Cannabidiol and nabiximols (CBD:THC 1:1); vs. no uniform comparator; graded by levels of evidence | Insomnia: unclear (Grade C recommendation) |
| 54 Saleska et al. 2024 | randomised controlled · 1,793 participants | Capsules with 15 mg CBD isolate or mixtures; 15 mg CBD daily; 4 weeks; vs. CBD isolate vs. CBD+CBN, CBD+CBN+CBC, melatonin, melatonin+... | Sleep disturbance (PROMIS Sleep Disturbance SF 8A): unclear (p < 0.001); Clinically important improvement in sleep quality: unclear (56% to 75%); Comparison CBD isolate vs. CBD+CBN/CBC: no difference |
Further studies in this area: 63 80 86 88 91 93 97 129 131 170 173 183 187 188 189 205 213 216 218 220 223 241 244 250
CBD (Cannabidiol): Further Outcomes in Studies
Further studies address very different questions, such as blood pressure, inflammation, body weight and liver values. In high blood pressure, oral cannabidiol lowered blood pressure more than placebo in two randomized controlled studies, in one of them already after one day of administration 84152. In gum inflammation, inflammation values improved more than with placebo in a randomized controlled study 74; general inflammation markers such as CRP did not change in several others 102134148151175. For body weight, the findings are inconsistent: a systematic review describes rather less appetite and weight 44, in anorexia the BMI increased more than with placebo in a small pilot study 165. Other studies found no difference 102131174. In contrast, there are side effects: in meta-analyses and a randomized controlled study, more adverse events occurred with oral cannabidiol than with placebo 93858, in other studies not 7123166. Liver values rose more often than with placebo in several controlled studies, also in healthy people 96076; at low dose and short administration, no difference was found 73147. Mainly oral solutions, oils, capsules and individual skin products were studied. A review on autism examined CBD-rich extracts with other cannabinoids; their effect cannot be attributed to cannabidiol alone 17. What remains open is the transferability to other forms and dosages as well as the question of how the findings behave with longer use and without accompanying standard therapy.
| Study | Design · participants | Preparation · dose · duration · comparison | Result |
|---|---|---|---|
| 1 Bilbao et al. 2022 | meta-analysis · 12,123 participants | Cannabidiol (CBD) compared with dronabinol, nabilone, nabiximols; vs. Placebo or other cannabinoids or comparator groups | Standardized mean difference (SMD) for Parkinsonism: improved (- 0.41[CI - 0.75, - 0.08] moderate grade) |
| 6 Samanta et al. 2026 | systematic review · 1,343 participants | highly purified cannabidiol oral solution (Epidiolex/Epidyolex); vs. no comparator; change after CBD initiation | neuropsychiatric function: unclear (n = 9/9 studies); cognitive function: unclear (n = 9/9); use of concomitant antiseizure medications: unclear (n = 7/8) |
| 7 Pratama et al. 2026 | meta-analysis · 1,154 participants | Adjunctive cannabidiol, highly purified oral; also liposomal and transdermal formulations; optimal 20 mg/kg per day; vs. Placebo in addition to standard therapy | adverse events (comparable to placebo) |
| 9 Silvinato et al. 2022 | meta-analysis · 1,034 participants | Cannabidiol as adjunct treatment; vs. Placebo | Total adverse events (increases total AEs by 12%); Serious adverse events (increases serious AE by 16%); Treatment abandonment (increases the risk of treatment abandonment by 12%) |
| 10 Wang et al. 2024 | meta-analysis · 972 participants | oral cannabidiol (CBD); 5, 10, 20, 25 or 50 mg/kg/day; vs. placebo or another CBD dose | treatment-emergent adverse events (TEAEs) |
| 12 Souza et al. 2022 | systematic review · 745 participants | Oral cannabidiol, partly add-on to anticonvulsants; at least one week; vs. Randomized controlled trials with repeated oral CBD administration | Gastrointestinal symptoms (59.5%); Somnolence (16.7%); Loss of appetite (16.5%) |
| 15 Vuilleumier et al. 2022 | systematic review · 667 participants | Cannabidiol, nabiximols, dronabinol, nabilone, PF-04457845; vs. Placebo | Adverse events |
| 17 Pereira et al. 2025 | systematic review · 494 participants | CBD-rich formulations (mixture with other cannabinoids); vs. placebo in some studies | social interaction: improved (modest benefits); core ASD symptoms and behavioral outcomes: improved (greater efficacy compared to placebo in some studies) |
Further studies in this area: 18 19 21 22 23 24 25 27 32 36 37 38 40 42 43 44 49 50 52 57 58 59 60 63 64 66 67 70 71 72 73 74 75 76 77 78 79 82 83 84 85 86 87 88 90 92 93 94 95 96 97 98 99 101 102 103 104 108 109 110 111 112 113 114 115 118 120 121 122 123 124 126 127 130 131 132 134 135 136 137 140 141 144 145 146 147 148 149 151 152 153 154 155 156 157 158 159 160 163 165 166 167 168 169 170 172 173 174 175 176 178 180 181 183 184 185 187 188 189 191 193 194 195 197 200 201 203 204 205 206 207 209 210 211 212 213 214 215 216 218 220 222 223 224 225 226 227 232 235 238 241 242 244 245 246 250 253 255
4. How Is CBD (Cannabidiol) Dosed? Preparation, Dose and Duration in Studies
The studies mainly used oral solutions for ingestion, oil drops, capsules and tablets as well as some topical skin products. In epilepsy, a highly purified oral solution was predominantly tested as an add-on therapy to standard treatment. Individual investigations used inhaled or transdermal forms; the doses are shown in the table.
