INTRODUCTION: -
Do not be surprised by this scientific study wherein we figure out if cannabis can be better used to treat anxiety or depression or both. A study in 2002 demonstrated that in the USA, and western Europe cannabis is a very commonly used illegal substance. Early scientific literature has mentioned that cannabis is mostly used in persons suffering from anxiety and depression and that too many times higher than casual users. They have noticed that use of cannabis is almost 20 to 29 percent in persons suffering from panic and social anxiety; although as high as 60 percent use has been seen by persons having panic symptoms. Also, persons with depression are also high users of cannabis.
This study is an effort to treat such users of cannabis, who are suffering from anxiety and depression. The only study done so far in 2004 was with Paroxetine for treatment of Panic Disorder (PD). This study called CCAP trial is a large scientific study involving three centers who were one of the highest consumers of cannabis. This study used a combination of behavioural therapy and medicines in which reduction of two parameters, ie, panic symptoms and depression symptoms were studied along with social phobia symptoms such fear of speaking in public.
METHODS: -
232 patients were selected who had panic disorder in the three different centers, ages ranging from 18 to 70 years, knowing English, had a telephonic connection, and agreed for taking part in this study.
PROCEDURES: -
The patients selected were interviewed, screened, and divided into Collaborative Care for Anxiety and Panic - CCAP treated, or usual care or control groups. The CCAP treatment in turn had two groups, one with Cognitive Behavioural Therapy or CBT, that is psychological treatment and the other psychiatric treatment. The CBT group was counselled by a health specialist, while the other group had a primary care physician as a mediator. Patients from the control group received medicines without psychiatric consultation. All telephonic interviews were done at start of study and after 3, 6, 9, and 12 months.
MEASURES: -
Panic symptoms were measured by a scale in periods of 3, 6, 9, and 12 months and patients were assessed for discomfort facing anxious situations. Social phobia symptoms were assessed on another scale in which patients fear of talking to people of high authority, etc.; while depression was assessed on a different scale where patients' depressive states were monitored for the last seven days. Patients were also assured of confidentiality of their interviews. Sample was divided into two groups, 1. Those reporting monthly use of cannabis, 2. Those using less than monthly.
They were then monitored for anxiety sensitivity, social phobia and depression at the start of the study.
Monthly cannabis users had lower income and were less likely to have a school education, and unlikely to be married.
Both the groups had patients with almost similar age, gender and race. The monthly users were reported to be anxious and depressed than the less monthly users. Monthly users were also reported to have more of social phobia and depression.
DISCUSSION: -
EFFECT MODERATION OF DEPRESSION: -
This study found no evidence that monthly intake of cannabis reduced the incidence of social phobia or panic attacks. It was also found out that relation anxiety with depression is quite common, leading one to believe that probably the origin of anxiety or depression could be the same. Hence use of cannabis may have a reducing effect on both anxiety and depression, but unfortunately this study was not meant to detect this relation.
Monthly cannabis users had a higher incidence of depression in the control group, than users in the CCAP group, using less than monthly cannabis, but CCAP group had better reduction in cases of depression than the control group.
Hence it appears that a combined CBT along with medicine treatment (as in CCAP group) could be the best way to reduce depression among occasional cannabis users.
Hence the results in this study suggest using the above treatment for Panic Disorder patients who occasionally use cannabis.
CONCLUSION: -
There appears to be no link between the treated patients and cannabis use for patients suffering from social phobia or are having panic symptoms. But in monthly users, symptoms of depression reduced significantly in the CCAP treatment group including in cases of less than monthly users, But as suggested, a combined treatment involving psychological therapy and medications may give best results for treatment of depression among occasional users. This is also significant as depression affects a huge number of people.
Compiled from various international research journals available at google scholar by D. Mukherjee having 38 years of pharmaceutical (Cardiac, Diabetic, Neurology, Pain & Inflammation products) experience with a Swiss Multinational Company NOVARTIS and edited by Dr Sandeep Ahlawat, MBBS