PTSD or Clinical Endocannabinoid Deficiency?
Joseph Rosado, MD, MBA*
Journal Title:Journal of Neurology, Psychiatry and Brain Research
Objective: A literature review was conducted supporting the theory of clinical endocannabinoid deficiency as it relates to PTSD together with a review on how to treat PTSD with medical cannabis.
Background: Posttraumatic stress disorder (PTSD) is a psychiatric disorder that can occur in people who have experienced or witnessed a traumatic event such as a natural disaster, a serious accident, a terrorist act, war/combat, rape or other violent personal assault.
The following statistics are based on the U.S. population:
About 7 or 8 out of every 100 people (or 7-8% of the population) will have PTSD at some point in their lives.
About 8 million adults have PTSD during a given year. This is only a small portion of those who have gone through a trauma.
About 10 of every 100 women (or 10%) develop PTSD sometime in their lives compared with about 4 of every 100 men (or 4%).
In the United States, New Mexico was the first state to list post-traumatic stress disorder (PTSD) as a condition for the use of medical cannabis. In a study published in Journal of Psychoactive Drugs, there was greater than 75% reduction in Clinician Administered Posttraumatic Scale for DSM-IV (CAPS) and it was concluded that Cannabis is associated with reductions in PTSD symptoms in some patients. Approximately 15% of US Veterans who are treated in Department of Veterans Affairs (VA) outpatient PTSD clinics report recent (past 6 months) cannabis use.
The theory of clinical endocannabinoid deficiency (CED) was presented in 2001 in two publications, but more thoroughly explored in 2004 in an article that has subsequently been cited frequently in the literature, it is based on the concept that many brain disorders are associated with neurotransmitter deficiencies, affecting acetylcholine in Alzheimer's disease, dopamine in parkinsonian syndromes, serotonin and norepinephrine in depression, and that a comparable deficiency in endocannabinoid levels might be manifest similarly in certain disorders that display predictable clinical features as sequelae of this deficiency.
Design/Methods: A literature review was conducted of the National Center for Biotechnology Information, U.S. National Library of Medicine PubMed from 2001-2019 specific to the topic of PTSD and Clinical Endocannabinoid Deficiency.
Conclusion: This literature review supports the feasibility of cannabis-based medicine as a promising treatment option in individuals with PTSD. Based on the promising results, it is recommended that large, double blind, placebo controlled cross-over trials be launched in jurisdictions where medical cannabis can be studied without limitations from the federal government.