Medical cannabis for treatment-resistant combat PTSD

Abstract

Targeting the endocannabinoid system may have a role in the treatment of post-traumatic stress disorder (PTSD). However, few studies have examined the effectiveness of cannabis on symptoms of PTSD, and more research is needed to ascertain cannabis' effectiveness. In this retrospective naturalistic study, we followed 14 relatively mature (32-68 years of age), treatment-resistant, chronic combat post-traumatic patients who remained severely symptomatic despite treatment with many lines of conventional treatment prior to receiving medicinal cannabis. Our findings show that total sleep score, subjective sleep quality, and sleep duration significantly improved (p < 0.01). Total PTSD symptom score and its subdomains (intrusiveness, avoidance, and alertness) showed improvement (p < 0.05). However, there was no improvement in the frequency of nightmares (p = 0.27). The mean follow-up time was 1.1 ± 0.8 years (range of 0.5 to 3 years).

Keywords: cannabis; combat PTSD; pittsburgh sleep quality index (PSQI); post-traumatic stress disorder (PTSD); posttraumatic diagnostic scale (PDS); sleep quality; treatment-resistant.

FIGURE 1

Scores of the posttraumatic diagnostic scale (PDS) and selected subdomains. Higher scores reflect worse symptom severity. Significance: *p < 0.05, ^**p < 0.01. For ratio and quasi-interval scales, means and standard errors are displayed, while medians are displayed for ordinal scales.

FIGURE 2

Scores of the pittsburgh sleep quality index (PSQI) and selected questions. Higher scores reflect worse symptom severity except in the case of sleep duration which is measured in hours. Significance: ^**p < 0.01. For ratio and quasi-interval scales, means and standard errors are displayed, while medians are displayed for ordinal scales.