Use of Medicinal Cannabis and Synthetic Cannabinoids in Post-Traumatic Stress Disorder (PTSD): A Systematic Review.

Umberto Volpe,Laura Orsolini,Stefania Chiappini,Domenico De Berardis,John Corkery,Roberto Latini,Gabriele Papanti

doi:10.3390/medicina55090525

Abstract

Background and Objectives: Post-traumatic stress disorder (PTSD) is a common psychiatric disorder resulting from a traumatic event, is manifested through hyperarousal, anxiety, depressive symptoms, and sleep disturbances. Despite several therapeutic approaches being available, both pharmacological and psychological, recently a growing interest has developed in using cannabis and synthetic cannabinoids stems from their consideration as more efficient and better tolerated alternatives for the treatment of this condition. The present paper aims to evaluate the clinical and therapeutic potentials of medical cannabis and synthetic cannabinoids in treating PTSD patients. Methods: A systematic electronic search was performed, including all papers published up to May 2019, using the following keywords (((cannabis[Title/]) OR (synthetic cannabinoids [Title/])) AND ((PTSD[Title/]) OR (Posttraumatic stress disorder[Title/]))) for the topics ‘Cannabis’, ‘Synthetic Cannabinoids’, ‘PTSD’, and MESH terms, on the PubMed, Cochrane Library, and Web of Science online databases. For data gathering purposes, PRISMA guidelines were followed. Results were organized into two groups, considering cannabis and synthetic cannabinoids as different therapeutic approaches for PTSD. Results: Present data show that cannabis and synthetic cannabinoids, both acting on the endocannabinoids system, may have a potential therapeutic use for improving PTSD symptoms, e.g., reducing anxiety, modulating memory-related processes, and improving sleep. Conclusions: Even though the current literature suggests that cannabis and synthetic cannabinoids may have a role in the treatment of PTSD, there is currently limited evidence regarding their safety and efficacy. Therefore, additional research is needed in order to better understand the effectiveness and therapeutic usage of these drug classes and monitor their safety.

Highlights

This review firstly aims at providing an overview of Post-traumatic stress disorder (PTSD) and briefly describing the current knowledge available relating to cannabis, cannabinoids, and their use in PTSD treatment
Symptomatology (4%) amongst PTSD participants, those with greater levels of traumatic intrusions and lower levels of well-being [36]. This result was echoed by a study that retrospectively evaluated PTSD symptoms described by patients following the New Mexico Medical Cannabis Program from 2009 to 2011, reporting a reduction of > 75% in PTSD symptomatology in patients using cannabis compared to when they were not [37]
A longitudinal, observational study evaluating the association between cannabis use and PTSD symptom severity recruited 2276 PTSD participants admitted to specialized veterans’ treatment programs, classified into four groups according to their cannabis use: those without cannabis use at admission or after discharge (“never used”); those who used cannabis at admission but not after discharge (“stoppers”); those who used at admission and after discharge (“continuing users”) and those using cannabis after discharge but not at admission

Summary

Introduction

Post-traumatic stress disorder (PTSD) is a psychiatric condition that develops as an aberrant adaptation to a traumatic event. The pathophysiology of PTSD involves several neurotransmitters, including the noradrenergic, serotonergic, endogenous cannabinoid, and opioid systems, as well as the hypothalamic–pituitary adrenal axis and the release of the corticotropin-releasing factor, which are systems involved in other psychiatric conditions, such as mood or anxiety disorders [4]. Post-traumatic stress disorder (PTSD) is a common psychiatric disorder resulting from a traumatic event, is manifested through hyperarousal, anxiety, depressive symptoms, and sleep disturbances. Results: Present data show that cannabis and synthetic cannabinoids, both acting on the endocannabinoids system, may have a potential therapeutic use for improving PTSD symptoms, e.g., reducing anxiety, modulating memory-related processes, and improving sleep. Additional research is needed in order to better understand the effectiveness and therapeutic usage of these drug classes and monitor their safety

Methods

Results

Discussion

Conclusion