Department of Psychiatry, University of Toronto, Baycrest Hospital, Permanent Address: 19 Tumbleweed Road, Toronto, Ontario M2J 2N2, Canada.
Curr Neuropharmacol. 2020;18(8):754-768. doi: 10.2174/1570159X18666200114142321.
The cannabinoids, Δ9 tetrahydrocannabinol and its analogue, nabilone, have been found to reliably attenuate the intensity and frequency of post-traumatic nightmares. This essay examines how a traumatic event is captured in the mind, after just a single exposure, and repeatedly replicated during the nights that follow. The adaptive neurophysiological, endocrine and inflammatory changes that are triggered by the trauma and that alter personality and behavior are surveyed. These adaptive changes, once established, can be difficult to reverse. But cannabinoids, uniquely, have been shown to interfere with all of these post-traumatic somatic adaptations. While cannabinoids can suppress nightmares and other symptoms of post-traumatic stress disorder, they are not a cure. There may be no cure. The cannabinoids may best be employed, alone, but more likely in conjunction with other agents, in the immediate aftermath of a trauma to mitigate or even abort the metabolic changes which are set in motion by the trauma and which may permanently alter the reactivity of the nervous system. Steps in this direction have already been taken.
大麻素，Δ9 四氢大麻酚及其类似物纳布隆，已被发现能可靠地减轻创伤后噩梦的强度和频率。本文探讨了创伤事件是如何在单次暴露后被大脑捕捉，并在随后的夜晚反复重现的。文中还调查了创伤引发的适应性神经生理、内分泌和炎症变化，这些变化改变了个性和行为。这些适应性变化一旦确立，就很难逆转。但是大麻素，独一无二，已被证明可以干扰所有这些创伤后的躯体适应。虽然大麻素可以抑制噩梦和创伤后应激障碍的其他症状，但它们并不是一种治愈方法。可能没有治愈方法。大麻素可能最好单独使用，但更可能与其他药物联合使用，在创伤发生后的立即治疗中，减轻甚至阻止由创伤引发的代谢变化，这些变化可能会永久改变神经系统的反应性。已经朝着这个方向迈出了一步。
