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PTSD & Anxiety Disorders

Several studies have found that cannabis/cannabinoids are effective in relieving many of the side effects associated with PTSD, such as anxiety, depression, and sleep troubles. However, primarily due to political research barriers, there are still frustratingly few large controlled clinical trials that examine cannabis administration with PTSD patients specifically. It is encouraging to see preclinical data that suggests using endocannabinoid-targeted therapeutics like cannabis for effectively relieving symptoms commonly associated with PTSD and anxiety-disorders.

Key Research Findings

Below are some scientific studies, review articles and additional resources with evidence regarding the therapeutic value of cannabinoids for PTSD patients.

Use and effects of cannabinoids in military veterans with posttraumatic stress disorder (2015)
  • “…the evaluated evidence indicates that substantial numbers of military veterans with PTSD use cannabis or derivative products to control PTSD symptoms, with some patients reporting benefits in terms of reduced anxiety and insomnia and improved coping ability.”
Cannabidiol Reduces the Anxiety Induced by Simulated Public Speaking in Treatment-Naı¨ve Social Phobia Patients (2011)
  • Pretreatment with CBD significantly reduced anxiety, cognitive impairment and discomfort in their speech performance, and significantly decreased alert in their anticipatory speech. The placebo group presented higher anxiety, cognitive impairment, discomfort, and alert levels when compared with the control group…
Effectiveness of cannabidiol oil for pediatric anxiety and insomnia as part of posttraumatic stress disorder: a case report. (2016)
  • “CBD may exert its anti-anxiety effect by activating adenosine receptors which play a significant role in cardiovascular function and cause a broad anti-inflammatory effect throughout the body. At high concentrations, CBD directly activates the 5-HT1A serotonin receptor, thereby conferring an antidepressant effect.
  • “Cannabidiol oil, an increasingly popular treatment of anxiety and sleep issues, has been documented as being an effective alternative to pharmaceutical medications. This case study provides clinical data that support the use of cannabidiol oil as a safe treatment for reducing anxiety and improving sleep in a young girl with posttraumatic stress disorder.”
Targeting the endocannabinoid system to treat anxiety-related disorders (2015)
  • “Targeting the endocannabinoid system could ameliorate stress-related symptoms by treating the cognitive and emotional features of PTSD.”
  • “Because of the anxiety-relieving effects of cannabinoids, endocannabinoid signaling has a prominent role in the regulation of fear, anxiety, and stress responses…”
  • “…these preclinical results strongly suggest that exogenous cannabinoids administered in proximity to trauma exposure could prevent the development of PTSD-like symptoms.”
Plasma Concentrations of Endocannabinoids and Related Primary Fatty Acid Amides in Patients with Post-Traumatic Stress Disorder (2013)
  • These results indicate that individuals with PTSD show significant differences in plasma concentrations of endocannabinoids and related N-acyl-ethanolamides when compared to healthy controls and to subjects who did not develop PTSD after trauma exposure.
Cannabis and the Anxiety of Fragmentation—A Systems Approach for Finding an Anxiolytic Cannabis Chemotype (2018)

Figure 1: Histogram of the perceived effectiveness of cannabis for the treatment of anxiety as rated by medical cannabis patients. Patients (n = 260) were asked to rate the effectiveness of cannabis for the treatment of anxiety on a Likert scale from 0 to 10, 0 being not effective at all and 10 being extremely effective. Average value was 8.03 (7.83–8.22 CI, p = 0.05) with a standard deviation of 1.60.

  • Cannabis can be used as an effective anxiolytic agent, but further investigations are required to find which chemotypes or doses are anxiolytic, and which are anxiogenic. From a broader perspective, cannabis can be produced sustainably, and its many uses could help us to preserve the biosphere we all need to survive, relieving anxiety worldwide.”
Elevated brain cannabinoid CB1 receptor availability in post-traumatic stress disorder: a positron emission tomography study. (2013)
  • “These results suggest that abnormal CB1 receptor-mediated anandamide [AEA] signaling is implicated in the etiology of PTSD, and provide a promising neurobiological model to develop novel, evidence-based pharmacotherapies for this disorder.”
Preliminary, Open-Label, Pilot Study of Add-On Oral D9 -Tetrahydrocannabinol in Chronic Post-Traumatic Stress Disorder (2014)
  • “This is the first report of the use of orally absorbable D9 -THC as add-on treatment in patients with chronic PTSD. The results show good tolerance and safety, reduction of PTSD hyperarousal symptoms, improved sleep quality and reduced frequency of nightmares.”
Posttraumatic stress disorder and cannabis use in a nationally representative sample. (2011)
  • “After adjusting for sociodemographic variables… PTSD diagnoses were associated with increased odds of lifetime history of cannabis use as well as past year daily cannabis use.”
The use of a synthetic cannabinoid in the management of treatment-resistant nightmares in posttraumatic stress disorder (PTSD). (2009)
  • The majority of patients (72%) receiving nabilone experienced either cessation of nightmares or a significant reduction in nightmare intensity. Subjective improvement in sleep time, the quality of sleep, and the reduction of daytime flashbacks and nightsweats were also noted by some patients. The results of this study indicate the potential benefits of nabilone, a synthetic cannabinoid, in patients with PTSD experiencing poor control of nightmares with standard pharmacotherapy.”
  • Highly recommended seminar with a series of informative mini lectures:
    • Medical Cannabis Research Barriers – Dr. Sue Sisley  (~13:00-39:00)
    • Traditional & Current PTSD Studies -Marcel Bonn Miller, Research Health Science Specialist with National Center for PTSD (~39:00-57:00)
    • Dosing Guidelines & Recommendations- Dr. Dustin Sulak (~58:00-116:00)
    • Clinical Application- Dr. Michelle Sexton, Founder and Chief Science Officer of Phytalab (~116:00-end)
Reductions in Circulating Endocannabinoid Levels in Individuals with Post-Traumatic Stress Disorder Following Exposure to the World Trade Center Attacks. (2013)
  • “…That both PTSD and depression are stress-related mental illnesses suggests that reduced concentrations of 2-AG could represent a peripheral biomarker of vulnerability to stress-related mood and anxiety disorders.”
Medical cannabis and mental health: A guided systematic review. (2017)
The endocannabinoid system provides an avenue for evidence‐based treatment development for PTSD. (2013)
  • “These biological findings, in the context of known involvement of the eCB [endocannabinoid] system in emotional memory extinction and recall, stress buffering and adaptation, as well as HPA function, suggest the possibility of a pivotal role for the eCB system in PTSD.”