Title:Nightmares and the Cannabinoids
Volume: 18
Issue: 8
Author(s): Mortimer Mamelak*
Affiliation:
- Department of Psychiatry, University of Toronto, Baycrest Hospital, Permanent Address: 19 Tumbleweed Road, Toronto, Ontario M2J 2N2,Canada
Keywords:
Nightmares, sleep, episodic memory, sharp wave ripple complex, cannabinoids, post-traumatic stress disorder.
Abstract: The cannabinoids, Δ9 tetrahydrocannabinol and its analogue, nabilone, have been found
to reliably attenuate the intensity and frequency of post-traumatic nightmares. This essay examines
how a traumatic event is captured in the mind, after just a single exposure, and repeatedly replicated
during the nights that follow. The adaptive neurophysiological, endocrine and inflammatory
changes that are triggered by the trauma and that alter personality and behavior are surveyed. These
adaptive changes, once established, can be difficult to reverse. But cannabinoids, uniquely, have
been shown to interfere with all of these post-traumatic somatic adaptations. While cannabinoids
can suppress nightmares and other symptoms of post-traumatic stress disorder, they are not a cure.
There may be no cure. The cannabinoids may best be employed, alone, but more likely in conjunction
with other agents, in the immediate aftermath of a trauma to mitigate or even abort the metabolic
changes which are set in motion by the trauma and which may permanently alter the reactivity
of the nervous system. Steps in this direction have already been taken.
