Cannabis: A potential efficacious intervention for PTSD or simply snake oil?

Abizaid, Alfonso; Merali, Zul; Anisman, Hymie

doi:10.1503/jpn.190021

Cited by 14 publications

(17 citation statements)

References 41 publications

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“…The prolonged stressors and symptoms persistence cause derangement in the central neurobiological process, particularly in the prefrontal cortex, hippocampus, amygdala, and cingulate gyrus [50] , which can lead to nightmares, sleep disruptions, and anxiety [51] , [52] . These symptoms affect patients' quality of life, functional ability, psychosocial functioning, and ability to work [53] . The mechanisms through which cannabis can reduce nightmares or sleep impairments are unknown [21] , [53] .…”

Section: Discussionmentioning

confidence: 99%

“…These symptoms affect patients' quality of life, functional ability, psychosocial functioning, and ability to work [53] . The mechanisms through which cannabis can reduce nightmares or sleep impairments are unknown [21] , [53] . It is speculated that active ingredients in cannabis, such as THC and CBD, potentiate the memory processing and endocannabinoid systems in the brain and thus, reduce sleep impairment, nightmares [53] , and overall PTSD symptoms.…”

Section: Discussionmentioning

confidence: 99%

“…The mechanisms through which cannabis can reduce nightmares or sleep impairments are unknown [21] , [53] . It is speculated that active ingredients in cannabis, such as THC and CBD, potentiate the memory processing and endocannabinoid systems in the brain and thus, reduce sleep impairment, nightmares [53] , and overall PTSD symptoms. Patients with reduced PTSD symptoms and emotional numbing may experience better quality of life, psychosocial functioning, and working ability [54] – [56] .…”

Section: Discussionmentioning

confidence: 99%

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Cannabis in the management of PTSD: a systematic review

Rehman¹,

Saini²,

Huang³

et al. 2021

AIMS Neuroscience

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Introduction Existing reviews exploring cannabis effectiveness have numerous limitations including narrow search strategies. We systematically explored cannabis effects on PTSD symptoms, quality of life (QOL), and return to work (RTW). We also investigated harm outcomes such as adverse effects and dropouts due to adverse effects, inefficacy, and all-cause dropout rates. Methods Our search in MEDLINE, EMBASE, PsycInfo, CINAHL, Web of Science, CENTRAL, and PubMed databases, yielded 1 eligible RCT and 10 observational studies (n = 4672). Risk of bias (RoB) was assessed with the Cochrane risk of bias tool and ROBINS-I. Results Evidence from the included studies was mainly based on non-randomized studies with no comparators. Results from unpooled, high RoB studies showed that cannabis was associated with a reduction in overall PTSD symptoms and improved QOL. Dry mouth, headaches, and psychoactive effects such as agitation and euphoria were the commonly reported adverse effects. In most studies, cannabis was well tolerated, but small proportions of patients experienced a worsening of PTSD symptoms. Conclusion Evidence in the current study primarily stems from low quality and high RoB observational studies. Further RCTs investigating cannabis effects on PTSD treatment should be conducted with larger sample sizes and explore a broader range of patient-important outcomes.

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Section: Discussionmentioning

confidence: 99%

Section: Discussionmentioning

confidence: 99%

Section: Discussionmentioning

confidence: 99%

See 1 more Smart Citation

Cannabis in the management of PTSD: a systematic review

Rehman¹,

Saini²,

Huang³

et al. 2021

AIMS Neuroscience

View full text Add to dashboard Cite

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“…Similarly, the results of open-label [56], populational [57], and double-blind placebo-controlled [56] studies have shown the benefits of using Δ 9 -tetrahydrocannabinol (THC), its synthetic version dronabinol or its analog nabilone to manage insomnia and nightmares in PTSD patients. However, contradictory results have also been reported, leading some authors to question the value of this Cannabis-based approach [58][59][60][61]. Differences in dose, route of administration, treatment regimen, level of THC tolerance, and current and past stress may account for the mixed findings above-mentioned [62].…”

