Bahji Anees, Meyyappan Arthi Chinna, Hawken Emily R
Department of Psychiatry, Queen's University, Kingston, Ontario, Canada.
Department of Psychiatry, Queen's University, Kingston, Ontario, Canada; Providence Care Hospital, Kingston, Ontario, Canada.
J Psychiatr Res. 2020 Oct;129:257-264. doi: 10.1016/j.jpsychires.2020.07.030. Epub 2020 Jul 31.
The aim of this study was to assess the efficacy and acceptability of cannabinoids for the treatment of anxiety disorders.
For this systematic review and meta-analysis, we searched for randomized trials utilizing cannabinoids for the treatment of adults with anxiety disorders. Primary outcomes were reduction in anxiety disorder symptoms, and study discontinuation due to adverse events. Evidence was synthesized as rate ratios (RRs) and as standardized mean differences (SMDs) using random-effects meta-analyses.
A total of 14 eligible trials representing 1548 individuals (median age: 33 years; range: 28-44; 66% male) were identified. Cannabinoids reduced anxiety symptoms (SMD = -1.85, 95% CI: -2.61 to -1.09) without causing significant adverse events. Greater efficacy was observed among younger patients (p < 0.01) and with longer treatment (p < 0.01). However, publication bias was substantial, and after correction, the overall anxiolytic effect was not statistically significant.
While cannabinoids may be of potential value in the treatment of anxiety disorders, the routine use of these treatments is not supported by the available evidence after correction for publication bias.
本研究旨在评估大麻素治疗焦虑症的疗效和可接受性。
在这项系统评价和荟萃分析中,我们检索了使用大麻素治疗成年焦虑症患者的随机试验。主要结局为焦虑症症状减轻以及因不良事件导致的研究中断。采用随机效应荟萃分析将证据综合为率比(RRs)和标准化均数差(SMDs)。
共识别出14项符合条件的试验,涉及1548名个体(中位年龄:33岁;范围:28 - 44岁;66%为男性)。大麻素可减轻焦虑症状(SMD = -1.85,95%CI:-2.61至-1.09),且未引起显著不良事件。在年轻患者(p < 0.01)和治疗时间较长的患者中观察到更大的疗效(p < 0.01)。然而,发表偏倚较大,校正后总体抗焦虑作用无统计学意义。
虽然大麻素在治疗焦虑症方面可能具有潜在价值,但在校正发表偏倚后,现有证据不支持常规使用这些治疗方法。