Medical Cannabis Review Articles and Reports on Post-Traumatic Stress Disorder (PTSD)

Medical Cannabis Review Articles and Reports on Post-Traumatic Stress Disorder (PTSD)

The Health Effects of Cannabis and Cannabinoids: The Current State of Evidence and Recommendations for Research
A report published by the U.S. National Academies of Sciences, Engineering, and Medicine.  2017. 
A rigorous review of relevant scientific research published since 1999, summarizing the current state of evidence regarding what is known about the health impacts of cannabis and cannabis-derived products, including effects related to therapeutic uses of cannabis and potential health risks related to certain cancers, diseases, mental health disorders, and injuries.  Sections on evidence of therapeutic effects include: chronic pain, cancer treatment, chemotherapy-induced nausea and vomiting, anorexia and weight loss associated with HIV/AIDS, cancer-associated anorexia-cachexia syndrome, anorexia nervosa, irritable bowel syndrome, epilepsy, spasticity associated with multiple sclerosis or spinal cord injury, Tourette syndrome, amyotrophic lateral sclerosis, Huntington’s disease, Parkinson’s disease, dystonia, dementia, glaucoma, traumatic brain injury/intracerebral hemorrhage, substance addiction, anxiety, depression, sleep disorders, posttraumatic stress disorder, and schizophrenia and other psychoses.  Chapters summarizing evidence of harms include: cancer, cardiometabolic risk, respiratory disease, immunity, injury and death, prenatal/perinatal/neonatal exposure, psychosocial, mental health, cannabis use problems, and abuse of other substances.

A Review of Medical Cannabis Studies relating to Chemical Compositions and Dosages for Qualifying Medical Conditions (PDF)
Office of Medical Cannabis.
Summary of clinical trials and prospective observational studies in humans, published in peer-reviewed journals, which focus on medical cannabis formulations consistent with Minnesota’s medical cannabis program.

Use and Effects of Cannabinoids in Military Veterans with Post Traumatic Stress Disorder
Bettenhauser K, Pilz J, Vollmer LE. Use and effects of cannabinoids in military veterans with posttraumatic stress disorder. Am J Health Syst Pharm 2015;72:1279-1284.
This clinically-oriented review article is focused on human studies. Current through mid-2014.

Marijuana Use is Associated with Worse Outcomes in Symptom Severity and Violent Behavior in Patients with Post Traumatic Stress Disorder
Wilkinson, S. T., Stefanovics, E., & Rosenheck, R. A. Marijuana use is associated with worse outcomes in symptom severity and violent behavior in patients with posttraumatic stress disorder. The Journal of clinical psychiatry 2015;76:1-478.
A study of 12,770 American veterans diagnosed with PTSD and admitted to specialized Veterans Affairs PTSD treatment programs from 1992-2011. Data comes assessments at intake and four months post-discharge. Though the authors say the findings suggest marijuana use may worsen PTSD symptoms or nullify the benefits of specialized intensive treatment, they acknowledge the results could also mean PTSD patients refractory to treatment are more likely to use marijuana in an attempt to self-medicate.

The Endocannabinoid System and Post Traumatic Stress Disorder (PTSD): From Preclinical Findings to Innovative Therapeutic Approaches in Clinical Settings
Berardi A, Schelling G, Campolongo P. The endocannabinoid system and the post traumatic stress disorder (PTSD): From preclinical findings to innovative therapeutic approaches in clinical settings. Pharmacol Res 2016;111:668-678.
Review of animal and human studies investigating the effects of cannabinoids on memory processes. Studies focusing on cannabinoids and memory consolidation, retrieval, and extinction are presented separately. Evidence from the slim literature on beneficial effects of cannabinoid drugs in PTSD patients is presented. Though this is a good, comprehensive article, insufficient editing has resulted in awkward wording occasionally.

Cannabinoids and Post-Traumatic Stress Disorder: Clinical and Preclinical Evidence for Treatment and Prevention
Mizrachi Zer-Aviv TM, Segev A, Akirav I. Cannabinoids and post-traumatic stress disorder: Clinical and preclinical evidence for treatment and prevention. Behav Pharmacol 2016 27:561-569
Review article encompassing pre-clinical and human studies. Current through mid-2016.

Marijuana and Other Cannabinoids as a Treatment for Post Traumatic Stress Disorder: A Literature Review
Steenkamp MM, Blessing EM, Galatzer-Levy IR, Hollahan LC, Anderson WT. Marijuaana and other cannabinoids as a treatment of posttraumatic stress disorder: A literature review. Depress Anxiety 2017;34:207-216.
Review article encompassing pre-clinical and human studies. Current through early-2016

Information for Health Care Professionals: Cannabis and the cannabinoids (PDF)
Health Canada. February, 2013.
Endocannabinoid system, clinical pharmacology, dosing, potential therapeutic uses (by condition), precautions, warnings, adverse effects, and overdose/toxicity.

