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Dr. Bob is Robert Hsiung, MD,
bob@dr-bob.orgShown: posts 1 to 25 of 38. This is the beginning of the thread.
Posted by odon on July 30, 2009, at 15:44:22
Is smoking a 'little' marijuana helpful for depression and anxiety?The reason I mentioned a little is because I've read a small amount can be good,and actually raises serotonin.Smoking too much lowers serotonin.Are their any risks as to possibly worsening ones condition?
Posted by Phillipa on July 30, 2009, at 16:52:04
In reply to Marijuana for depression/anxiety,good or bad idea?, posted by odon on July 30, 2009, at 15:44:22
Don't know but heard it's very relaxing. Phillipa
Posted by linkadge on July 30, 2009, at 16:52:32
In reply to Marijuana for depression/anxiety,good or bad idea?, posted by odon on July 30, 2009, at 15:44:22
Well to be honest, one will never recieve unbiased information about marajuanna from health care professionals. I hear about amotivational syndrome, but clearly they are not considering that the standard conventional SSRI + AP for GAD can also cause nasty amotivaitonal syndrome.
I know people who use it for GAD and mild / moderate depression who swear by it. As you said canabanoid agonists can increase serotonin and norepinephrine activity, perhaps high doses do not have this effect.
Cannabanoid agonists have clear antidepressant / anxiolytic effects in animal models and cannabanoid antagonists can have teh side effect of depression.
Paranoia can be a side effect, but I think this can easily be minimized or avoided if one is careful.
I guess the best advice is to get a source that you really trust, then start low and see where this gets you.
Linkadge
Posted by shasling on July 30, 2009, at 17:21:44
In reply to Marijuana for depression/anxiety,good or bad idea?, posted by odon on July 30, 2009, at 15:44:22
There is a study out,at least one i know of that showed a small amount of thc acted as a mood elevator.
Problem they had....der was the difficulty to keep that dose response curve,so if they had trouble doing it in trials,i tend to believe someone trying it would,i guess youd take one big good hit and hold it?
Posted by morganpmiller on July 30, 2009, at 22:02:42
In reply to Marijuana for depression/anxiety,good or bad idea?, posted by odon on July 30, 2009, at 15:44:22
I'm not against smoking marijuana. I'm not against smoking it to treat mild depression. I do think it is a bad idea to use marijuana to treat depression. I think it is addictive and I think it does cause brain damage when smoked enough over over a period of time. Plus, you are damaging your lungs at the same time. Don't believe all the hype that says it's not bad for your lungs and it's not addictive.
Just like alcohol, marijuana may make you feel better but over the long haul it will make your depression worse. At least antidepressants have been shown to possibly reverse some of the damage done by depression. I am pretty sure marijuana does not do this.
Posted by chumbawumba on July 30, 2009, at 22:57:51
In reply to Marijuana for depression/anxiety,good or bad idea?, posted by odon on July 30, 2009, at 15:44:22
I could see how a little bit might lift the mood. But if you are prone to anxiety or paranoia it might make those things worse temporarily. It tends to make my mind race sometimes. Also I just demolish my kitchen I get so ravenously hungry.
Marijuana these days is a very powerful drug. I have bought various strains of cannabis from medical marijuana dispensaries here in California and it is strong as hell. One hit can be incapacitating. So you might want to find some way to dilute the strength a bit, through a lower grade of cannabis perhaps or through edibles.
Fun for recreational use occasionally. I'm not so sure about regular use for depression or anxiety, especially anxiety. My pot smoking buddy from college has sworn off of it because it exacerbates his panic attacks.
Posted by linkadge on July 31, 2009, at 14:44:47
In reply to Re: Marijuana for depression/anxiety,good or bad idea?, posted by chumbawumba on July 30, 2009, at 22:57:51
>I do think it is a bad idea to use marijuana to >treat depression. I think it is addictive and I >think it does cause brain damage when smoked >enough over over a period of time.
I don't think we really have the data to make those assumptions. Some people who smoke marijuanna have a kind of dysthymia which may be caused by marijuanna or it may predate the use of it.
The notion that MJ causes schizophrenia is not clear cut. Low doses of MJ appear to improve the negative symptoms of schizophrenia and may be why those with the illness are attracted to its effects.
While I think it is clear that the drug is bad for lung health, the case for neurotoxicity is not clear as well. Some compounds in marijuanna actually have potent neuroprotective effects. Cannabanoid agonists also exert neroprotective effects at certain concentrations. As with many drugs too (i.e. stimulants), neurotoxicitiy depends may on drug concentration. A large study on the effects of MJ on cognition arrived at inconclusive results. Many of the cognative effects clear up after the drug is stopped. Some of the cognative effects may simply be due to the fact that people tend not to be too mentally active while stoned. Some of the cognative effects may actually predate the MJ use (i.e. ADHD patients who get relief from hyperactivity and impulsitivty with its use).
MJ can cause panic attacks, but can also reduce anxiety in certain people. Just like SSRI's can worsen some people's anxiety.
