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药用大麻在创伤后应激障碍中的应用:当前文献综述

The Use of Medicinal Marijuana for Posttraumatic Stress Disorder: A Review of the Current Literature.

作者信息

Yarnell Stephanie

机构信息

Department of Psychiatry, Yale University, New Haven, Connecticut.

出版信息

Prim Care Companion CNS Disord. 2015 May 7;17(3). doi: 10.4088/PCC.15r01786. eCollection 2015.

Abstract

BACKGROUND

Medicinal marijuana has already been legalized in over 23 states with more considering legalization. Despite the trend toward legalization, to date, there has been no systematic review of the existing literature for the efficacy of medicinal marijuana for many of the conditions for which it is proposed to treat. This study seeks to understand the current literature regarding the use of medicinal marijuana in the treatment of posttraumatic stress disorder (PTSD).

DATA SOURCES

PubMed and PsycINFO databases were searched until April 2014 for articles outlining outcomes of case files, control studies, and observational studies regarding the efficacy of medicinal marijuana in treating PTSD. Various combinations of the following search terms were used: marijuana, medicinal marijuana, cannabis, cannabinoid, PTSD, efficacy, trial, and neurobiology.

STUDY SELECTION

Full text of each article was reviewed, and those directly addressing the question of efficacy of medicinal marijuana on PTSD symptomatology were included. Data were extracted from a total of 46 articles.

RESULTS

Analysis revealed that most reports are correlational and observational in basis with a notable lack of randomized, controlled studies. Many of the published studies suggest a decrease in PTSD symptoms with marijuana use. Though the directionality of cannabis use and PTSD could not be fully differentiated at this time, there appears to also be a correlation between PTSD and problematic cannabis use. Despite this finding, there is a growing amount of neurobiological evidence and animal studies suggesting potential neurologically based reasons for the reported efficacy.

CONCLUSIONS

Posttraumatic stress disorder is 1 of the approved conditions for medicinal marijuana in some states. While the literature to date is suggestive of a potential decrease in PTSD symptomatology with the use of medicinal marijuana, there is a notable lack of large-scale trials, making any final conclusions difficult to confirm at this time.

摘要

背景

医用大麻已在超过23个州实现合法化,还有更多州在考虑合法化。尽管有合法化的趋势,但迄今为止,对于医用大麻在许多其拟治疗病症上的疗效,尚未对现有文献进行系统综述。本研究旨在了解当前关于使用医用大麻治疗创伤后应激障碍(PTSD)的文献情况。

数据来源

检索了PubMed和PsycINFO数据库,直至2014年4月,以查找概述医用大麻治疗PTSD疗效的病例档案、对照研究和观察性研究的结果。使用了以下搜索词的各种组合:大麻、医用大麻、大麻属植物、大麻素、PTSD、疗效、试验和神经生物学。

研究选择

对每篇文章的全文进行了审查,纳入了直接探讨医用大麻对PTSD症状疗效问题的文章。共从46篇文章中提取了数据。

结果

分析显示,大多数报告基于相关性和观察性,明显缺乏随机对照研究。许多已发表的研究表明,使用大麻后PTSD症状有所减轻。尽管目前无法完全区分大麻使用与PTSD之间的方向性,但PTSD与问题性大麻使用之间似乎也存在关联。尽管有这一发现,但越来越多的神经生物学证据和动物研究表明,所报告的疗效可能存在基于神经学的原因。

结论

创伤后应激障碍是一些州批准使用医用大麻的病症之一。虽然迄今为止的文献表明使用医用大麻可能会减轻PTSD症状,但明显缺乏大规模试验,因此目前难以得出任何最终结论。

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