A Preliminary Look at the Potential Role of the Endocannabinoid System in the Management of PTSD
George A. Fraser
Consultant psychiatrist, Canadian Forces Health Services Centre (Ottawa), Mental Health department.
Neurobiology of Post-traumatic Stress Disorder. Hauppauge, New York: Nova Science Publishers, 2010, 376 pages.
The newly discovered endocannabinoid system (ECS) and the ongoing research into its role in the central nervous system (CNS) has important ramifications in the understanding and treatment of posttraumatic stress disorder (PTSD). While the connection with this system and PTSD is in its early stages, and only one small clinical study involving patients with PTSD being treated with an endocannabinoid agonist has been published to date, [1] nonetheless emerging investigations into the endocannabinoid system are promising and warrant a dialogue and speculation about the potential benefits of endocannabinoid ligands in the treatment of PTSD. This chapter will consider three areas related to the endocannabinoid system and how it may be connected to the field of posttraumatic stress disorder. First will be an overview of the recent discovery of endocannabinoid system. Next, research studies pointing to potentially interesting relationships between cannabinoids, endocannabinoids and PTSD will be discussed. Finally, clinical issues and questions arising out of actual field experience using nabilone, a synthetic cannabinoid, will be presented. This latter area will be of interest to clinicians who may consider using a synthetic cannabinoid for the first time with a PTSD patient. It will be based on the above mentioned clinical trial which used a synthetic cannabinoid in managing treatment resistant PTSD nightmares which was carried out by this author.