Papini Santiago, Sullivan Gregory M, Hien Denise A, Shvil Erel, Neria Yuval
New York State Psychiatric Institute, 1051 Riverside Drive, New York, NY, 10032, USA; City College of New York, 160 Convent Avenue, New York, NY, 10031, USA; Columbia University Medical Center, W. 168th Street, New York, NY, 10032, USA.
New York State Psychiatric Institute, 1051 Riverside Drive, New York, NY, 10032, USA; Columbia University Medical Center, W. 168th Street, New York, NY, 10032, USA.
Biol Psychol. 2015 Jan;104:8-18. doi: 10.1016/j.biopsycho.2014.10.010. Epub 2014 Nov 4.
Despite the lack of clinical research, marijuana and synthetic cannabinoids have been approved to treat posttraumatic stress disorder (PTSD) in several states in the United States. This review critically examines preclinical research on the endocannabinoid system (ECS) in order to evaluate three key questions that are relevant to PTSD: (1) Does ECS dysfunction impact fear extinction? (2) Can stress-related symptoms be prevented by ECS modulation? (3) Is the ECS a potential target for enhancing PTSD treatment? Disruption of the ECS impaired fear extinction in rodents, and ECS abnormalities have been observed in PTSD. Targeting fear memories via the ECS had mixed results in rodents, whereas augmented cannabinoid receptor activation typically facilitated extinction. However, the translational value of these findings is limited by the paucity and inconsistency of human research. Further investigation is necessary to determine whether incorporating cannabinoids in treatment would benefit individuals with PTSD, with cautious attention to risks.
尽管缺乏临床研究,但大麻和合成大麻素已在美国多个州被批准用于治疗创伤后应激障碍(PTSD)。本综述批判性地审视了内源性大麻素系统(ECS)的临床前研究,以评估与PTSD相关的三个关键问题:(1)ECS功能障碍是否会影响恐惧消退?(2)通过ECS调节能否预防与压力相关的症状?(3)ECS是否是增强PTSD治疗效果的潜在靶点?ECS的破坏会损害啮齿动物的恐惧消退,并且在PTSD中已观察到ECS异常。通过ECS靶向恐惧记忆在啮齿动物中产生了不同的结果,而增强大麻素受体激活通常有助于消退。然而,这些发现的转化价值受到人类研究的匮乏和不一致的限制。有必要进行进一步调查,以确定在治疗中加入大麻素是否会使PTSD患者受益,同时要谨慎关注风险。