Hi everyone my name is Alyssa Reese and I'm a first year medical student at the Jacobs School
of Medicine. I do research at DENT Neurological Institute and today I'll be discussing
medical cannabis as a plausible replacement for current anxiety and depression medications.
So you all may be familiar with anxiety disorder and major depressive disorder as it's very common the
United States. In fact, 31.1 percent of U.S. adults experience anxiety disorder during their life and
in 2017 approximately 11 million U.S. adults were severely impaired by a major depressive episode
and with the COVID pandemic, I'm sure these numbers have increased. And currently, the treatment methods
for anxiety and major depressive disorder aren't great. They come with a variety of side effects and
it's often difficult to get the best dose for the patient and they may have to change medications
and dosing frequently in order to find something that works for them. So one of my research
questions for my literature review asked "what is the overlap between the mechanisms of the current
anti-anxiety and antidepressant medications with cannabinoids?" And using this knowledge, what are
the potential implications of replacing current anxiety and depression medications with medical
cannabis? So some background about the medical cannabis plant. We have the cannabis plant and
many different compounds within it. So you may be familiar with THC and CBD.
THC is known for being the more psychoactive ingredient while CBD is known for being the
more calming or soothing ingredient. And then there's also a variety of phytochemicals which
we still don't know that much about but we do know that they could potentially have different effects,
so the different levels of the THC the CBD and the phytochemicals can lead to different effects on
the human body. but how does our brain know how to react to these substances? Because we can take in
many different substances, but why would it cause a psychoactive effect versus a calming effect?
Well, we already have a system that has cannabinoids in it. So this is called the
endogenous cannabinoid system and we have endogenous cannabinoids such as 2-AG and AEA
and these are just substances in our body that act like medical cannabis, and what these do is
that they bind to cannabinoid receptors and they act as chemical messengers. And in turn, when they
interact with these receptors they can release more messengers and these chemical messengers
are commonly referred to as neurotransmitters and they can have a variety of effects on the body.
So basically medical cannabis can act just like the body's natural endocannabinoids
and use the same exact system to exert a variety of different effects.
So my literature review revealed promising data from studies that
demonstrated positive effects of medication substitution based on mechanism overlap.
What I found was that the medications that are used for anxiety and MDD are very similar in
terms of their mechanism to medical cannabis. They can alter chemical messengers such as serotonin,
dopamine, and GABA in very similar ways in order to have a positive effect on the human patient.
So you can see here that we have separate anxiety and separate medical cannabis treatments, but
in actuality these can actually overlap and have very similar effects
on your neurotransmitters and the effects that they can have positively on the body.
So one recent retrospective chart analysis at DENT, which basically just means that we looked at old
charts, found that patients with both anxiety and depression when taking medical cannabis
had great benefit from it. So we had 101 patients with anxiety and depression and 88% of those
participants had symptomatic benefit for medical cannabis. And we also saw that they reduced their
medication use so benzodiazepine and SSRIs and SNRIs are medications used for anxiety
and MDD and we found that the benzodiazepine is reduced by 42.57% in participants. Um, and
then the anxiety and MDD medications such as SSRIs reduced in 20.79% of participants, so as you can see
from this study it shows that substituting those anxiety and depression medications with medical
cannabis may be beneficial for patients. And multiple other studies corroborated this as well.
So what comes next with this research? Obviously I couldn't cover too much today, but we're really
looking at randomized controlled clinical trials basically just experiments where we can really
see what the effects of the medical cannabis is and realize why the medical cannabis is working
similarly to the medications for anxiety and depression. We also want to advocate for
quality insurance and make sure we have proper ratios of THC, CBD, and those phytochemicals I
was talking about so we can kind of narrow down what effect it will have based on the ratios of
those ingredients, and then just more retrospective studies to evaluate medical cannabis are always
important in order to see how medical cannabis can affect a variety of conditions.
And that concludes my presentation. If you have any questions feel free to reach out
to me at adreese (at) buffalo.edu. Thank you and have a great day!