There have been indications that cannabis or some of its components, primarily THC and CBD, diminish particular symptoms of PTSD.
People suffering from post-traumatic distress disorder report that cannabis reduces the severity of their symptoms by more than half, at least in the short term, according to a recent study led by Carrie Cuttler, a Washington State University assistant professor of psychology.
Cuttler and her colleagues analyzed data of more than 400 people who tracked changes in their PTSD symptoms before and after cannabis use with Strainprint, an app developed to help users learn what types of medical cannabis work best for their symptoms. The group collectively used the app more than 11,000 times over a 31-month period.
The study, recently published in Journal of Affective Disorders, shows cannabis reduced the severity of intrusions, returning thoughts of a traumatic event, by about 62%; flashbacks by 51%, irritability by 67%, and anxiety by 57%. The symptom reductions were not permanent, however.
Individuals presenting with PTSD characteristics frequently use cannabis in an effort to self-medicate, reporting that the drug diminished anxiety and arousal and enhanced sleep. Importantly, PTSD was associated with increased expression of cannabinoid receptor type 1 (CB1) and reduced peripheral levels of the eCB anandamide as well as a compensatory increase of CB1 availability, which was linked to excessive threat processing and with features of anxious arousal. In essence, a deficiency of eCB signalling reflects a stress endophenotype underlying PTSD, raising the possibility that endocannabinoid manipulations could be potentially useful in a therapeutic capacity.
As in the case of many other purported benefits of cannabis, much of the supportive evidence in humans has come from anecdotal or case reports as well as observational studies that provide little evidence of a causal connection.
In this regard, in a small study 5 mg of THC twice a day as an add-on treatment enhanced sleep quality and reduced the frequency of nightmares, PTSD hyperarousal and global symptom severity. The synthetic analogue of THC, nabilone, similarly enhanced sleep, reduced nightmares and diminished other PTSD symptoms among patients.
Unfortunately, the available data showing a cannabinoid–PTSD link in human clinical trials have been relatively sparse and yielded mixed results, ranging from ameliorated symptoms to cautions concerning its efficacy. Furthermore, because PTSD is so often comorbid with depressive illnesses and anxiety disorders, it is uncertain whether the eCB links reflect a direct causal connection to PTSD or actions related to anxiety or depression.
In addition to potentially reducing PTSD symptoms, cannabis also mitigates the propensity for inflammation and may be useful in psychological conditions that involve elevated inflammatory processes within the brain. This would include a subset of depressed individuals in whom inflammation may be a component of the illness and may contribute to threat processing linked to PTSD in trauma survivors. In fact, anti-inflammatory agents can diminish PTSD features in an animal model, and in humans PTSD was accompanied by elevated circulating proinflammatory cytokines.
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