The case for the additive properites of the drug is not that clear cut as well. Animals will self administer the drug, but only up to a certain point (unlike crack, meth etc). Animals will kind of maintain a maintainance dose of the drug and be perfectly happy with it. The same is true in humans. Most people just do a certain amount and then keep it at that. Sure they will get withdrawl if they stop, but the same is true with paxil.
Linkadge
Posted by Phillipa on July 31, 2009, at 19:51:10
In reply to Re: Marijuana for depression/anxiety,good or bad idea?, posted by linkadge on July 31, 2009, at 14:44:47
If marijuana can cause schizophenia wouldn't that negate that it is biological? Just asking Phillipa
Posted by linkadge on July 31, 2009, at 21:11:58
In reply to Re: Marijuana for depression/anxiety,good or bad idea? » linkadge, posted by Phillipa on July 31, 2009, at 19:51:10
>If marijuana can cause schizophenia wouldn't >that negate that it is biological?
Well, yes. I guess the arugment is that it serves to "unmask" schizophrenia in susceptable individuals.
Linkadge
Posted by Phillipa on July 31, 2009, at 21:24:30
In reply to Re: Marijuana for depression/anxiety,good or bad idea?, posted by linkadge on July 31, 2009, at 21:11:58
Link a trigger. Love ya Phillipa
Posted by morganpmiller on July 31, 2009, at 21:46:32
In reply to Re: Marijuana for depression/anxiety,good or bad idea?, posted by linkadge on July 31, 2009, at 14:44:47
I think we just like to disagree.
Chronic marijuana smoking damages the brain.
There is no way you can compare marijuana to SSRIs. No way whatsoever. Marijuana gets u high for a very short time and then it is gone. It can impair your judgement. Really linkage, are you serious here? Yes you are, that's the scary thing.
Until big pharma synthesizes a pill with a long half life using the components of marijuana that act on depresion, there is no way we can begin to talk about marijuana being used successfully to treat depression.
You give me one person that has smoked marijuana over the years that does not show holes in their brain after pet scans and has not lost much of their short term memory, and maybe I will take marijuana as an antidepressant seriously.
Morgan
Posted by morganpmiller on July 31, 2009, at 21:53:26
In reply to Re: Marijuana for depression/anxiety,good or bad idea?, posted by linkadge on July 31, 2009, at 21:11:58
Actually marijuana could be one of many triggers that sends someone in to their first psychotic break. There is evidence that without any triggers and given the right environment, many people predisposed to schizophrenia may never have a psychotic break. These people may go on to live totally normal lives without any serious mental health issues.
Marijuana is NOT good for you. If you don't have a need to treat pain related to cancer, HIV, or some other issue, you will not benefit in any way from marijuana. It has not nutritional value and it does nothing to help heal the brain after suffering from depression/anxiety.
Linkage, are you a marijuana smoker?
Posted by Dima on August 1, 2009, at 2:16:04
In reply to Re: Marijuana for depression/anxiety,good or bad idea?, posted by morganpmiller on July 31, 2009, at 21:53:26
> Actually marijuana could be one of many triggers that sends someone in to their first psychotic break. There is evidence that without any triggers and given the right environment, many people predisposed to schizophrenia may never have a psychotic break. These people may go on to live totally normal lives without any serious mental health issues.
>
> Marijuana is NOT good for you. If you don't have a need to treat pain related to cancer, HIV, or some other issue, you will not benefit in any way from marijuana. It has not nutritional value and it does nothing to help heal the brain after suffering from depression/anxiety.
>
> Linkage, are you a marijuana smoker?Could you back up the things you say with sources? One gentleman I read about receives marijuana from the government from some outdated program that they didn't grandfather away with the new laws. He smokes twelve or so joints a day and has for the past ten or twenty years. He still gives speeches and has no noticeable negative consequences of the smoking.
http://blogs.salon.com/0002762/stories/2005/02/18/irvRosenbergAndTheCompassi.html
Posted by morganpmiller on August 1, 2009, at 3:05:49
In reply to Re: Marijuana for depression/anxiety,good or bad idea?, posted by Dima on August 1, 2009, at 2:16:04
Yeah and my grandmother has smoked cigarettes for 50 years and has not died from lung cancer. But she is developing emphysema.
Many of us are walking around with impaired brains/memories appearing to be perfectly healthy otherwise.
Fine, I will do the research.
It still baffles me that you think marijuana is harmless. At least that is the impression I am getting. Let me guess, you smoke regularly.
Posted by morganpmiller on August 1, 2009, at 3:22:33
In reply to Re: Marijuana for depression/anxiety,good or bad idea?, posted by Dima on August 1, 2009, at 2:16:04
this one talks more of damage to developing brains:
From what I read, I don't think marijuana can damage the brain the way I thought it could. I just know people that have smoked it for years that are hurting to remember the simplest of things. Just as with psychiatric medications, everyone's reaction is different.
