Clinical Studies and Case Reports

On this site you will find clinical studies with cannabis or single cannabinoids in different diseases and case reports on the use of cannabis by patients.
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TitleMedical cannabis use in post-traumatic stress disorder: a naturalistic observational study.
Author(s)Reznik I.
Journal, Volume, IssueAbstract presented at the Cannabinoid Conference 2011, 8-10 September, Bonn, Germany.
Major outcome(s)In most cases a significant improvement in quality of life and pain, with some positive changes in severity of posttraumatic stress disorder was observed.
IndicationPosttraumatic stress disorderAbstract
MedicationCannabis

Introduction: Posttraumatic stress disorder (PTSD) is a pervasive and devastating anxiety disorder, the lifetime prevalence of which, as assessed in several community-based studies, is reach up to 8%. Frequently, PTSD is associated with other mental and somatic conditions such as depression (in up to 70% cases) and severe pain of various origins. Many PTSD patients frequently use marijuana as "a emotional regulation strategy to reduce or to manage perceived aversive psychological or mood states". Meanwhile, the optimal treatment for PTSD and its comorbid conditions is still in development and the effectiveness and safety of Cannabis (Medical marijuana) use in such patients is not clear.

Methods: As a part of our routine consulting work, we assessed the mental condition of 79 adult PTSD patients, who applied to the Ministry of Health in order to obtain a license for the Medical Cannabis. The group consisted of patients with "pure" PTSD (18 patients), PTSD patients with clinical depression (27 patients) and patients suffering from PTSD/chronic pain comorbidity (34 patients). Clinician-Administered PTSD scale (CAPS) was used for traumatic symptoms assessment and Quality of Life Scale was filled out. The changes in Clinical Global Impression-Improvement scale (CGI-I) were registered. The data on their somatic conditions and pain level was provided by their treating physicians. Only part of them (about 50%) got Medical Cannabis licenses (study group). We followed up them (periodical evaluation) for a period of about two years.

Results: Majority of PTSD patients used also the conventional medications (such as antidepressants and sedatives, pain killers etc), prescribed them by their treating physicians. Medical Cannabis (as sativa and/or indica species) was provided by several companies. The Cannabis daily dosage was in range 2-3 gr/day (containing about 20% of cannabioids active compounds THC/CBD). In most cases a significant improvement in Quality of Life and pain scores, with some positive changes in CAPS scores was observed. Under this combine (Cannabis + conventional medications) treatment, the patients reported a discontinuation or lowering the dosage of pain killers and sedative pharmacological agents. The majority of improved PTSD patients belonged to groups with either pain and/or depression comorbidity. No exacerbations or serious adverse events were reported.

Conclusion: This naturalistic observational study represents a first attempt to assess and to monitor the effectiveness and safety of the Medical Cannabis use in PTSD patients. The results show good tolerability and other benefits (especially in the quality of life & on CGI-I) of such flexible combine approach, particularly, in the patients with either pain and/or depression comorbidity. Further large-scale investigations are needed to substantiate our observations and to elaborate the most effective and safe therapeutic approaches to these difficult-to-treat group.

Route(s)Inhalation
Dose(s)
Duration (days)
Participants79 patients with posttraumatic stress disorder
DesignOpen study
Type of publicationMeeting abstract
Address of author(s)MaReNa Diagnostic and Consulting Center, Bat-Yam/Tel-Aviv, Israel, ilyarez@netvision.net.il
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