| Preparation or form | Dose | Duration | Study |
|---|---|---|---|
| Capsules with 15 mg CBD isolate or mixtures | 15 mg CBD daily | 4 weeks | 54 |
| Capsules with 15 mg CBD isolate, some plus CBN/CBC/melatonin | 15 mg CBD, 5 mg melatonin, 15 mg CBN, 5 mg CBC | 4 weeks | 55 |
| Plant-derived highly purified cannabidiol (Epidiolex, 100 mg/mL oral solution) | 10 mg/kg/day (GWPCARE3 only) or 20 mg/kg/day | 14 weeks: 2-week titration, 12-week maintenance | 56 |
| Medicinal cannabis: CBD alone or THC/CBD combination | Escalating doses up to 600 mg CBD/day | 4 weeks | 57 |
| highly purified plant-derived cannabidiol (Epidiolex, 100 mg/ml oral solution) | 25 mg/kg/day or 50 mg/kg/day, titrated from 5 mg/kg/day | 16 weeks (4-week titration, 12-week maintenance) | 58 |
| ZYN002, transdermal cannabidiol gel | 250 mg or 500 mg daily (weight-based) | 12 weeks | 59 |
| Cannabidiol, 5 mg/kg/day (2.5 mg/kg twice daily) | 5 mg/kg/day, divided into two doses | 28 days | 60 |
| Plant-derived cannabidiol tablets | 50 mg daily | 24 weeks | 61 |
| Transdermal cannabidiol | 195 mg or 390 mg twice daily | 12 weeks double-blind, then open-label extension up to 2 years | 62 |
| 10% full spectrum CBD-oil, sublingual, over-the-counter | low dose (exact dose not reported) | 30 days, 4-week follow-up | 63 |
| Nanodispersible cannabidiol oral solution 150 mg/mL | — | 15 weeks | 64 |
| Oral capsules with THC 2.5 mg plus CBD 2.5 mg | Three times daily, days -1 to 5 | 7 days per cycle | 65 |
| CBD oil 100 mg/mL, titrated | 0.5 mL once daily to 2 mL three times daily; median selected dose 400 mg/day | 28 days | 66 |
| Cannabidiol (CBD), partly as THC&CBD combination | CBD max 45 mg/day; THC&CBD 22.5/45 mg/day | 6 weeks treatment, then 1-week phaseout | 67 |
| oral CBD-terpene formulation, THC-free | 300 mg CBD plus 1 mg each of eight terpenes | 4 weeks, ≥4 days/week, crossover | 68 |
5. Is CBD (Cannabidiol) Safe? Side Effects in Studies
Adverse events were more common with cannabidiol than with placebo, especially diarrhea, drowsiness, loss of appetite and elevated liver values 123839. In other studies, the side effects did not differ from placebo 7123166. Elevated liver values and drowsiness occurred mainly with concomitant use of valproate or clobazam 712. Several controlled studies also found elevated liver values in healthy individuals 96076, while others did not with a low dose and short administration 73147.
