Cannabis Treatments for PTSD Show Promise but Lack Evidence, Review Finds
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Despite increasing prescription rates, cannabis treatments for post-traumatic stress disorder (PTSD) aren’t supported by adequate evidence, according to a new review of existing studies.
The systematic review, published in the Journal of Dual Diagnosis, found that cannabinoids such as CBD hold promise for reducing nightmares and assisting with sleep, but more research is needed to determine if these cannabis compounds should be used in routine clinical practice.
Marijuana and PTSD
PTSD is a type of anxiety disorder that can develop following exposure to a stressful event. Typical symptoms can include nightmares, hyper-reactivity, and insomnia; many with the condition are at a greater risk of developing other mental health problems and engaging in self-destructive behaviors.
As cannabinoids can module the body’s natural endocannabinoid system, which has been recognized as an important factor in the body’s response to stress, some clinicians have speculated that the cannabis chemicals could form the basis for new PTSD therapeutics.
Indeed, medical cannabis is an approved medication for PTSD in several US states, and certain cannabis companies even offer complimentary membership to US military veterans struggling with the condition.
“There has been a recent surge of interest in the use of cannabinoids to treat PTSD, particularly from military veterans, many of whom are already self-medicating or obtaining prescriptions in some American states,” said Chandni Hindocha, the review's lead author, in a press statement.
“The lack of evidence supporting cannabis as a PTSD treatment is striking given the vast interest in it, and the large unmet need for better PTSD treatments.”
The PTSD review
The research team from University College London reviewed ten studies that had involved participants with PTSD using cannabinoids to reduce their symptoms.
Each study was deemed to have had a medium to high risk of bias and only one had involved a randomised controlled trial.
In their conclusion, the authors of the review wrote that “most studies to date are small and of low quality, with significant limitations to the study designs precluding any clinical recommendations about its use in routine clinical practice.”
Although the team did find that cannabis products appeared to reduce PTSD symptoms, such as insomnia and nightmares, they were unable to endorse clinical use without further studies.
“Based on the evidence, we cannot yet make any clinical recommendations about using cannabinoids to treat PTSD,” said the study's senior author, Michael Bloomfield. “Current prescribing of cannabinoids for PTSD is not backed up by high quality evidence, but the findings certainly highlight the need for more research, particularly long-term clinical trials.”
The researchers also encouraged future PTSD researchers to broaden their range of participants, which have traditionally worked in the US army.
“Many of these studies have been conducted in military veterans,” Bloomfield added. “We also need to be looking at other groups, as PTSD can vary depending on the nature of the trauma so different approaches may benefit different groups.”
Speaking to Analytical Cannabis in 2017, Philip Blair, a retired US army colonel and private physician, told of the effect he had witnessed CBD having in veterans.
“I’ve seen first-hand in my pre-clinical trials CBD's positive effects: reduced anger, reduced anxiety and jumpiness, reduced drug dependency, increase in quality of sleep, increased feelings of well-being and more. From a medical perspective, there’s no doubt in my mind, CBD is a non-addictive, non-psychoactive, incredibly viable treatment for PTSD patients.”