Cannabidiol (CBD), processed by the endocannabinoid system, is one of the naturally-occurring cannabinoids in cannabis and has emerged as an effective pharmaceutical therapy. In the last two years, Canada and Sweden approved CBD for multiple sclerosis pain. The United States also approved CBD for treating certain types of epilepsy in June.
Research is now emerging that shows CBD has huge potential in treating the symptoms of Post Traumatic Stress Disorder (PTSD). The journal Frontiers in Neuroscience published a review at the end of July which concisely summarizes the effect of CBD on PTSD symptoms. The authors take a close look at the progression of research from animal studies in rats to human trials and convincingly make the case for CBD’s potential for effectively treating PTSD.
What is PTSD
PTSD is a psychiatric disorder that affects people who have lived through a traumatic event. Around 10% of the population will experience PTSD at some point in their lives. Service members and combat veterans who have participated in armed combat have a much higher risk of developing the disorder.
Symptoms of PTSD can include:
- intrusive thoughts
- being easily startled
- difficulty sleeping
- angry outbursts
- feeling emotionally numb.
PTSD is debilitating for those afflicted, but unfortunately, an effective pharmaceutical treatment has not been identified.
PTSD, Memory, and Why Available Pharmaceuticals Don’t Work
Posttraumatic stress disorder–and other trauma-related disorders are thought to arise when the learning process for aversive memories becomes poorly regulated.
Take for example a near-fatal car crash — this unpleasant and dangerous experience creates an aversive memory. The next time you pass through the intersection where the crash occurred, you will likely recall the car crash (memory retrieval). Recalling the car crash could create feelings of anxiety or some other negative emotional response. This response is called fear conditioning.
You pass through that same intersection many times and recall the memory, but thankfully you do not experience any additional trauma. As time passes, you no longer feel anxious when remembering the car crash. You have lost the fear conditioning response. This final step is called memory extinction.
On the other hand, someone with unique brain chemistry could experience the exact same car crash but is unable to end the fearful conditioning response. Each time they pass through the intersection, they are overtaken by a panic attack. They begin avoiding the intersection entirely. They also have terrifying nightmares where they relive the car crash in excruciating detail. These are classic symptoms of PTSD.
PTSD is essentially a memory and learning disorder. Antidepressants and anti-anxiety drugs fail when it comes to effectively treating the symptoms because they do not target the causal root of the symptoms.
Here’s a great video on PTSD’s effect on the body, brain, and emotions:
Why Cannabis and CBD for PTSD?
Cannabis and CBD offer promising alternatives to antidepressants and anti-anxiety drugs for PTSD. But to understand why cannabis and CBD were considered by researchers, aside from growing anecdotal evidence, you need to understand the endocannabinoid, or eCB, system.
The endocannabinoid system is made up of cannabinoid receptors and cannabinoid receptor proteins. This system is present throughout your nervous system, including your brain. Keep in mind, the eCB system is made up of native proteins and protein receptors that are expressed from your endogenous genes. Your cannabinoid receptors can be stimulated by the ingestion of cannabinoid-containing substances like cannabis.
There is a wealth of research showing that the eCB system plays a role in anxiety, learning, and emotional responses. This has put the eCB system in the spotlight as a target for pharmaceutical therapies. Researchers know that cannabidiol can stimulate the eCB system via cannabinoid type 1 (CB1) receptors. PTSD patients are also more likely to use cannabis and have altered levels of cannabinoid receptors.
CBD and PTSD: Rodent and Human Studies
The recent Frontiers in Neuroscience review summarizes seven studies looking at the effects of CBD on fear conditioning in rats as a model for PTSD in humans. In each case, CBD treatment had a positive effect by helping to decrease the fear conditioning response.
How exactly did CBD decrease the fear conditioning response? The most convincing studies showed that CBD helped the process of extinction for the fearful memory through the CB1 receptor.
In humans, trial results were equally promising. The review outlined two case studies that reported reductions in symptoms associated with PTSD, including anxiety and sleep disturbances, with CBD use. Two other larger trials looked at general cannabis use. One trial studied healthy individuals with fear conditioning (similar to the behavioral model used in the rat studies) and saw that cannabis facilitated fear conditioning memory extinction. Another trial studied patients suffering PTSD and found an association between cannabis use and reduced PTSD symptoms.
CBD as a Pharmacotherapy
CBD also has some general benefits as a pharmaceutical. Unlike Cannabis, isolated CBD does not have psychoactive properties, making it more practical for those who do not want to experience an altered state of mind with their medication.
As mentioned, antidepressants and anti-anxiety drugs have been used to treat PTSD in the past. However, these drugs usually have significant negative side effects, like sexual dysfunction and suicidal ideation, making patients less likely to stick to their treatment. Although more long-term studies are needed, CBD does not appear to have drastic side effects.
More clinical trials will be needed before doctors can start prescribing CBD to treat PTSD, but a huge amount of progress has been made.
This review also highlights the increasing acceptance of CBD as a valuable medical therapeutic. In the future, as more research is conducted, you’ll see the clinically-proven benefits of CBD will continue to grow.