Medical cannabis for psychiatric disorders

Over last few years researchers’ attention has been focused on use of medical cannabis due to global regulatory loosening. This fact significantly increased cannabinoid therapeutics analytical data in psychiatric field. Many of them suggest that cannabinoid might improve depressive disorders and symptoms, anxiety disorders, attention-deficit hyperactivity disorder, Tourette syndrome, post-traumatic stress disorder, or psychosis. Moreover, as an adjunctive treatment CBD has shown promising evidence in the treatment of schizophrenia and a potential effect for attention deficit/hyperactivity disorder ADHD symptoms.  

Corresponding to the study published in Permanent Journal in January 2019, CBD capsules containing (25mg/d – 175mg/d) has decreased the anxiety. Moreover, this effect was sustained during the study period. Authors of above study claimed that results seem to follow the conclusions of existing preclinical and clinical data on CBD.  

Still, we are missing high-quality evidence where mental disorders are the primary target of the treatment. This is based on the fact that most of the existing data are derived from studies where mental disorders are secondary to another medical condition. Especially chronic noncancer pain and multiple sclerosis.  

In the above circumstances we should be aware of clinical consideration when prescribing and using high-THC formulations. Epidemiological and experimental evidence suggest that the use of cannabis with a high concentration of THC might be harmful for young people and people showing anxiety or psychotic disorders. Caution should be taken also in cardiovascular and respiratory disorders, pregnancy and breast-feeding should be taken. 

References

  1. Sarris J, Sinclair J, Karamacoska D, Davidson M, Firth J. Medicinal cannabis for psychiatric disorders: a clinically-focused systematic review. BMC Psychiatry. 2020;20(1):24. doi:10.1186/s12888-019-2409-8
  2. Shannon S, Lewis N, Lee H, Hughes S. Cannabidiol in Anxiety and Sleep: A Large Case Series. Perm J. 2019;23:18-041. doi:10.7812/TPP/18-041
  3. Black N, Stockings E, Campbell G, et al. Cannabinoids for the treatment of mental disorders and symptoms of mental disorders: a systematic review and meta-analysis. Lancet Psychiatry. 2019;6(12):995-1010. doi:10.1016/S2215-0366(19)30401-8
  4. Forti MD, Quattrone D, Freeman TP, et al. The contribution of cannabis use to variation in the incidence of psychotic disorder across Europe (EU-GEI): a multicentre case-control study. Lancet Psychiatry. 2019;6(5):427-436. doi:10.1016/S2215-0366(19)30048-3

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