Obsessive-compulsive disorder (OCD) is a mental disorder that is characterized by intrusive obsessive thoughts and repetitive behaviors, which can significantly impair ordinary function. While there are treatments available, such as psychological therapy and antidepressant medication, they can take several months to become effective and often come with side effects. As a result, researchers are exploring alternative treatments for OCD, including the use of cannabis-based medicine.
A review article published in Cannabis and Cannabinoid Research examines the possibility of using the endocannabinoid system (ECS) to modulate anxiety, fear, and repetitive behaviors associated with OCD. The ECS is a complex system within the body that regulates emotionality, and animal and human studies have implied that it may play a role in OCD.
The authors note that CB1 cannabinoid receptors are found in the same regions of the brain and central nervous system that have been implicated in OCD. Several animal and human studies have evaluated the effect of administering cannabinoids and modulating the ECS on repetitive behavior and other symptoms of OCD.
From their review of relevant animal studies, the researchers found that CB1R agonists and metabolic enzymes of the ECS can have an anti-anxiety effect when given at specific dosages. Modulation of the metabolic enzymes was also linked to a decreased responsiveness to stress and the facilitation of fear extinction. In relation to repetitive behavior, studies suggested that insufficient CB1R activity might lead to a dependence on previously learned behaviors and habits.
In human clinical studies, CBR1 agonists such as dronabinol (a THC analog) as well as cannabidiol (CBD) were found to be useful in curbing anxiety and enhancing the extinction of fear memories in healthy adults. Survey data from investigations into the effects of cannabis on patients with Tourette syndrome also suggested a link between the ingestion of cannabinoids and the reduction of motor tics and the urge to perform compulsive behaviors.
The researchers were able to find only three case studies that directly dealt with OCD and the effects of cannabinoids on its symptoms. In all three cases, patients had failed to respond to conventional treatments before being given dronabinol. Within 10 days to two weeks of starting treatment with dronabinol, patients reported a significant improvement in OCD symptoms as measured by their Yale-Brown Obsessive Compulsive Scale scores.
The researchers conclude their review by recommending further investigation into the action of cannabinoids on OCD symptomatology as it appears that cannabinoids could be an effective novel treatment for this debilitating condition. Further study into the mechanisms underlying ECS activity in relation to OCD symptomology is also recommended. Overall, these findings suggest that cannabinoid-based medicine could offer an alternative treatment for individuals suffering from OCD who may not have responded to other therapies.