Cannabis Instead of Antidepressants?

  • It's probably no surprise that cannabis could be a potential treatment for anxiety.
  • However, since it's not legal in most countries, research in this area significantly lags behind and it will take some time before this changes.
  • A recent study by Dr. Cuttler and her colleagues, however, showed that this unexplored area opens up great possibilities.

A recent study, which is the first of its kind, showed that regular cannabis consumption reduces a person's susceptibility to anxiety, even when sober.

The study, published in Psychopharmacology, found that people who used cannabis every or almost every day responded to stressful situations with blunted reactions, even some time after abstaining. Those who did not use cannabis reported feelings of anxiety during stressful situations and also showed increased levels of the stress hormone cortisol. Chronic cannabis users experienced less anxiety and cortisol levels remained at normal levels.

"It seems that cannabis affects stress even after the period of intoxication."– Dr. Carrie Cuttler, co-author of the study

The study included 40 people who regularly used cannabis during the previous year and 42 people who had used cannabis no more than ten times in their life, and not at all in the last year. All participants abstained 12 to 18 hours before the study.

"Based on our findings, we can say that cannabis seems to affect stress even after the period of intoxication," says the researcher, professor from Washington State University and co-author of the study, Dr. Carrie Cuttler.

"But," she warns, "we are not yet able to say with certainty whether stress suppression is a good or bad thing."

But one thing we know. Too much cortisol is definitely a bad thing. It is associated with everything - from anxiety and depression to digestive problems, heart disease, insomnia and memory problems. But too little cortisol can also cause problems, because this hormone helps to use accumulated energy and properly respond to stressful situations.

Cuttler thinks more research is needed to determine whether reduced cortisol levels affect anxiety therapeutically or harmfully in the long term. However, she adds that regarding cannabis and addiction, research is showing promising findings.

"We examined withdrawal syndrome in chronic users and observed whether they would experience increased desire for cannabis in a stressful situation," she reveals, "and surprisingly, we have no evidence that this occurs."

Anxiety disorders are among the most common mental illnesses in the USA. They affect approximately 40 million adults annually, which is about 18% of the population.

Benzodiazepines such as Xanax or Klonopin are often prescribed for short-term acute relief from anxiety and panic attacks. While they are very effective in the short term, they also have many side effects - drowsiness, confusion, disorientation. The body also quickly develops tolerance and addiction, with over 8,000 Americans dying from benzodiazepine overdose in 2015.

Does Depression and Anxiety Lead to Cannabis?

Selective serotonin reuptake inhibitors (SSRIs) such as Prozac and Zoloft are often prescribed for long-term relief from anxiety disorders. However, they also cause many side effects, including insomnia, headaches, drowsiness, decreased libido, and increased risk of suicidal thoughts.

Anxiety is also one of the most common reasons for cannabis use and researchers suggest that this option has relatively few side effects, low potential for addiction and almost no risk of overdose. But since cannabis is still classified as a Schedule I drug, very little research has been conducted on its long-term therapeutic potential for treating anxiety (until Cuttler's recent study).

Cuttler and her colleagues plan to repeat their study with a longer period of abstinence to truly clarify whether their results remain valid. They also hope to be able to conduct this study on rats to confirm their findings.

"One limitation of this research is that we cannot ethically control who uses cannabis every day and who does not," Cuttler explains. "So when our research indicates they have a blunted stress response, it may also mean that people who are already less susceptible to stress are more likely to use cannabis long-term. With rats, we can control both stress and cannabis."

Another recent study, published in Pharmacological Research, found that cannabidiol (CBD) may increase the effectiveness of the neurotransmitter GABA, which works to counteract substances released by cortisol during anxiety-inducing situations (such as glucose). While high doses of THC have the potential to worsen anxiety, CBD, which is a non-psychoactive substance, does not carry this risk.

The entire research is very promising, but Cuttler emphasizes that for anxiety, neither cannabis nor pharmaceutical medications should be the first step in treatment.

"As a psychologist, I believe that the ideal treatment for anxiety is cognitive-behavioral therapy (CBT)," she says. "In the short term, this therapy has the same results as anxiety medications, but in the long term (8-10 sessions) it outperforms these medications, and without negative side effects. I think about cannabis similarly – it can help treat symptoms, but it won't eliminate the root of the problem."