The main psychoactive component of cannabis seems to reduce persistent and distressing nightmares in people with post-traumatic stress disorder (PTSD). The drug dronabinol – purified tetrahydrocannabinol (THC) oil extracted from cannabis plants – was more than twice as likely to lead to a complete cessation of nightmares in people with the mental health condition than a placebo. Although it is unclear why it has this effect, THC may suppress the stage of sleep when dreams are most likely to occur.
About 4 per cent of the global population have PTSD at some point in their lives. It causes people to repeatedly recollect a traumatic event, often through nightmares. Treatments like trauma therapy can help, but these aren’t always easily accessible, and no interventions specifically focus on relieving nightmares.
Is CBD a wonder drug or waste of money? Here’s what the evidence says Stefan Röpke at the Charité–Universitätsmedizin Berlin hospital in Germany sees people with PTSD every day and says some report getting relief from their nightmares if they take a small amount of cannabis before bed. Röpke and his colleagues recruited 171 people with PTSD who experienced frequent, intense nightmares, assessed via a standard 0-to-8-point scale.
Eighty-seven of the participants were instructed to take dronabinol – which is approved to treat nausea and vomiting caused by cancer drugs, and loss of appetite in people with acquired immunodeficiency syndrome (AIDS) – 1 hour before bed every night for 10 weeks. The remaining 84 participants took a placebo. They started on 2.5 milligrams and gradually increased the dose until their nightmares stopped or they reached the maximum 15 mg dose.
Röpke stresses people shouldn’t self-medicate with cannabis: “Treatment with dronabinol [and similar interventions] should be prescribed and monitored by a physician.” After 10 weeks, nightmare severity decreased by about 3.7 points in the dronabinol group – 1.5 points more than the placebo group. The researchers also found that 58 per cent of the dronabinol group experienced at least a 50 per cent reduction in their nightmare frequency and intensity, compared with 29 per cent of the placebo group. What’s more, 37 per cent in the former group experienced a complete cessation of their nightmares, compared with 15 per cent of the placebo group.
THC’s psychoactive effects meant that around 4 in 5 of the participants who took it gauged that they weren’t in the placebo group. However, half of those given a placebo thought they received dronabinol. Expectancy of an effect may explain some of the results, but probably not all of them, says Röpke.
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