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  • Anxiety, Bipolar Disorder/s, Depression, Mental Disorders, Schizophrenia
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Prospects for the Use of Cannabinoids in Psychiatric Disorders

Please use this link to access this publication. Abstract Increasing evidence suggests an essential role of the endocannabinoid system in modulating cognitive abilities, mood, stress, and sleep. The psychoactive effects of cannabis are described as euphoric, calming, anxiolytic, and sleep-inducing and positively affect the mood, but can also adversely affect therapy. The responses to cannabinoid medications depend on the patient's endocannabinoid system activity, the proportion of phytocannabinoids, the terpenoid composition, and the dose used. There is some evidence for a therapeutic use of phytocannabinoids in psychiatric conditions. THC and CBD may have opposing effects on anxiety. Current guidelines recommend caution in using THC in...
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Endocannabinoids, cannabinoids and the regulation of anxiety

Please use this link to access this publication. Abstract Cannabis has been used for hundreds of years, with its ability to dampen feelings of anxiety often reported as a primary reason for use. Only recently has the specific role cannabinoids play in anxiety been thoroughly investigated. Here we discuss the body of evidence describing how endocannabinoids and exogenous cannabinoids are capable of regulating the generation and termination of anxiety states. Disruption of the endogenous cannabinoid (eCB) system following genetic manipulation, pharmacological intervention or stress exposure reliably leads to the generation of an anxiety state. On the other hand, upregulation of eCB signaling is capable...
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Does cannabis use impact cognitive behavioural therapy outcomes for anxiety and related disorders? A preliminary examination

Please use this link to access this publication. Abstract Objectives The current study examined whether cannabis use frequency and cannabis-related problem severity (as per the Cannabis Use Disorder Identification Test-Revised) predicted outcomes of cognitive behavioural therapy (CBT) for anxiety and related disorders. It was predicted that greater frequency of cannabis use and greater cannabis-related problem severity would be associated with dampened treatment outcomes compared to less severe cannabis use presentations. Methods Participants were 253 adults seeking treatment for anxiety and related disorders. Cannabis use was categorized as non-use (n = 135), infrequent use (using monthly to 4 times per month; n = 45), and frequent use (using 2 or more times per week; n = 73). Individuals who reported using cannabis completed...
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An investigation of cannabis use for insomnia in depression and anxiety in a naturalistic sample

Abstract Background Little is known about cannabis use for insomnia in individuals with depression, anxiety, and comorbid depression and anxiety. To develop a better understanding of distinct profiles of cannabis use for insomnia management, a retrospective cohort study was conducted on a large naturalistic sample. Methods Data were collected using the medicinal cannabis tracking app, Strainprint®, which allows users to monitor and track cannabis use for therapeutic purposes. The current study examined users managing insomnia symptoms in depression (n = 100), anxiety (n = 463), and comorbid depression and anxiety (n = 114), for a total of 8476 recorded sessions. Inferential analyses used linear mixed effects modeling to examine self-perceived...
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UK Medical Cannabis Registry: an analysis of clinical outcomes of medicinal cannabis therapy for generalized anxiety disorder

ABSTRACT Objectives Anxiety disorders are one of the most common reasons for seeking treatment with cannabis-based medicinal products (CBMPs). Current pharmacological treatments are variable in efficacy and the endocannabinoid system has been identified as a potential therapeutic target. This study aims to detail the changes in health-related quality-of-life (HRQoL) and clinical safety following CBMP therapy for generalized anxiety disorder. Methods A case series from the UK Medical Cannabis Registry was performed. Primary outcomes included changes from baseline in patient-reported outcome measures (the General Anxiety Disorder Scale (GAD-7), EQ-5D-5L (a measure of health-related quality of life), and Sleep Quality Scale (SQS)) at 1, 3 and...
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Medicinal Cannabis for the Treatment of Anxiety Disorders: a Narrative Review

