Medical cannabis for treatment-resistant combat PTSD

Nacasch, Nitsa; Avni, Chen; Toren, Paz

doi:10.3389/fpsyt.2022.1014630

Cited by 8 publications

(2 citation statements)

References 36 publications

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“… 16 Similarly, Pillai et al 17 reported reductions in PTSD symptomatology after commencing CBMP treatment, with effects sizes at 1, 3 and 6 months varying between 0.30 and 0.50 for the avoidance, intrusion and hyperarousal subscales of the Impact of Event Scale – Revised (IES-R), as well as for the total IES-R score. 18 Nacasch et al 19 also reported positive effects of CBMPs for people with PTSD, albeit in a smaller sample.…”

Section: Evidence Base For Use In Ptsdmentioning

confidence: 98%

Medicinal cannabis for treating post-traumatic stress disorder and comorbid depression: real-world evidence

Lynskey,

Athanasiou-Fragkouli,

Thurgur

et al. 2024

BJPsych open

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Background Cannabis-based medicinal products (CBMPs) are increasingly being used to treat post-traumatic stress disorder (PTSD), despite limited evidence of their efficacy. PTSD is often comorbid with major depression, and little is known about whether comorbid depression alters the effectiveness of CBMPs. Aims To document the prevalence of depression among individuals seeking CBMPs to treat PTSD and to examine whether the effectiveness of CBMPs varies by depression status. Method Data were available for 238 people with PTSD seeking CBMP treatment (5.9% of the treatment-seeking sample) and 3-month follow-up data were available for 116 of these. Self-reported PTSD symptoms were assessed at treatment entry and at 3-month follow-up using the PTSD Checklist – Civilian Version (PCL-C). The probable presence of comorbid depression at treatment entry was assessed using the nine-item Patient Health Questionnaire (PHQ-9). Additional data included sociodemographic characteristics and self-reported quality of life. Results In total, 77% met screening criteria for depression, which was associated with higher levels of PTSD symptomatology (mean 67.8 v. 48.4, F(1,236) = 118.5, P < 0.001) and poorer general health, quality of life and sleep. PTSD symptomatology reduced substantially 3 months after commencing treatment (mean 58.0 v. 47.0, F(1,112) = 14.5, P < 0.001), with a significant interaction (F(1,112) = 6.2, P < 0.05) indicating greater improvement in those with depression (mean difference 15.3) than in those without (mean difference 7). Conclusions Depression is common among individuals seeking CBMPs to treat PTSD and is associated with greater symptom severity and poorer quality of life. Effectiveness of CBMPs for treating PTSD does not appear to be impaired in people with comorbid depression.

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Section: Evidence Base For Use In Ptsdmentioning

confidence: 98%

Medicinal cannabis for treating post-traumatic stress disorder and comorbid depression: real-world evidence

Lynskey,

Athanasiou-Fragkouli,

Thurgur

et al. 2024

BJPsych open

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“…From a small number of case reports and uncontrolled studies, beneficial effects on different symptoms in patients with PTSD have been reported after use of cannabis 96 97 98 , THC, nabilone 99 100 101 , and pure CBD 102 103 , respectively.…”

Section: Cannabis -Based Medicines In Selected Psychiatric I...mentioning

confidence: 99%

Cannabinoids in the Treatment of Selected Mental Illnesses: Practical Approach and Overview of the Literature

Müller-Vahl

2024

Pharmacopsychiatry

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Although an increasing number of patients suffering from mental illnesses self-medicate with cannabis, current knowledge about the efficacy and safety of cannabis-based medicine in psychiatry is still extremely limited. So far, no cannabis-based finished product has been approved for the treatment of a mental illness. There is increasing evidence that cannabinoids may improve symptoms in autism spectrum disorder (ASD), Tourette syndrome (TS), anxiety disorders, and post-traumatic stress disorder (PTSD). According to surveys, patients often use cannabinoids to improve mood, sleep, and symptoms of attention deficit/hyperactivity disorder (ADHD). There is evidence suggesting that tetrahydrocannabinol (THC) and THC-containing cannabis extracts, such as nabiximols, can be used as substitutes in patients with cannabis use disorder.Preliminary evidence also suggests an involvement of the endocannabinoid system (ECS) in the pathophysiology of TS, ADHD, and PTSD. Since the ECS is the most important neuromodulatory system in the brain, it possibly induces beneficial effects of cannabinoids by alterations in other neurotransmitter systems. Finally, the ECS is an important stress management system. Thus, cannabinoids may improve symptoms in patients with mental illnesses by reducing stress.Practically, cannabis-based treatment in patients with psychiatric disorders does not differ from other indications. The starting dose of THC-containing products should be low (1–2.5 mg THC/day), and the dose should be up-titrated slowly (by 1–2.5 mg every 3–5 days). The average daily dose is 10–20 mg THC. In contrast, cannabidiol (CBD) is mainly used in high doses>400 mg/day.

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