Is cannabis treatment for anxiety, mood, and related disorders ready for prime time?

Abstract

Anxiety and related disorders are the most common mental conditions affecting the North American population. Despite their established efficacy, first-line antidepressant treatments are associated with significant side effects, leading many afflicted individuals to seek alternative treatments. Cannabis is commonly viewed as a natural alternative for a variety of medical and mental health conditions. Currently, anxiety ranks among the top five medical symptoms for which North Americans report using medical marijuana. However, upon careful review of the extant treatment literature, the anxiolytic effects of cannabis in clinical populations are surprisingly not well-documented. The effects of cannabis on anxiety and mood symptoms have been examined in healthy populations and in several small studies of synthetic cannabinoid agents but there are currently no studies which have examined the effects of the cannabis plant on anxiety and related disorders. In light of the rapidly shifting landscape regarding the legalization of cannabis for medical and recreational purposes, it is important to highlight the significant disconnect between the scientific literature, public opinion, and related policies. The aim of this article is to provide a comprehensive review of the current cannabis treatment literature, and to identify the potential for cannabis to be used as a therapeutic intervention for anxiety, mood, and related disorders. Searches of five electronic databases were conducted (PubMed, MEDLINE, Web of Science, PsychINFO, and Google Scholar), with the most recent in February 2017. The effects of cannabis on healthy populations and clinical psychiatric samples will be discussed, focusing primarily on anxiety and mood disorders.

Modulatory effects of cannabinoids on brain neurotransmission

“…Turna et al . () have evaluated the evidence for using cannabis for treatment for and anxiety and mood disorders and they have concluded that the evidence supporting use of cannabis as a psychopharmacological treatment for anxiety, mood and related disorders appears to be comprised of a few, primarily single‐dose studies. Unfortunately, these studies have small sample sizes, as well as shortfalls in the overall study designs which limit the clinical application of findings.…”

“…A recent longitudinal study of psychiatry outpatients who used medial cannabis showed at baseline worse mental and physical health function compared with non-users and non-medical use was associated with higher suicidal ideation, worse mental health function and fewer psychiatry visits (Bahorik et al, 2018). Turna et al (2017) have evaluated the evidence for using cannabis for treatment for and anxiety and mood disorders and they have concluded that the evidence supporting use of cannabis as a psychopharmacological treatment for anxiety, mood and related disorders appears to be comprised of a few, primarily single-dose studies. Unfortunately, these studies have small sample sizes, as well as shortfalls in the overall study designs which limit the clinical application of findings.…”

Characteristics of Canadians likely to try or increase cannabis use following legalization for nonmedical purposes: a cross-sectional study

“…12,[39][40][41][42] However, there is very limited evidence that cannabis use is effective for treating symptoms related to mental illnesses (e.g., anxiety and posttraumatic stress disorder). [42][43][44][45] The public may underestimate the harms associated with cannabis use. A 2017 survey of 16 280 US adults found that 22.4% believe cannabis is not addictive and 9% believe there are no risks associated with cannabis use.…”

Examining the use of Cannabinoid-based Medicine among older residential care recipients diagnosed with dementia: A study protocol for a double blind randomised cross-over trial

“…For example in pre-clinical trials, THC is found to be a partial CB1 antagonist and improves immune function (24), encourages amyloidogenesis (14, 21, 22, 4 25, 26), reduces neuropsychiatric symptoms, pain sensation (27), stimulates appetite (20)(21)(22)28) and inhibits acetylcholinesterase, similarly to cholinesterase inhibitors such as Donepezil (29). CBD is an inverse CB1 agonist (30) that promotes neurogenesis and vasodilatation within the brain, increases neuronal plasticity and cerebral blood flow (31), prevents cell destruction, and holds antiinflammatory (neuro and peripheral inflammation), analgesic, anticonvulsant and anxiolytic properties (24). CBD is an important compound as it reverses the negative consequences on cognition and ameliorates the psychoactive properties of THC (20)(21)(22)28).…”