Abstract Purpose of review Anxiety is a prevalent mental health condition which manifests as a disproportionate response of fear to a perceived threat. Different types of anxiety disorders vary in their pathophysiology, symptoms and treatments. The causes of anxiety disorders are complex and largely unknown; however, it has been suggested that a number of brain mechanisms and neurotransmitters are involved in the development of these conditions. While there are non-pharmacological treatments for anxiety, many patients are prescribed medications such as selective serotonin reuptake inhibitors, serotonin and noradrenaline reuptake inhibitors and/or benzodiazepines. Unfortunately, these medications have issues with efficacy and safety, and therefore, there is...
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Anxiety and cognitive-related effects of Δ 9-tetrahydrocannabinol (THC) are differentially mediated through distinct GSK-3 vs. Akt-mTOR pathways in the nucleus accumbens of male rats

Please use this link to access publication Abstract Rationale Δ9-tetrahydrocannabinol (THC) is the primary psychoactive compound in cannabis and is responsible for cannabis-related neuropsychiatric side effects, including abnormal affective processing, cognitive and sensory filtering deficits and memory impairments. A critical neural region linked to the psychotropic effects of THC is the nucleus accumbens shell (NASh), an integrative mesocorticolimbic structure that sends and receives inputs from multiple brain areas known to be dysregulated in various disorders, including schizophrenia and anxiety-related disorders. Considerable evidence demonstrates functional differences between posterior vs. anterior NASh sub-regions in the processing of affective and cognitive behaviours influenced by THC. Nevertheless, the...
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Acute effects of oral delta-9-tetrahydrocannabinol (THC) on autonomic cardiac activity and their relation to subjective and anxiogenic effects

Please use this link to access publication Abstract Cannabis is the most commonly used psychotropic drug in the United States, after alcohol. Despite its apparent sedative and calming effects, cannabis and its main psychoactive constituent, ∆9-tetrahydrocannabinol (THC) can produce serious adverse effects including tachycardia and anxiety. These effects can be especially pronounced in women, who remain underrepresented in clinical cannabinoid research. The present study is one of the first to characterize the effects of single doses of oral THC on autonomic nervous system function in healthy adult women. Occasional female cannabis users participated in three laboratory sessions in which they received oral THC (7.5 and 15 mg) and placebo. Autonomic...
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“Flower Power”: Controlled Inhalation of THC-Predominant Cannabis Flos Improves Health-Related Quality of Life and Symptoms of Chronic Pain and Anxiety in Eligible UK Patients

Abstract In November 2018, the UK’s Home Office established a legal route for eligible patients to be prescribed cannabis-based products for medicinal use in humans (CBPMs) as unlicensed medicines. These include liquid cannabis extracts for oral administration (“oils”) and dried flowers for inhalation (“flos”). Smoking of CBPMs is expressly prohibited. To date, THC-predominant cannabis flowers remain the most prescribed CBPMs in project Twenty21 (T21), the first multi-center, prospective, observational UK cannabis patient registry. This observational, prospective data review analyzes patient-reported outcome measures (PROMS) collected by T21 associated with the inhalation of KHIRON 20/1, the most prescribed CBPM in the project. PROMS collected at baseline...
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Medicinal cannabis for the treatment of anxiety disorders

Please use this link to access publication Abstract Background: Anxiety is second most common reason for medicinal cannabis prescription in Australia and is being treated with both Delta9-tetrahydrocannabinol (THC)-containing and cannabidiol (CBD)-dominant products. Objective: The aim of this article is to summarise recent advances in the understanding of medicinal cannabis in treating anxiety and recent trends in prescribing. Discussion: Clinical trials and laboratory studies provide evidence of anxiolytic effects of CBD in healthy volunteers and clinical populations, although current evidence is insufficient to support CBD as a first-line treatment. The evidence regarding the use of THC-dominant products for anxiety is ambiguous, with exacerbation of...
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