Use of a synthetic cannabinoid (nabilone) in the ongoing management of posttraumatic stress disorder nightmares in the Canadian Armed Forces: Results of an anonymous online survey

Abstract

Introduction: The synthetic cannabinoid nabilone has shown promise in the management of posttraumatic stress disorder (PTSD) nightmares. To date, three clinical papers have been published showing positive results in nightmare suppression in civilian and military populations. This medication came on the market as an antiemetic. Nabilone has been used on an off-label basis at the Canadian Forces Operational Trauma and Stress Support Centre (OTSSC) in Ottawa for over a decade for PTSD nightmares. To date, there are no published reports of the ongoing experiences of patients who have been prescribed this medication for nightmare suppression. This research was conducted with the intent to fill this gap in the literature. Methods: An anonymous online survey was conducted in order to obtain a better understanding of the clinical effects experienced by those who continued taking nabilone. Eligible participants were active military members diagnosed with PTSD who were prescribed nabilone for the suppression of chronic nightmares. Results: Sixty military members responded to questions related to their ongoing experience using nabilone. Prior to taking nabilone, they had suffered from PTSD nightmares for an average of seven years. Suppression of nightmares was reported by 73% of respondents who continued taking nabilone. A small proportion self-discontinued nabilone to determine whether the medication was still needed. Of those who discontinued, most reported a return of nightmares an average of 1 week later; however, not all experienced a recurrence of nightmares. These findings support attempting a reduction or cessation at some point during treatment. For those who continued to experience nightmares, suppression was achieved with similar dosages to those previously prescribed; this suggests that nightmares are chronic and may need a longer duration of treatment. Discussion: This is the first survey to capture data for nabilone as a PTSD nightmare treatment beyond seven weeks. The results of this survey conform to the existing literature showing the efficacy of nabilone, a synthetic cannabinoid, as having a positive effect on nightmare suppression.