Sunday, December 2, 2012

Medical Cannibis/Marijuana in post-traumatic stress disorder and use: A naturalistic observational study, Athens Psychiatric Conference, Dec. 2 2012

These are my rough notes from the psychiatric conference in Athens Dec. 2 2012

Post Traumatic Stress Disorder: Psychiatric Comorbidity and complications Chairs: I Reznick (Israel) and D. Papadatou

 Medical Cannibis/marijuana in Post Traumatic Stress Disorder and use - a naturalistic observational study I. Reznick
- Chief Psychiatrist, MaReNa Diagnostic and Consulting Centre,Bat-Yam/Tel-Aviv, affiliated to Sackler Faculty of Medicine, Tel Aviv University, Israel

 Life time prevalence PTSD rate 6.8% - kessler et al 34 -50% of patients referred for tx of pain, have full blown PTSD or significant symptatmologiy -60 to 70% of patients dx with Chronic PTSD developed subsequent significant depressive symptamatology Current ways of PTSD management - all three of current guidlinesrecommend use of CBT or SSRI’s as first line tx -it is known efficacy is modest to moderate at most -many ptsd patients frequently use marijuana in presumably in order to relieve persistent stress and depression to reduce pain -there is obviously a lack of clinical studies
Fraser GA - use of synthetic cannabinoid in manatement of treatment resistant nightmares in PTSD - CNS Neuroscience Ther. 2009

 Naturalistic study - Question - we do not know what kind of PTSD patients could benefit

We assessed the mental condition of 167 adult PTSD patients who applid to the Ministry of Health for license for medical cannibis
3 groups PTSD patients only “so called pure”
PTSD patients with depression
 PTSD with chronic pain First group often young women raped - social anxiety, can’t leave homes, don’t have physical pain difficulty was that ministry of health wouldn’t grant continuation because they didn’t have physical pain 
We followed majority (85%) longitudinally for a period of more than 3 years
 Only about 50 % of applirers were able to get license (study group)
Daily dosage was in range 2-3 gr/day - (containing 20 to 25% of active compound, mostly THC) Majority of PTSD used also conventional medications (antidepressants, sedatives and pain killers0 from their treating physicans and psychiatrists.
3 groups - all groups improved
CAPS scale - no significant change in thre groups
Quality of Life Scale improved all three
Clinical Global Impression - PTSD and pain - best results, though all improved
 Patients reported discontinuance or lowering the dosage of pain killers No exacerbation or serious adverse events - no new panic attacks, or psychosis
 (The presenter was truly impressive, articulate, humble, learned, concerned - this is the kind of “science’” needed in this field where to date there has been far too much ‘politics’ and way too little ‘science’) DSCN0252 DSCN0257 DSCN0258

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