Cannabis in the management of PTSD: a systematic review

Yasir Rehman; Amreen Saini; Sarina Huang; Emma Sood; Ravneet Gill; Sezgi Yanikomeroglu; Yasir Rehman; Amreen Saini; Sarina Huang; Emma Sood; Ravneet Gill; Sezgi Yanikomeroglu

doi:10.3934/Neuroscience.2021022

AIMS Neuroscience

2021, Volume 8, Issue 3: 414-434. doi: 10.3934/Neuroscience.2021022

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Review

Cannabis in the management of PTSD: a systematic review

1.
Health Research Methodology, McMaster University, Hamilton, Ontario, Canada
2.
Michael DeGroote Institute of Pain and Research Center, McMaster University, Hamilton, Ontario, Canada
3.
Canadian Academy of Osteopathy, Hamilton, Ontario, Canada
4.
Faculty of Science, McMaster University, Hamilton, Ontario, Canada
5.
Faculty of Health Sciences, McMaster University, Hamilton, Ontario, Canada

Received: 17 February 2021 Accepted: 08 May 2021 Published: 13 May 2021

Introduction
Existing reviews exploring cannabis effectiveness have numerous limitations including narrow search strategies. We systematically explored cannabis effects on PTSD symptoms, quality of life (QOL), and return to work (RTW). We also investigated harm outcomes such as adverse effects and dropouts due to adverse effects, inefficacy, and all-cause dropout rates.

Methods
Our search in MEDLINE, EMBASE, PsycInfo, CINAHL, Web of Science, CENTRAL, and PubMed databases, yielded 1 eligible RCT and 10 observational studies (n = 4672). Risk of bias (RoB) was assessed with the Cochrane risk of bias tool and ROBINS-I.

Results
Evidence from the included studies was mainly based on non-randomized studies with no comparators. Results from unpooled, high RoB studies showed that cannabis was associated with a reduction in overall PTSD symptoms and improved QOL. Dry mouth, headaches, and psychoactive effects such as agitation and euphoria were the commonly reported adverse effects. In most studies, cannabis was well tolerated, but small proportions of patients experienced a worsening of PTSD symptoms.

Conclusion
Evidence in the current study primarily stems from low quality and high RoB observational studies. Further RCTs investigating cannabis effects on PTSD treatment should be conducted with larger sample sizes and explore a broader range of patient-important outcomes.
- PTSD,
- cannabis,
- THC,
- nabilone,
- symptoms reduction,
- functional improvement,
- systematic review,
- meta-analysis,
- cannabinoid
Citation: Yasir Rehman, Amreen Saini, Sarina Huang, Emma Sood, Ravneet Gill, Sezgi Yanikomeroglu. Cannabis in the management of PTSD: a systematic review[J]. AIMS Neuroscience, 2021, 8(3): 414-434. doi: 10.3934/Neuroscience.2021022

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Abstract

Introduction

Existing reviews exploring cannabis effectiveness have numerous limitations including narrow search strategies. We systematically explored cannabis effects on PTSD symptoms, quality of life (QOL), and return to work (RTW). We also investigated harm outcomes such as adverse effects and dropouts due to adverse effects, inefficacy, and all-cause dropout rates.

Methods

Our search in MEDLINE, EMBASE, PsycInfo, CINAHL, Web of Science, CENTRAL, and PubMed databases, yielded 1 eligible RCT and 10 observational studies (n = 4672). Risk of bias (RoB) was assessed with the Cochrane risk of bias tool and ROBINS-I.

Results

Evidence from the included studies was mainly based on non-randomized studies with no comparators. Results from unpooled, high RoB studies showed that cannabis was associated with a reduction in overall PTSD symptoms and improved QOL. Dry mouth, headaches, and psychoactive effects such as agitation and euphoria were the commonly reported adverse effects. In most studies, cannabis was well tolerated, but small proportions of patients experienced a worsening of PTSD symptoms.

Conclusion

Evidence in the current study primarily stems from low quality and high RoB observational studies. Further RCTs investigating cannabis effects on PTSD treatment should be conducted with larger sample sizes and explore a broader range of patient-important outcomes.

Conflict of interest

The authors declare no conflict of interest.

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