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|Title||Mitigation of post-traumatic stress symptoms by Cannabis resin: A review of the clinical and neurobiological evidence.|
|Author(s)||Passie T, Emrich HM, Karst M, Brandt SD, Halpern JH.|
|Journal, Volume, Issue||Drug Test Anal. 2012 Jul;4(7-8):649-59. doi: 10.1002/dta.1377. Epub 2012 Jun 26.|
|Major outcome(s)||Significant improvement in one patient with PSD with cannabis|
|Indication||Posttraumatic stress disorder||Abstract
It is known from clinical studies that some patients attempt to cope with the
symptoms of post-traumatic stress disorder (PTSD) by using recreational drugs.
This review presents a case report of a 19-year-old male patient with a spectrum
of severe PTSD symptoms, such as intense flashbacks, panic attacks, and
self-mutilation, who discovered that some of his major symptoms were dramatically
reduced by smoking cannabis resin. The major part of this review is concerned
with the clinical and preclinical neurobiological evidence in order to offer a
potential explanation of these effects on symptom reduction in PTSD. This review
shows that recent studies provided supporting evidence that PTSD patients may be
able to cope with their symptoms by using cannabis products. Cannabis may dampen
the strength or emotional impact of traumatic memories through synergistic
mechanisms that might make it easier for people with PTSD to rest or sleep and to
feel less anxious and less involved with flashback memories. The presence of
endocannabinoid signalling systems within stress-sensitive nuclei of the
hypothalamus, as well as upstream limbic structures (amygdala), point to the
significance of this system for the regulation of neuroendocrine and behavioural
responses to stress. Evidence is increasingly accumulating that cannabinoids
might play a role in fear extinction and antidepressive effects. It is concluded
that further studies are warranted in order to evaluate the therapeutic potential
of cannabinoids in PTSD.
Symptoms of severe post-traumatic stress disorder in a young man were significantly improved following self-treatment with cannabis, according to a case report from the Department of Psychiatry of Hannover Medical School, Germany. From about the age of four, the patient was a victim of long-time sadistic sexual abuse by his father and paternal uncle, which continued until age 15 when he attempted to commit suicide for the second time.
The authors of the report first saw the patient several years later when he was admitted to the psychiatric department for safety and stabilization during a crisis with severe, uncontrolled flashbacks, panic attacks, and impulses for self-mutilation. These had resulted in severe self-injury in the past (mainly lacerations from cutting with knives). After a few days of treatment and stabilization he was referred back to the inpatient psychotherapy treatment centre. In the following weeks his condition improved dramatically. When he was asked what his idea was about the improvement of his condition, he confessed that he had learned to smoke cannabis resin from some other inpatients. He had discovered that he could prevent dissociative states by smoking cannabis when he first felt reactivation and intensification of traumatic memories experienced as flashbacks. Although he still experienced flashback phenomena after the use of cannabis, it alters their course and intensity.
|Participants||1 patient with posttraumatic stress disorder|
|Design||Uncontrolled case report|
|Type of publication||Medical journal|
|Address of author(s)||Department of Psychiatry, Social Psychiatry and Psychotherapy, Hannover Medical School, Hannover, Germany; Laboratory for Integrative Psychiatry, Division of Alcohol and Drug Abuse, Harvard Medical School, McLean Hospital, Belmont, MA, USA. dr.passie@gmx.|