The Use of Medical Cannabis in the Treatment Comorbid Anxiety and Depression (4674)

Objective: To evaluate the efficacy and adverse effects of medical cannabis in the treatment of anxiety and depression.

Background: According to the NIMH, anxiety and depression affect the American adult population at rates of 19.1% and 7.1%. Incidence of anxiety and depression is highest amongst females at 23.4% & 8.7% respectively as compared to males at 14.3% & 5.3% respectively. With medical cannabis (MC) legal in 33 states, MC may present as a treatment option for patients with anxiety and/or depression.

Design/Methods: This retrospective chart analysis was conducted on patients with comorbid anxiety and depression as diagnosed by a board-certified neurologist in a neurologic outpatient setting in New York State. Patients were certified to use MC as part of New York State’s Medical Marijuana Program.

Results: 101 (82=female, 19=male) patients aged 23–87 years with anxiety and depression medicating with benzodiazepines and selective serotonin/norepinephrine reuptake inhibitors (SSRI/SNRIs) were included. Symptomatic benefit was appreciated in 88.12% (n=89) on MC treatment, with 23.76% reporting improvement in anxiety (n=24) and 2.97% reporting improvement in depression (n=3). Benzodiazepine usage was reduced in 42.57%, with 13.86% discontinuing. SSRI/SNRI usage was reduced in 20.79%, with 18.81% discontinuing. These results were most commonly achieved using one MC product (69.31%), with 75.25% of patients utilizing sublingual administration via tincture. 20:1 and 1:1 (THC:CBD) ratio products were most commonly associated with positive outcomes. Only 22.77% (n=23) of the population reported side effects with the most common being somnolence (2.97%). One patient discontinued as a result of side effect and no serious AEs were reported.

Conclusions: MC is well-tolerated in patients with anxiety and depression, and may play a role in one’s ability to reduce benzodiazepine and/or SSRI/SNRI medication consumption. Efficacy and medication reduction was most often exhibited in those using 20:1 and 1:1 (THC:CBD) ratios. Further investigations, including randomized placebo-controlled trials are needed to confirm these results.

Disclosure: Dr. Mechtler has received personal compensation in the range of $100,000-$499,999 for serving as a Consultant for Jushi Inc. Dr. Mechtler has received personal compensation in the range of $10,000-$49,999 for serving on a Speakers Bureau for Amgen. Dr. Mechtler has received personal compensation in the range of $10,000-$49,999 for serving on a Speakers Bureau for Novartis. Dr. Mechtler has received personal compensation in the range of $10,000-$49,999 for serving on a Speakers Bureau for Allergan. Dr. Mechtler has received personal compensation in the range of $10,000-$49,999 for serving on a Speakers Bureau for Eli Lilly. Dr. Mechtler has received personal compensation in the range of $10,000-$49,999 for serving on a Speakers Bureau for Teva. Dr. Mechtler has received personal compensation in the range of $10,000-$49,999 for serving on a Speakers Bureau for Biohaven. Dr. Mechtler has received personal compensation in the range of $10,000-$49,999 for serving on a Speakers Bureau for Lundbeck. Dr. Mechtler has received stock or an ownership interest from Jushi Co.. The institution of Dr. Mechtler has received research support from The Harry Dent Family Foundation, Inc. The institution of Dr. Mechtler has received research support from Teva. The institution of Dr. Mechtler has received research support from Novartis. The institution of Dr. Mechtler has received research support from Biogen. The institution of Dr. Mechtler has received research support from Eli Lilly. The institution of Dr. Mechtler has received research support from Genetech. The institution of Dr. Mechtler has received research support from Alder. The institution of Dr. Mechtler has received research support from Acadia. The institution of Dr. Mechtler has received research support from Avanir. The institution of Dr. Mechtler has received research support from Boston Biomed. The institution of Dr. Mechtler has received research support from Sensorion. The institution of Dr. Mechtler has received research support from Allergan. The institution of Dr. Mechtler has received research support from ElectroCore. The institution of Dr. Mechtler has received research support from Amgen. The institution of Dr. Mechtler has received research support from Biohaven. The institution of Dr. Mechtler has received research support from Xenon. The institution of Dr. Mechtler has received research support from Miles for Migraine. The institution of Dr. Mechtler has received research support from American Migraine Foundation. The institution of Chris Ralyea has received research support from Harry Dent Family Foundation. The institution of Chris Ralyea has received research support from Colgate Palmolive. Mr. Hart has nothing to disclose. Mr. Bargnes has received research support from Harry Dent Family Foundation.