Genetics to Cannabis: Implications for Treating PTSD

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Severe depression and a heightened sense on anxiety tend to be symptoms of PTSD in returning Veterans from our wars in Iraq and Afghanistan.   Nevertheless, these symptoms and how veterans cope with these issues in their everyday life vary significantly.    In fact, many returning veterans (see video below) can be oblivious to the problem until friends and family point out that their reactions to everyday frustrations seem well out of proportion to the circumstances.

While many Veterans are receiving treatment for PTSD, recent studies by the GAO suggest that the Department of Veteran Affairs (“VA”) is failing our Veterans and their loved one. A recent GAO report points out that “10% of vets treated by VA have major depressive disorder and 94% of those are prescribed anti-depressants.” Sadly, VA protocols have not changed much over the past several years as anti-depressant medication seems to deal with the symptoms of PTSD rather than provide any meaningful therapy for those Veterans at risk.

Do Genes Play a Role in Depression?

While the VA has been glacially slow to accept new treatment protocols, a number of scientific studies suggest that the genetic makeup of human beings could play a factor in recurring depression. For instance, Healthline reports that a British Research team:

” . . . recently isolated a gene that appears to be prevalent in multiple family members with depression. The chromosome 3p25-26 was found in more than 800 families with recurrent depression. Scientists believe as much as 40 percent of those with depression can trace it to a genetic link. Environmental and other factors make up the other 60 percent.

Research has also shown that people with parents or siblings who have depression are up to three times more likely to have the condition. This can be due to heredity or environmental factors that have a strong influence.”

Scientists at Stanford recently concluded that “This could mean that in most cases of depression, around 50% of the cause is genetic, and around 50% is unrelated to genes (psychological or physical factors). Or it could mean that in some cases, the tendency to become depressed is almost completely genetic, and in other cases it is not really genetic at all. We don’t know the answer yet.

While it is still far to early to draw any conclusions from these initial studies, the treatment of PTSD could become far more targeted and hopefully, effective, if it is determined that our genetic makeup plays a major factor in one’s propensity for depression.

Citing this and other studies, Dr. Richard Friedman, a professor of clinical psychiatry at Weill Cornell Medical College, concluded in an Op-Ed piece for the New York Times:

Recent neuroscience research explains why, in part, this may be the case. For the first time, scientists have demonstrated that a genetic variation in the brain makes some people inherently less anxious, and more able to forget fearful and unpleasant experiences. This lucky genetic mutation produces higher levels of anandamide — the so-called bliss molecule and our own natural marijuana — in our brains.

In short, some people are prone to be less anxious simply because they won the genetic sweepstakes and randomly got a genetic mutation that has nothing at all to do with strength of character. About 20 percent of adult Americans have this mutation.

Dr. Friedman then goes on to make a compelling case why marijuana or cannabis might be useful in treating PTSD.   As SFTT has argued many times, there is a vast difference between “treating the symptoms” of PTSD and “treating PTSD.”   As the most recent GAO Report suggests most Veterans diagnosed with PTSD are served a cocktail of prescription anti-depressants drugs which in some cases may have led to suicide.    While “prescription” cannabis in a controlled environment may reduce anxiety disorders, it is impossible to predict how well those symptoms may be masked if ingested with other anti-depressants.

SFTT’s own findings have suggested that well over 80% of Veterans suffering from PTSD suffer from substance abuse.    As such, clinical studies focused on one variable should be rigorously questioned before reaching any conclusions.  Nevertheless, found below is some recent research into using cannabis to treat PTSD.

Cannabis for Treating PTSD?

Citing research published in the Journal Neuropsychoparmacology, the Huffington Post reports the following:

” . . . administering of synthetic cannabinoids to rats after a traumatic event can prevent behavioral and physiological symptoms of PTSD by triggering changes in brain centers associated with the formation and holding of traumatic memories.

 ‘While cannabinoids occur naturally in the cannabis plant, this research was done with WIN 55,212-2, a synthetic cannabinoid that produces a similar, effect to that of THC, marijuana’s main psychoactive compound. The researchers specifically looked at the effect of this synthetic cannabinoid on exposure to trauma reminders. Among individuals who suffer from trauma, it is common for non-traumatic events (for instance, sirens going off) to evoke the memory of the traumatic event, thus amplifying the negative effects of the trauma.

“The findings of our study suggest that the connectivity within the brain’s fear circuit changes following trauma, and the administration of cannabinoids prevents this change from happening,” the researchers concluded. “This study can lead to future trials in humans regarding possible ways to prevent the development of PTSD and anxiety disorders in response to a traumatic event.”

Dr. Friedman, quote previously in his New York Times article titled “The Feel Good Gene,” goes on to comment on the use of cannabis in treating anxiety disorders:

“The endocannabinoid system, so named because the active drug in cannabis, THC, is closely related to the brain’s own anandamide, is the target of marijuana and has long been implicated in anxiety . . .  We all have anandamide, but those who have won the lucky gene have more of it because they have less of an enzyme called FAAH, which deactivates anandamide. It is a mutation in the FAAH gene that leads to more of the bliss molecule anandamide bathing the brain.

“People with the variant FAAH gene are less anxious and are thus less inclined to like marijuana. They actually experience a decrease in happiness when smoking marijuana, compared with those with the normal FAAH gene, who find it pleasurable. If you naturally have more of the real thing you understandably have little use for marijuana.

“Studies show that those without the variant gene suffer more severe withdrawal when they stop using cannabis. Here, at last, is an example of a mutation that confers an advantage: lower anxiety and protection against cannabis dependence — and possibly to addiction to some other drugs, too.”

Sadly, Dr. Friedman engages is some wishful posturing to help those that “are genetically disadvantaged” due to “a random and totally unfair assortment of genetic variants.”

The fact is that we are all walking around with a random and totally unfair assortment of genetic variants that make us more or less content, anxious, depressed or prone to use drugs . . . But psychotropic medications, therapy and relaxation techniques don’t help everyone, so what’s wrong with using marijuana to treat anxiety? . . . The problem is that cannabis swamps and overpowers the brain’s cannabinoid system, and there is evidence that chronic use may not just relieve anxiety but interfere with learning and memory. What we really need is a drug that can boost anandamide — our bliss molecule — for those who are genetically disadvantaged.

It is prophetic talk like this to prescribe “bliss” medications  that create the expectation that there is some “silver bullet” that will help Veterans with PTSD reclaim their lives.  Test and test some more, but don’t promote “bliss” pie-in-the-sky without fully addressing the potential harmful side-effects caused by cannabis, particularly when used in combination with other prescription drugs.

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