Section: Fear Memory Extinction and Reconsolidationmentioning

confidence: 99%

Effects of ∆9-tetrahydrocannabinol on aversive memories and anxiety: a review from human studies

et al. 2020

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Background: Posttraumatic stress disorder (PTSD) may stem from the formation of aberrant and enduring aversive memories. Some PTSD patients have recreationally used Cannabis, probably aiming at relieving their symptomatology. However, it is still largely unknown whether and how Cannabis or its psychotomimetic compound Δ 9-tetrahydrocannabinol (THC) attenuates the aversive/traumatic memory outcomes. Here, we seek to review and discuss the effects of THC on aversive memory extinction and anxiety in healthy humans and PTSD patients. Methods: Medline, PubMed, Cochrane Library, and Central Register for Controlled Trials databases were searched to identify peer-reviewed published studies and randomized controlled trials in humans published in English between 1974 and July 2020, including those using only THC and THC combined with cannabidiol (CBD). The effect size of the experimental intervention under investigation was calculated. Results: At low doses, THC can enhance the extinction rate and reduce anxiety responses. Both effects involve the activation of cannabinoid type-1 receptors in discrete components of the corticolimbic circuitry, which could couterbalance the low "endocannabinoid tonus" reported in PTSD patients. The advantage of associating CBD with THC to attenuate anxiety while minimizing the potential psychotic or anxiogenic effect produced by high doses of THC has been reported. The effects of THC either alone or combined with CBD on aversive memory reconsolidation, however, are still unknown. Conclusions: Current evidence from healthy humans and PTSD patients supports the THC value to suppress anxiety and aversive memory expression without producing significant adverse effects if used in low doses or when associated with CBD. Future studies are guaranteed to address open questions related to their dose ratios, administration routes, pharmacokinetic interactions, sex-dependent differences, and prolonged efficacy.

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“…Delta-9tetrahydrocannabinol (THC) is the principal psychoactive constituent of cannabis, and most, if not all, of the effects associated with the use of cannabis, are caused by THC (Kimura et al, 2019). Beyond these effects on physical conditions, cannabis has been reported to improve neurocognitive and psychiatric conditions, such as Alzheimer's disease, anxiety disorders, and bipolar disorder (Abizaid et al, 2019;Sarris et al, 2020;Burggren et al, 2019). The endocannabinoid system (ECS) plays key modulatory roles during synaptic plasticity and homeostatic brain processes (Lu & Mackie, 2016).…”

Section: Introductionmentioning

confidence: 99%

Role of Cannabinoid Receptors in Psychological Disorder

Jha

Patel

2020

Borneo J Pharm

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Cannabinoid receptors, located throughout the body, are part of the endocannabinoid system. Cannabinoid CB1 and CB2 receptors are G protein-coupled receptors present from the early stages of gestation, which is involved in various physiological processes, including appetite, pain-sensation, mood, and memory. Due to the lipophilic nature of cannabinoids, it was initially thought that these compounds exert several biological effects by disrupting the cell membrane nonspecifically. Recent biochemical and behavioral findings have demonstrated that blockade of CB1 receptors engenders antidepressant-like neurochemical changes (increases in extracellular levels of monoamines in cortical but not subcortical brain regions) and behavioral effects consistent with antidepressant/antistress activity. We aim to define various roles of cannabinoid receptors in modulating signaling pathways and association with several pathophysiological conditions.

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Cannabis: A potential efficacious intervention for PTSD or simply snake oil?

Cited by 14 publications

References 41 publications

Cannabis in the management of PTSD: a systematic review

Cannabis in the management of PTSD: a systematic review

Effects of ∆9-tetrahydrocannabinol on aversive memories and anxiety: a review from human studies

Role of Cannabinoid Receptors in Psychological Disorder

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