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In this study, we examined the effects of CBD versus placebo on (i) psychophysiological, craving and anxiety responses to alcohol and appetitive cues; (ii) tolerability measures including cognitive functioning.<\/jats:p><\/jats:sec><jats:sec><jats:title>Methods<\/jats:title><jats:p>Twenty\u2010two non\u2010treatment\u2010seeking individuals with AUD (DSM\u20105) participated in a cross\u2010over, double\u2010blind, randomized trial, receiving either 800\u2009mg of CBD or matched placebo over 3\u2009days. A laboratory alcohol cue reactivity task with appetitive control (juice) and alcohol exposures, and subsequent recovery periods to examine regulation of cue\u2010elicited responses after cue\u2010offset (recovery) was completed, with psychophysiological indices of autonomic nervous system activity (skin conductance, high\u2010frequency heart rate variability [HF\u2010HRV]) and self\u2010reported measures (alcohol craving and anxiety). Self\u2010reported scales of sedation and neuropsychological executive function tasks were also completed.<\/jats:p><\/jats:sec><jats:sec><jats:title>Results<\/jats:title><jats:p>CBD sessions were significantly associated with elevated parasympathetic nervous system (PNS) activity across the task, as indicated by increased HF\u2010HRV. Reductions in self\u2010reported anxiety during cue exposure stages compared to placebo sessions were also evidenced. Reductions in self\u2010reported alcohol craving after cue exposure were seen during CBD sessions only. There were no significant differences between CBD and placebo on executive functioning performance.<\/jats:p><\/jats:sec><jats:sec><jats:title>Conclusions<\/jats:title><jats:p>In a short\u2010term regimen, CBD appears to modulate PNS activity, reduce cue\u2010elicited anxiety during cue exposure and reduce alcohol craving after cue exposure while not significantly impairing cognition. Large, parallel clinical trials with longer term regimens are now needed to determine the therapeutic potential of CBD in the management of AUD.<\/jats:p><\/jats:sec>","DOI":"10.1111\/acer.15514","type":"journal-article","created":{"date-parts":[[2025,2,1]],"date-time":"2025-02-01T15:00:26Z","timestamp":1738422026000},"page":"448-459","update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":12,"title":["Cannabidiol alters psychophysiological, craving and anxiety responses in an alcohol cue reactivity task: A cross\u2010over randomized controlled trial"],"prefix":"10.1111","volume":"49","author":[{"given":"Tristan","family":"Hurzeler","sequence":"first","affiliation":[{"name":"Specialty of Addiction Medicine, Sydney Medical School, Faculty of Medicine and Health University of Sydney  Sydney New South Wales Australia"},{"name":"Edith Collins Centre for Translational Research (Alcohol, Drugs &amp; Toxicology), Royal Prince Alfred Hospital Sydney Local Health District  Sydney New South Wales Australia"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-0777-3033","authenticated-orcid":false,"given":"Warren","family":"Logge","sequence":"additional","affiliation":[{"name":"Specialty of Addiction Medicine, Sydney Medical School, Faculty of Medicine and Health University of Sydney  Sydney New South Wales Australia"},{"name":"Edith Collins Centre for Translational Research (Alcohol, Drugs &amp; Toxicology), Royal Prince Alfred Hospital Sydney Local Health District  Sydney New South Wales Australia"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Joshua","family":"Watt","sequence":"additional","affiliation":[{"name":"Specialty of Addiction Medicine, Sydney Medical School, Faculty of Medicine and Health University of Sydney  Sydney New South Wales Australia"},{"name":"Edith Collins Centre for Translational Research (Alcohol, Drugs &amp; Toxicology), Royal Prince Alfred Hospital Sydney Local Health District  Sydney New South Wales Australia"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Iain S","family":"McGregor","sequence":"additional","affiliation":[{"name":"Lambert Initiative for Cannabinoid Therapeutics University of Sydney  Sydney New South Wales Australia"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Anastasia","family":"Suraev","sequence":"additional","affiliation":[{"name":"Lambert Initiative for Cannabinoid Therapeutics University of Sydney  Sydney New South Wales Australia"},{"name":"School of Psychology, Faculty of Science University of Sydney  Sydney New South Wales Australia"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-8915-8872","authenticated-orcid":false,"given":"Paul S.","family":"Haber","sequence":"additional","affiliation":[{"name":"Specialty of Addiction Medicine, Sydney Medical School, Faculty of Medicine and Health University of Sydney  Sydney New South Wales Australia"},{"name":"Edith Collins Centre for Translational Research (Alcohol, Drugs &amp; Toxicology), Royal Prince Alfred Hospital Sydney Local Health District  Sydney New South Wales Australia"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-0868-9928","authenticated-orcid":false,"given":"Kirsten C.","family":"Morley","sequence":"additional","affiliation":[{"name":"Specialty of Addiction Medicine, Sydney Medical School, Faculty of Medicine and Health University of Sydney  Sydney New South Wales Australia"},{"name":"Edith Collins Centre for Translational Research (Alcohol, Drugs &amp; Toxicology), Royal Prince Alfred Hospital Sydney Local Health District  Sydney New South Wales Australia"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"311","published-online":{"date-parts":[[2025,2]]},"reference":[{"key":"e_1_2_9_2_1","doi-asserted-by":"publisher","DOI":"10.1176\/appi.books.9780890425787"},{"key":"e_1_2_9_3_1","doi-asserted-by":"publisher","DOI":"10.3390\/ph15040473"},{"key":"e_1_2_9_4_1","doi-asserted-by":"publisher","DOI":"10.1016\/S1389-9457(00)00065-4"},{"key":"e_1_2_9_5_1","doi-asserted-by":"publisher","DOI":"10.1006\/nimg.1996.0247"},{"key":"e_1_2_9_6_1","doi-asserted-by":"publisher","DOI":"10.1111\/j.1530-0277.1995.tb01554.x"},{"key":"e_1_2_9_7_1","doi-asserted-by":"publisher","DOI":"10.1037\/\/0021\u2010843x.99.4.344"},{"key":"e_1_2_9_8_1","doi-asserted-by":"publisher","DOI":"10.1046\/j.1360-0443.1999.9433273.x"},{"key":"e_1_2_9_9_1","unstructured":"Cruz N.A. 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