PTSD

PTSD is a trauma- and stressor-related disorder defined in DSM-5-TR by intrusion, avoidance, negative alterations in cognition/mood, and arousal symptoms persisting >1 month after exposure to a qualifying traumatic event. The "endocannabinoid deficiency" hypothesis (Hill, Hillard, and colleagues) posits that reduced anandamide tone at CB1 receptors impairs fear extinction, providing a rationale for cannabinoid therapeutics. NASEM (2017) rated evidence as limited that nabilone improves PTSD symptoms. The first FDA-regulated placebo-controlled trial of smoked cannabis for PTSD in U.S. veterans (Bonn-Miller, Sisley, et al., PLOS ONE 2021; MAPS-sponsored) randomized 80 participants across high-THC, high-CBD, balanced THC/CBD, and placebo arms and found no significant difference on the primary CAPS-5 outcome at end of Stage 1 ⚠️. A MAPS/Sisley Phase 3 trial has been planned/initiated to address power and dosing limitations. → See also: Nabilone, CB1 receptor, Anandamide, Endocannabinoid system.