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Cannabinoids should undergo rigorous safety, efficacy testing.

THE RESULTS FROM BLACK ETAL, demonstrate that use of cannabinoids is unsupported for treating ADHD, PTSD, Tourette syndrome, psychosis, and depressive and anxiety disorders and symptoms, especially given that other approved medications for these conditions already exist, Deepak D'Souza, MBBS, MD, wrote in a related editorial.

"In light of the paucity of evidence, the absence of good quality evidence for efficacy, and the known risk of cannabinoids, their use as treatments for psychiatric disorders cannot be justified at present," said Dr. D'Souza.

In addition, the conditions examined in the systematic review by Dr. Black, Dr. Stockings, and colleagues are distinct, and it is unclear how cannabinoids could treat these various conditions unless cannabinoids' effects are similar to those of benzodiazepines, Dr. D'Souza noted. Another issue is that information on safety and efficacy of cannabinoids is also unknown, and factors such as optimal dosing, treatment duration, and tetrahydrocannabinol (THC) to cannabidiol (CBD) ratio must also be established to begin trials. Finally, cannabinoids are also subject to tolerance issues with long-term exposure and would need to be considered for use with chronic psychiatric disorders.

"With cannabinoids, it seems that the cart (use) is before the horse (evidence)," Dr. D'Souza concluded. "If cannabinoids are to be used in the treatment of psychiatric disorders, they should first be tested in randomized controlled trials and subjected to the same regulatory approval process as other prescription medications."

Dr. D'Souza is affiliated with the department of psychiatry at Yale University in New Haven, Conn. He reported receiving grants from the National Institutes of Health, Veterans Health Administration Office of Research and Development, Heffter Foundation, Wallace Foundation, and Takeda. He also reported serving on the physicians advisory board of the medical marijuana program for the state of Connecticut.

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Title Annotation:VIEW ON THE NEWS
Publication:Clinical Psychiatry News
Date:Dec 1, 2019
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