Obsessive Compulsive Disorder

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Marijuana for OCD: Is There Any Science for Symptom Relief?

New-Research-Suggests-That-Cannabis-Could-Bring-Relief-For-OCD-Symptoms

Obsessive compulsive disorder, otherwise known as OCD, affects the lives of 1.2% of the adult population (7). When it comes to OCD, scientists believe the endocannabinoid system plays a significant role in regulating anxious thoughts and behaviors. Endocannabinoids are fat-based neurotransmitters that the body receives through CB1 and CB2 receptors, helping regulate mood, stress and sleep (1).

Researchers believe that CB1 receptors, which are located mostly in the brain, have the potential to regulate fear and anxiety behaviors, which are trademark symptoms of OCD (1). High densities of these CB1 receptors are located in the basal ganglia, cerebellum, hippocampus, prefrontal cortex, and amygdala portions of the brain (13). This is important because these areas of the brain are associated with OCD. 

Δ9- tetrahydrocannabinol (THC) and cannabidiol (CBD), some of the endocannabinoids found in cannabis, have been shown to activate the CB1 receptors as well as the serotonin 5-HT1A receptor, directly regulating anxiety and fear (1). New research initiatives are necessary to determine what benefits cannabis compounds may have for OCD, as well as the long-term effects.

Check out our guide on the endocannabinoid system for more information.

Alleviating OCD with Medical Cannabis

Managing OCD with cannabis can be difficult because larger doses of THC typically increase paranoia and anxiety symptoms (1). In addition, there is not a ton of qualitative research or clinical trials regarding OCD specifically. There is a lot of information about how medical marijuana helps calm anxiety as well as its potential use as an additional tool during fear exposure therapy sessions (4). In animal models of anxiety and compulsive behaviors, cannabinoids have been shown to help improve these symptoms (13). 

Research suggests that CBD indirectly activates the CB1 receptors and inhibits adenosine signaling in the brain in order to reduce anxiety. In addition, preclinical studies in rodents show that there is a potential for cannabis to reduce the body’s ongoing response to fear (fear extinction) as well as helping maintain balance between goal-directed and habitual actions in the brain (13). Small clinical studies have demonstrated some benefit for symptoms, but larger well-controlled studies are necessary.

Different Cannabis Recommendations for Anxiety

Patients with OCD symptoms may benefit from (4):

  • High CBD, 1 mg CBD to 1mg THC, or CBD only doses if a patient is worried about getting impaired.
  • Starting with a low dose (between 2-20 mg) before bedtime, and using cannabis during the day once a functional dose has been determined.
  • Sticking to cannabis and CBD vape concentrates or oral tinctures, because product labeling contains a chemical breakdown of the product. It also is easy to measure the amount taken as opposed to edibles and cannabis flower. Talk to your provider first about which option may work best for you.

Considerations to Keep in Mind

It is important to note that many studies advise people with OCD to stay away from cannabis, and they can be at risk for a substance abuse disorder. As a patient with OCD it is important to weigh the quality and quantity of OCD and anxiety studies regarding positive and negative results to the benefits of taking cannabis and other medications for this condition in a conversation with your healthcare provider. 

Of course, working with your healthcare provider and following up regularly are necessary components of a proper, individualized treatment plan and can’t be replaced by cannabinoids alone. Always seek medical care for new or worsening symptoms.

Understanding Obsessions and Compulsions

Obsessions are repeated thoughts, urges, or mental images that cause the patient to experience anxiety. Some common obsessions include fear of germs, aggressive thoughts towards self or others; having to have things in symmetrical or perfect order; and unwanted thoughts involving sex, religion, or harm (6).

Compulsions are repetitive behaviors that a person has regarding the obsessions they experience. This is different then having rituals of doing things a certain way. For example, someone with a fear of germs may compulsively wash their hands and can’t stop thinking about how they need to wash their hands. A compulsion may also be arranging things in a particular order and repeatedly checking on things such as making sure the door is locked (6).

Everyone worries about if they locked the front door or if they left the stove on. The difference with OCD patients is that they can’t control their thoughts or behavior, even if they are excessive and they spend at least one hour a day on these thoughts and behaviors. In addition, they do not get pleasure from performing the compulsive behaviors and instead get a brief relief in anxiety (6). Traditional treatment options for OCD may include prescription antidepressants and cognitive behavioral therapy. 

An OCD Patient’s Perspective

A recent study in the Journal of Affective Disorders analyzed data from Strainprint, an app that allows medicinal cannabis users to track doses and changes in their symptoms. Data from 87 users identified as having OCD tracked obsessive thoughts, compulsions and anxiety episodes over approximately 3 years (5).