| Study | Reported side effects |
|---|---|
| 1 Bilbao et al. 2022 | Cannabinoids produce different adverse events; low to moderate evidence |
| 2 de et al. 2026 | Somnolence, decreased appetite, diarrhea, fatigue, behavioral changes; transaminase elevation with valproate |
| 3 Chou et al. 2025 | No difference in withdrawals due to adverse events |
| 4 Peacock et al. 2022 | No increased risk of movement disorders with cannabidiol |
| 5 Zhu et al. 2025 | Cannabidiol 20 mg/kg/day most likely to induce adverse events; cannabidiol 10 mg/kg/day second for serious adverse reactions |
| 6 Samanta et al. 2026 | gastrointestinal, most commonly diarrhea (17-34%), vomiting (5-50%), decreased appetite (7-20%) |
| 7 Pratama et al. 2026 | mostly mild; hepatic enzyme elevations and somnolence more frequent with valproate or clobazam |
| 9 Silvinato et al. 2022 | Total AEs +12%, serious AEs +16%, treatment abandonment +12%, transaminase elevation +15% |
| 10 Wang et al. 2024 | TEAEs: no significant difference between doses |
| 11 Larsen et al. 2020 | Overall well tolerated with mild side effects |
| 12 Souza et al. 2022 | Gastrointestinal 59.5%, somnolence 16.7%, appetite loss 16.5%, hypertransaminasemia 12.8% |
| 13 Saranti et al. 2025 | somnolence, loss of appetite, diarrhea, fatigue, increased serum aminotransferases; mostly mild to moderate and reversible |
6. What Remains Open: Limits of the Evidence
- Many controlled studies are small and short, which limits the transferability of the results.
- The form, dose and purity of cannabidiol vary considerably between studies, which makes a direct comparison difficult.
- For combination products with THC or other cannabinoids, the effect cannot be attributed to cannabidiol alone.
- Long-term data on benefits and safety are largely lacking.
- Whether a concomitant standard therapy was given is often unclear and influences the results.
7. Bottom Line: What Is Established About CBD (Cannabidiol)
In controlled studies in humans, cannabidiol as an add-on therapy shows a clear improvement in seizure control in epilepsy. In pain and sleep, the findings are mixed; in anxiety and substance use disorders, controlled studies mostly showed no advantage over placebo. The strength of the evidence is limited by small, short studies and inconsistent preparations. With mixed preparations containing THC or other cannabinoids, it is not possible to attribute the effect to cannabidiol alone.
Frequently Asked Questions
How well has CBD (cannabidiol) been studied in humans?
We evaluated 327 human studies on CBD (cannabidiol), including 183 randomised controlled trials and 55 meta-analyses or systematic reviews; the controlled studies include 12,663 participants in total. As of 10 October 2026.
Does CBD (cannabidiol) help with pain? What the studies show
Does CBD (cannabidiol) help with anxiety? What the studies show
Does CBD (cannabidiol) help with epilepsy? What the studies show
Does CBD (cannabidiol) help with addiction? What the studies show
Does CBD (cannabidiol) help with psychosis? What the studies show
Does CBD (cannabidiol) help with skin? What the studies show
What is cannabidiol and how does it work?
Cannabidiol (CBD) is a cannabinoid from the hemp plant that, unlike THC, is not intoxicating. It is the active substance of approved medicines against certain forms of epilepsy. The mechanisms of action are not fully understood, and the effects vary depending on the area of use.
Which forms of CBD were investigated in the studies?
The studies predominantly used oral solutions for ingestion, oil drops, capsules and tablets. In epilepsy, a highly purified oral solution was mainly used as an add-on therapy. Individual investigations also tested topical skin products or inhaled forms.
How safe is CBD?
In the studies, side effects such as fatigue, loss of appetite, diarrhea and elevated liver values occurred frequently. Some controlled studies found no differences from placebo in side effects. The tolerability depends on dose and concomitant medication; elevated liver values occurred mainly together with valproate or clobazam.
Are there studies on CBD for anxiety?
Yes, several controlled studies investigated CBD for anxiety. Most found no difference from placebo; evidence of an effect comes mainly from reviews and trials with a single dose. The results are mixed, and the studies are often small and short.
Can CBD help with sleep problems?
Two small studies found better sleep quality, one of them with a gel for topical application. Other studies saw no difference from placebo in insomnia. The findings are mixed and the observation periods are usually short.
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Every statement on this page carries its evidence tier — proven, plausible or hypothesis — and leads to the original work. The decision in the individual case rests with the practitioner; we provide the connections.