Mental Health: People are sick & tired of feeling sick & tired and are moving from standard meds to medicinal cannabis. Is the shift warranted?

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Anxiety and depression are leading causes of disease and disability around the world. In the U.S. alone, anxiety disorders affect 40M adults each year and close to 20M experience at least one major depressive episode. Compounding the problem is Covid-19: this JAMA report, for example, found a 3-fold increase in depression.

All this against a backdrop of the standard medications like Zoloft and Paxil failing too many people. Not only will they not work, or work well, they come with side effects such as worsening the underlying mental health condition, weight gain, or sexual dysfunction, resulting in patients discontinuing treatment.

Since “pharmacotherapeutic options remain subpar” and because “an increasing number of people struggling with anxiety and/or depression are trying cannabis products for symptom management,” researchers in the U.S. looked into whether medicinal cannabis helps people deal with their symptoms.

They enrolled 538 people suffering from depression & anxiety, 368 of whom used medicinal cannabis to control their symptoms and 170 who didn’t but were considering it (the control group). The investigators compared the two groups at baseline using questionnaires to measure various health outcomes.

Results: Medicinal cannabis users reported less severe depression – but not anxiety; and superior sleep, quality of life, and lower average pain relative to the non-users. This effect was strongest among participants using CBD-dominant products (vs THC-dominant or balanced CBD:THC).

What’s more, on the anxiety front, when the control group initiated medicinal cannabis use during the follow-up period they showed a significant reduction in both depression and anxiety symptoms.

Importantly, these findings build on earlier work by this same research group & others:

Our group previously found that medicinal cannabis users reported reduced anxiety and depression when compared to a control group that was considering, but had not yet initiated medicinal cannabis. A handful of studies have previously examined the anxiolytic effects of THC and CBD in clinical populations, and most of these have found a positive effect.

Finally, a crucial finding that’s consistent throughout the literature: the side effects of medicinal cannabis were small:

Adverse effects attributed by participants to cannabis product use were infrequent, were more associated with THC-dominant product use, and, with the exception of nausea, were distinct from those typically associated with antidepressants … Our work shows  a potential for [treatment] without many of the negative side effects associated with traditional antidepressants. 

Physician and cannabis clinician Benjamin Caplan, MD, nicely sums up the research:

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