Patients reported that they experienced the following regarding their disorder and using medicinal cannabis (5):

  • 60% reduction in compulsions—higher concentrations of CBD and higher doses typically predicted larger reductions in compulsions.
  • 49% reduction in intrusive thoughts, but the later cannabis use sessions were associated with smaller reduction in those intrusions later in the study period.
  • 52% reduction in anxiety after using cannabis.

 

Note: Veriheal does not intend to give this as professional medical advice. Do not attempt to self-diagnose, or prescribe treatment based on the information provided on this page. Always consult a physician before making any decision on the treatment of a medical condition.

 

References

1. Blessing, E. M., Steenkamp, M. M., Manzanares, J., & Marmar, C. R. (2015). Cannabidiol as a Potential Treatment for Anxiety Disorders. Neurotherapeutics : the journal of the American Society for Experimental NeuroTherapeutics12(4), 825–836. https://link.springer.com/article/10.1007%2Fs13311-015-0387-1

2. Kayser, R. R., Haney, M., Raskin, M., Arout, C., & Simpson, H. B. (2020). Acute effects of cannabinoids on symptoms of obsessive‐compulsive disorder: A human laboratory study. Depression and Anxiety, 37(8), 801-811. https://onlinelibrary.wiley.com/doi/abs/10.1002/da.23032

3. Kedzior, K.K., Laeber, L.T. A positive association between anxiety disorders and cannabis use or cannabis use disorders in the general population- a meta-analysis of 31 studies. BMC Psychiatry 14, 136 (2014). https://bmcpsychiatry.biomedcentral.com/articles/10.1186/1471-244X-14-136

4. Johnson, B., MS,RDN. (2020, Spring). Calming Anxiety with Cannabis. CRx Magazine. Retrieved December 29, 20, from https://www.crxmag.com/issues/2020/spring/calming-anxiety-with-cannabis.shtml# 

5. Muzay, D., LaFrance, E. M., & Cutter, C. (jan 15, 2020). Acute Effects of Cannabis on Symptoms of Obsessive-Compulsive Disorder [Abstract]. Journal of Affective Disorders, 279, 158-163. https://www.sciencedirect.com/science/article/abs/pii/S0165032720328202?via%3Dihub

6. Obsessive-Compulsive Disorder. (n.d.). Retrieved January 19, 2021, from https://www.nimh.nih.gov/health/topics/obsessive-compulsive-disorder-ocd/index.shtml

7. Obsessive-Compulsive Disorder (OCD). (n.d.). Retrieved January 19, 2021, from https://www.nimh.nih.gov/health/statistics/obsessive-compulsive-disorder-ocd.shtml

8. Rabinak, C. A., Angstadt, M., Sripada, C. S., Abelson, J. L., & Liberzon, I. (2013). Cannabinoid facilitation of fear extinction memory recall in humans [Abstract]. Neuropharmacology, 64, 396-402. https://link.springer.com/article/10.1007/s00213-017-4648-z

9. Raymundi, A. M., Silva, T. R., Sohn, J. M., Bertoglio, L. J., & Stern, C. A. (2020). Effects of ∆9-tetrahydrocannabinol on aversive memories and anxiety: A review from human studies. BMC Psychiatry, 20(1). https://pubmed.ncbi.nlm.nih.gov/32842985/

10. Scarante, F. F., Vila-Verde, C., Detoni, V. L., Ferreira-Junior, N. C., Guimarães, F. S., & Campos, A. C. (2017). Cannabinoid Modulation of the Stressed Hippocampus. Frontiers in molecular neuroscience10, 411. https://www.frontiersin.org/articles/10.3389/fnmol.2017.00411/full

11. Stoner SA. Effects of Marijuana on Mental Health: Anxiety Disorders. Alcohol & Drug Abuse Institute, University of Washington, June 2017. URL: http://adai.uw.edu/pubs/pdf/2017mjanxiety.pdf

12. Walsh, Z., Gonzalez, R., Crosby, K., S Thiessen, M., Carroll, C., & Bonn-Miller, M. O. (2017). Medical cannabis and mental health: A guided systematic review. Clinical psychology review51, 15–29. https://www.sciencedirect.com/science/article/abs/pii/S0272735816300939?via%3Dihub

13. Kayser RR, Snorrason I, Haney M, Lee FS, Simpson HB (2019) The endocannabinoid system: a new treatment target for obsessive compulsive disorder? Cannabis and Cannabinoid Research 4:2, 1–11, https://www.liebertpub.com/doi/10.1089/can.2018.0049 

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Content Medically Reviewed By: Dr. Abraham Benavides, MD
Content Medically Reviewed By: Dr. Abraham Benavides, MD

Contributors: Sarah Walker and Samantha Velez
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