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Cannabinoid Drugs in Mental Health Disorders

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NeuroPsychopharmacotherapy

Abstract

Endocannabinoid signalling plays an important role in affect, anxiety, and reward, and thus targeting this system could potentially be used to treat mental health and substance use disorders. This chapter discusses the current state of the clinical evidence evaluating the potential of various cannabinoid drugs as mental health and addiction pharmacotherapy, with a focus on randomized controlled trials. A few small clinical trials have found preliminary evidence for different cannabinoids in mental health disorders, including cannabidiol (CBD) for anxiety disorders, and Δ9-tetrahydrocannabinol (THC) for post-traumatic stress disorder (PTSD) and Tourette syndrome. The evidence for cannabinoids in other mental health conditions (e.g., psychotic disorders) is mixed. The clinical evidence also suggests that a combination of CBD and THC may be useful in reducing cannabis craving and/or withdrawal in patients with cannabis use disorder (CUD), with possible longer-term effects on reducing cannabis use and promoting abstinence. CBD alone may have the potential to reduce cannabis use, promote tobacco smoking cessation, and attenuate opioid craving, though these findings need replication. Finally, the cannabinoid type-1 (CB1) receptor antagonist rimonabant showed promise as a smoking cessation pharmacotherapy, yet this drug was withdrawn from the market due to serious psychiatric adverse effects. The current evidence demonstrates the potential for cannabinoid drugs in the treatment of mental health and substance use disorders, yet this evidence is clearly in its early stages. Future directions for the field are discussed.

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Authors and Affiliations

  1. Campbell Family Mental Health Research Institute, Centre for Addiction and Mental Health (CAMH), Department of Psychiatry, University of Toronto, Toronto, ON, Canada

    Stefan Kloiber

  2. Translational Addiction Research Laboratory, CAMH, Toronto, ON, Canada

    Justin Matheson

  3. Department of Psychiatry, University of Toronto, Toronto, ON, Canada

    Helena K. Kim

  4. Translational Addiction Research Laboratory, Acute Care Program, and Campbell Family Mental Health Research Institute, CAMH, Departments of Family and Community Medicine, Pharmacology and Toxicology, Psychiatry, and Institute of Medical Science, University of Toronto, Toronto, ON, Canada

    Bernard Le Foll

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  1. Stefan Kloiber
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  2. Justin Matheson
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  3. Helena K. Kim
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  4. Bernard Le Foll
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Correspondence to Stefan Kloiber .

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Editors and Affiliations

  1. Dept Psychiatry , Psychosomatics & Psychotherapy, University of Würzburg, Medical School Clinical Neurochemistry, Würzburg, Germany

    Peter Riederer

  2. Inst für Psychologische Medizin, Haag, Bayern, Germany

    Gerd Laux

  3. Fujita Health University School Medicine, Toyoake, Aichi, Japan

    Toshiharu Nagatsu

  4. Center Translational Res Neurol Diseases, Dalian Med Uni Shanghai Inst Health Sc Center Translational Res Neurol Diseases, Dalian, China

    Weidong Le

  5. Würzburg, Bayern, Germany

    Christian Riederer

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  1. Clinic and Policlinic for Psychiatry, Psychosomatics and Psychotherapy, Univsersity of Hospital Würzburg, Würzburg, Germany

    Peter Riederer

  2. Department of Psychiatry, University of South Denmark, Odense, Denmark

    Peter Riederer

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Kloiber, S., Matheson, J., Kim, H.K., Le Foll, B. (2021). Cannabinoid Drugs in Mental Health Disorders. In: Riederer, P., Laux, G., Nagatsu, T., Le, W., Riederer, C. (eds) NeuroPsychopharmacotherapy. Springer, Cham. https://doi.org/10.1007/978-3-319-56015-1_465-1

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