CAN-SAD: Investigating the Effects of Cannabidiol on Social Anxiety Disorder
Study Details
Study Description
Brief Summary
The purpose of this study is to test whether a single-dose of Epidiolex (cannabidiol) is associated with reduced psychological, physiological, and neuroimaging measures of anxiety in people diagnosed with social anxiety disorder (SAD).
| Condition or Disease | Intervention/Treatment | Phase |
|---|---|---|
|
Phase 4 |
Detailed Description
Using a randomized, double-blind, placebo-controlled, parallel-group study design, this scientific investigation will examine the effect of 3 milliliters (mL) of Epidiolex (100mg cannabidiol/mL) on behavioral, physiological, and neuroimaging measures of anxiety in subjects diagnosed with SAD. The study will enroll 50 subjects with SAD who will be randomized in a double-blind manner to receive either Epidiolex or placebo before experiencing the Trier Social Stress Test (TSST), the gold-standard for ethically inducing stress in a controlled laboratory setting. Following the TSST, neuroimaging measures of emotional processing and self-referential processing will be acquired using functional magnetic resonance imaging (fMRI).
This study will be conducted primarily at Massachusetts Institute of Technology with research and clinical support from Massachusetts General Hospital.
Study Design
Arms and Interventions
| Arm | Intervention/Treatment |
|---|---|
| Active Comparator: Cannabidiol 300mg Cannabidiol (3mL Epidiolex), oral, single-dose |
Drug: Cannabidiol
Participants randomized to the cannabidiol arm will receive 3mL of Epidiolex (100mg cannabidiol/mL) in a single-dose.
Other Names:
|
| Placebo Comparator: Placebo Placebo (3mL sesame seed oil), oral, single-dose |
Drug: Placebo
Participants randomized to the placebo arm will receive 3mL of placebo (sesame seed oil) in a single dose.
|
Outcome Measures
Primary Outcome Measures
- Change in Acute Subjective Anxiety [-180 minutes, -15 minutes, -5 minutes, +10 minutes, +20 minutes, +30 minutes]
Subjective anxiety will be assessed with a modified Visual Analog Mood Scale (VAMS) which utilizes a vertical 100 millimeter (mm) bipolar visual scale between two opposing moods consisting of the following word pairs: calm-excited, relaxed-tense, and tranquil-troubled. Total subjective anxiety for each timepoint will be the average distance from the bottom for the three-question battery. VAMS will be assessed 15 minutes before drug administration (-180 minutes before start of TSST), 150 minutes after drug administration (-15 minutes before start of TSST), after the Anticipation Phase (-5 minutes before start of TSST), after the Stress Procedures (+10 minutes after start of TSST), after 5 minutes in the Recovery Phase (+20 minutes after start of TSST), and 15 minutes after start of the Recovery Phase (+30 minutes after start of TSST).
Secondary Outcome Measures
- Differences in Salivary Alpha Amylase [-180 minutes, -15 minutes, -5 minutes, +10 minutes, +20 minutes, +30 minutes]
Physiological stress will be assessed indirectly with salivary alpha amylase (sAA) activity which is regulated by the sympathetic branch of the autonomic nervous system. Samples will be collected using the SalivaBio Oral Swab (SOS) from Salimetrics. Participants will place the SOS in their mouth for 1-2 minutes at each timepoint to collect saliva. sAA will be assessed 15 minutes before drug administration (-180 minutes before start of TSST), 150 minutes after drug administration (-15 minutes before start of TSST), after the Anticipation Phase (-5 minutes before start of TSST), after the Stress Procedures (+10 minutes after start of TSST), after 5 minutes in the Recovery Phase (+20 minutes after start of TSST), and 15 minutes after start of the Recovery Phase (+30 minutes after start of TSST).
Other Outcome Measures
- Differences in fMRI BOLD Response [+45 minutes]
Patterns of brain activation measured as blood-oxygenation-level dependent (BOLD) signals will be assessed using 3.0 Tesla (3T) functional magnetic resonance imaging (fMRI). Several exploratory imaging paradigms, including the emotional face-matching task (EFMT) and the self-referential comment task (SRCT), will be used to examine differences between participants who receive Epidiolex (cannabidiol) and those that receive placebo. Neuroimaging will begin approximately 210 minutes after drug administration (+45 minutes after the TSST).
Eligibility Criteria
Criteria
Inclusion Criteria:
-
Ability and willingness to provide written informed consent.
-
Sufficiently fluent in English to participate in the trial.
-
Between 18-55 years of age (inclusive).
-
Right-hand dominant.
-
Current medications are stable for past 30 days (no changes to dose or frequency).
-
Negative result on pregnancy test (if female).
-
Negative result on urine drug screening.
-
Current diagnosis of social anxiety disorder (QuickSCID-5).
-
Liebowitz Social Anxiety Scale (LSAS ≥ 60).
Exclusion Criteria:
-
History of bipolar disorder, schizophrenia, psychosis, delusional disorders.
-
History of eating disorder within past 6 months.
-
History of any traumatic brain injury.
-
Currently diagnosed with diabetes mellitus.
-
Presence of severe medical illness that would prevent completion of study procedures.
-
Presence of significant neurological illness or cognitive dysfunction (e.g.; seizures, dementia).
-
History of substance use disorder within past 6 months (other than nicotine and caffeine).
-
Use of any cannabis-containing products in past 30 days (CBD or THC).
-
Use of beta-blockers or benzodiazepines in past 2 weeks.
-
History of claustrophobia.
-
Contraindications for MRI (e.g.; shrapnel).
-
Presence of any other medical condition that, in the investigator's opinion, may interfere with the study procedures.
-
Use of concomitant medication that has a strong interaction with CYP3A4 or CYP2C19 (as assessed through Lexicomp).
-
History of liver disease.
-
History of hypersensitivity to cannabinoids.
-
History of hypersensitivity to sesame seed oil.
-
Currently breastfeeding (if female).
Contacts and Locations
Locations
| Site | City | State | Country | Postal Code | |
|---|---|---|---|---|---|
| 1 | Massachusetts General Hospital | Boston | Massachusetts | United States | 02114 |
| 2 | Massachusetts Institute of Technology | Cambridge | Massachusetts | United States | 02139 |
Sponsors and Collaborators
- Massachusetts Institute of Technology
- Massachusetts General Hospital
Investigators
- Principal Investigator: John D.E. Gabrieli, PhD, Massachusetts Institute of Technology
Study Documents (Full-Text)
None provided.More Information
Publications
None provided.- 2206000688