OCD and cannabis therapy: Recent studies show progress

Karhlyle Fletcher, The Fresh Toast
January 25, 2021 – Published on healthing.ca

Obsessive-compulsive disorder (OCD) is an anxiety disorder that is distinguished by obsession, habits and rituals, such as, for example, things that are always done when opening a door. These behaviours are often carried out to accomplish a “just-right feeling”.

The disorder is commonly comorbid with other conditions, including Tourette syndrome. OCD varies widely from person to person, and research continues to develop.

It is estimated that two to three per cent of the population has OCD. About a third of those with the condition don’t experience benefits from traditional therapy or medicines, according to a 2020 study published in Frontiers in Psychiatry. As a result of this, deep brain stimulation surgery has been suggested as a possible treatment option.

In the recent study, researchers note “there is increasing evidence that the endocannabinoid system (ECS) might be involved in the pathophysiology of OCD. In line with this hypothesis, from a limited number of case studies, it is suggested that CBM (cannabimovone) might be effective in the treatment of OCD.”

Using the serotonin model, which is why doctors prescribe selective serotonin re-uptake inhibitors, cannabis may be able to benefit those with OCD or related anxiety disorders by either promoting balance with the ECS or regulating the presence of serotonin. As the ECS suffers when someone is under high stress, the ability of cannabis to relieve stress may also help the condition.

The study, which was led by Natalia Szejko of Yale University’s School of Medicine, includes a case report of a 22-year-old, along with an overview of relevant animal studies, a review of studies on cannabis’s effects on those with OCD and a review of studies on the effects of cannabis among those with Tourette syndrome.

Before trying cannabis, the 22-year-old patient was prescribed pills that he quit following a week of treatment because of nausea, headache and no positive effects. However, after finding the right concentration of THC, the patient “reported a marked reduction of obsessions and compulsions of about 70 per cent, as well as general relaxation, improved sleep and concentration at school, as well as overall improvement of his quality of life, resulting in better social functioning and reduced problems at work.” The subject was also able to lessen his nicotine use.

One study “reported a marked reduction of obsessions and compulsions of about 70 per cent.”

The analysis of the other cases included that of a 38-year-old woman with severe OCD. She found that by smoking cannabis off the street that her symptoms improved. After changing her treatment to including Dronabinol, she saw a 50 pr cent decrease in her OCD symptoms. Another patient, a 36-year-old man with schizophrenia and OCD who didn’t respond adequately to electroconvulsive therapy, saw marked improvement after including Dronabinol in his treatment.

Yet another case, a man who was suffering from unwanted repetitive sexual and violent thoughts stemming from brain trauma, didn’t see improvement after being prescribed “fluvoxamine, clomipramine, mirtazapine, risperidone, olanzapine, clozapine, ziprasidone, haloperidol, quetiapine, memantine, ondansetron, intravenous ketamine, N-acetylcysteine, gabapentin, clonazepam, plus mood-stabilizing agents,” yet his symptoms improved after two weeks of being given Dronabinol.

Similarly, those with Tourette syndrome, including a 16-year-old patient suffering from rage attacks, have found relief from Dronabinol.

This analysis opens up the conversation about using cannabis as an alternative to selective serotonin re-uptake inhibitors, and combining cannabis with traditional therapy to improve the efficacy of both.