From the Guidelines
Cessation of cannabis use can lead to panic attacks in some individuals, particularly those who were regular users, due to withdrawal symptoms that include increased anxiety. When considering the potential effects of stopping cannabis use, it's crucial to prioritize the individual's mental health and well-being, as the risk of panic attacks is a significant concern 1. The evidence suggests that long-term daily cannabis users may experience non–life-threatening withdrawal symptoms after cessation of cannabis, including irritability, restlessness, anxiety, sleep disturbances, appetite changes, and abdominal pain 1.
Key Considerations
- The risk of panic attacks is higher in individuals who have been using cannabis regularly, as their brains have adapted to the constant presence of the substance 1.
- Withdrawal symptoms, including anxiety, can occur within 3 days after cessation and may last up to 14 days 1.
- Gradually reducing cannabis use rather than abruptly stopping can help minimize withdrawal symptoms 1.
- Individuals who experience severe anxiety or panic attacks should seek medical help, as their healthcare provider might recommend temporary use of anti-anxiety medications or cognitive behavioral therapy to manage these symptoms 1.
Recommendations for Clinicians
- Be aware of the potential for panic attacks and other withdrawal symptoms in patients who are reducing or stopping cannabis use 1.
- Counsel patients on the importance of gradual reduction in cannabis use to minimize withdrawal symptoms 1.
- Monitor patients for signs of anxiety and panic attacks, and be prepared to provide appropriate treatment and support 1.
From the Research
Cessation of Cannabis Use and Panic Attacks
- The relationship between cannabis use and panic attacks is complex, with some studies suggesting that cessation of cannabis use may lead to panic attacks in some individuals 2.
- A case study published in 2023 reported a 32-year-old male with no prior psychiatric history who experienced panic attacks after quitting cannabis use after 10 years of chronic dependence 2.
- Another study published in 1988 found that patients with panic anxiety were more likely to experience increased anxiety while smoking marijuana, and many spontaneously stopped using marijuana due to increased anxiety 3.
Cannabis Use and Panic Anxiety
- Research suggests that cannabis use can contribute to the development of anxiety disorders, including panic attacks, although the direction of causality is unclear 4, 5.
- A study published in 2020 found that Δ9-tetrahydrocannabinol (THC) was associated with an anxiogenic response, while cannabidiol (CBD) was found to have anxiolytic activity 4.
- Epidemiological studies have found that cannabis use is associated with an increased risk of panic attacks and panic disorder, although the relationship is complex and influenced by various factors 5, 6.
Prospective Associations
- A prospective study published in 2008 found that cannabis use and dependence were significantly associated with an increased odds for the development of panic attacks and panic disorder 6.
- Another study published in 2010 found that lifetime marijuana use was significantly associated with increased odds of a lifetime panic attack history and a current diagnosis of panic disorder 5.