Cannabis: The Evidence for Medical Use
Barnes MP, Barnes JC. Report published by Northumberland, Tyne & Wear NHS Foundation Trust, May 2016.
Literature review and discussion of strength of evidence of effectiveness for a wide variety of medical conditions.  This report was commissioned by the All Party Parliamentary Group for Drug Policy Reform (UK).  The authors note they received no renumeration other than a small grand from the APPG for Drug Policy Reform for their work and that they have no commercial interests in cannabis or cannabis products.  The report includes good discussions of the evidence – or lack thereof – for long-term negative effects often ascribed to marijuana use: psychotic disorders, dependence, respiratory system cancer, cognition, amotivational syndrome, and decreased brain volume.

Information for Health Care Professionals: Cannabis and the cannabinoids (PDF)
Health Canada. February, 2013.
Endocannabinoid system, clinical pharmacology, dosing, potential therapeutic uses (by condition), precautions, warnings, adverse effects, and overdose/toxicity.

Integrating Endocannabinoid Signaling and Cannabinoids into the Biology and Treatment of Posttraumatic Stress Disorder
Hill MN, Campolongo P, Yehuda R, Patel S. Integrating endocannabinoid signaling and cannabinoids into the biology and treatment of posttraumatic stress disorder. Neuropsychopharmacology 2018;43:80-102.
Detailed, technical – but readable – discussion of biological findings associated with PTSD, the role of endocannabinoid signaling in these biological processes, and the impact cannabinoids have on these processes. The authors conclude, “Together, these data create an evidence-based rationale implicating the endocannabinoid system as a potential candidate system, whose impairment could be a substrate for the etiology of PTSD, as well as a target for the development of a novel class of drugs that could be used to treat symptoms of PTSD.”

Benefits and Harms of Plant-Based Cannabis for Posttraumatic Stress Disorder: A Systematic Review
O’Neil ME, Nugent SM, Morasco BJ, Freeman M, Low A, et al. Benefits and harms of plant-based cannabis for posttraumatic stress disorder. Ann Intern Med 2017;167:332-340.
Systematic review of studies (systematic reviews, controlled clinical trials, and observational studies using control groups) of non-pregnant adults with PTSD that assessed the effects of plant-based cannabis preparations or whole-plant extracts, published through March 2017. Inclusion criteria identified two systematic reviews and three individual studies (two cohort studies and a case-control study). The authors’ conclusion was similar to that of the two included systematic reviews, “Evidence is insufficient to draw conclusions about the benefits and harms of plant-based cannabis preparations in patients with PTSD” and the conclusion statement went on to note, “but several ongoing studies may soon provide important results. A useful part of the paper is a table describing these ongoing studies, including two randomized controlled trials of various cannabis products as therapy for PTSD. Funded by the US Department of Veteran Affairs.

Cannabis: A potential efficacious intervention for PTSD or simply snake oil?
Abizaid A, Merali Z, Anisman H. Cannabis: A potential efficacious intervention for PTSD or simply snake oil? J Psychiatry Neurosci 2019;44:75-78.
This editorial provides a brief, balanced, readable discussion of the current state of what is known about the potential of cannabis and cannabinoids as therapy for PTSD. It covers the challenges of animal models of PTSD, involvement of the endocannabinoid system in PTSD, and the (limited) evidence for effectiveness in humans with PTSD. With 44 references, this article could serve as a good introduction to the topic.

A review of medical marijuana for the treatment of posttraumatic stress disorder: Real symptom re-leaf or just high hopes?
Shishko I, Oiveira R, Moore TA, Almeida K. A review of medical marijuana for the treatment of posttraumatic stress disorder: Real symptom re-leaf or just high hopes? Ment Health Clin 2018;26:86-94.
This review article discusses the five studies their search revealed: one open-label prospective study and four observational studies. The last paragraph of the article: “In summary, a high percentage of patients do not tolerate and/or respond to conventional treatment options for PTSD. The cannabinoid system plays a role in PTSD and may be a novel mechanism for treatment. Marijuana use in patients with PTSD is common and may be associated with self-medicating. It has been theorized that medical marijuana may help with global improvement of PTSD symptoms. Currently, marijuana is not legal for medical purposes on the federal level; however, it is approved for PRSD in various states. Although some positive data exists for the use of marijuana in PTSD, current evidence is limited to anecdotal experiences, case reports, and observational studies, which leads to a lack of quality evidence to currently support the use of marijuana to treat PTSD.”

Updated Friday, November 08, 2019 at 08:36AM