I am all for medicinal uses of marijuana and the legalization of marijuana, I just don't think it has it's place in treating depression/anxiety. If anything, it will make the depression/anxiety worse over time.
Posted by linkadge on August 1, 2009, at 16:13:04
In reply to Re: Marijuana for depression/anxiety,good or bad idea?, posted by morganpmiller on July 31, 2009, at 21:46:32
>Chronic marijuana smoking damages the brain.
Uh, sorry. I don't think we have the data to make that conclusion.
>There is no way you can compare marijuana to >SSRIs. No way whatsoever.
Yes there is and I am doing it. I know a handful of people with GAD who went off pot as per doctors advice, when through the whole SSRI / SNRI merry go round and ended up back on pot saying it worked bettter for anxiety, insomnia, appetite loss etc. There is a lot of reseach these days on the theraptutic effects of cannabanoids in mental illness. One avenue is the use of FAAH inhibitors. These drugs block the breakdown of anandamide. Anandamide is the brains own version of marijuanna. It binds to the same receptors as THC and induces the same effects. In higher doses, anandamide produces the same euphoria side effect as THC.
I am not advocating smoking so much marijuanna to get high as a kite. I think in lower doses you can get a theraptutic effect perhaps by correcting an endocannabanoid deficiancy (which some authors have documented in clinical depression).
>Marijuana gets u high for a very short time and >then it is gone. It can impair your judgement.
I wouldn't say that. There is more in marijuanna than just THC. Some of the compounds in MJ have a half life of more than a week. One of the substances, cannabidol, has anti-anxiety and antipsychotic effects. It contributes in no way to the "high" of the drug. By the way, I am not recomending using doses of cannabis that get you high.
>Really linkage, are you serious here? Yes you >are, that's the scary thing.
No, what I think is scarry is that people recieve misinformation about a) the real health risks associated with marijuanna use b) the real health risks of conventional treatments for depression / anxiety.
Lets face it. The medical community has adopted the use of marijuanna. With a prescription you can obtain medicinal marijuanna. You could never obtain medicinal PCP, or medicinal crack cocaine. Obviously the medical community agrees that in certain circumstances there is a theraputic effect which outweights the risks. All treatments have risks. I am by no way telling people to go out and smoke marijuanna. I am just stating that there is some evidence of why it appears to really help some people.
>Until big pharma synthesizes a pill with a long >half life using the components of marijuana that >act on depresion, there is no way we can begin >to talk about marijuana being used successfully >to treat depression.
We can talk about it. We are talking about it right now. There are many people who use the substance to quell negative moods. I have a friend that failed every SSRI, 4 TCA's and both MAOI's, yet swears by his 3 puff rule to keep him out of the hospital.
>You give me one person that has smoked marijuana >over the years that does not show holes in their >brain after pet scans and has not lost much of >their short term memory, and maybe I will take >marijuana as an antidepressant seriously.
Unfortunately, there is no such evidence that marijuanna produces "holes in the brain". These sorts of images have been demonstrated with meth or crack users, but not in association with monodrug (marijuanna) users.
It is abundantly clear that higher doses of marijuanna can impair cognition while the user is on the drug. Other than that there is not a lot of evience of residual effects.
A number of other psychiatric drugs can cause significant memory impairment. Depakote, lithium, AP's, TCA's, nardil, topomax, benzodiazapines to name a few.
Linkadge
Posted by linkadge on August 1, 2009, at 16:27:09
In reply to Re: Marijuana for depression/anxiety,good or bad idea?, posted by morganpmiller on July 31, 2009, at 21:53:26
>There is evidence that without any triggers and >given the right environment, many people >predisposed to schizophrenia may never have a >psychotic break.
That statement makes no sence for a variety of reasons. You are basically saying that people with a predisposition to schizophrenia who never got schizophrenia did so because they avoided certain environmental triggers. This is a nonsensicle and inherently unprovable statement.
>Marijuana is NOT good for you. If you don't have >a need to treat pain related to cancer, HIV, or >some other issue, you will not benefit in any >way from marijuana.Again, these are bold statements that make absolutely no consideration for the individual circumstances and factors that are affecting people's lives. There are many people who use marijuanna for depression, anxiety, bipolar disorder etc. Some have used conventional treatments and can make direct comparisons. These patients would claim they do infact benefit from it, and unfortunatley your belief that they do not beneifit is an opinion, no more or less valuble than my own. I would recomend some of the scientific abstracts provided on the following site:
http://cannabis.net/refs/index.html
>It has not nutritional value and it does nothing >to help heal the brain after suffering from >depression/anxiety.
That may not be true. Marijuanna has profound effects on the HPA axis. It can dramatically reduce cortisol secretion, increase melatonin synthesis, restore appetite and sleep in certain patients. Certain cannabanoid constituents of marijuanna also appear to have potent neurotrophic effects see:
http://cannabis.net/neogenesis/index.html
Linkadge
Posted by linkadge on August 1, 2009, at 16:29:13
In reply to Re: Marijuana for depression/anxiety,good or bad idea?, posted by morganpmiller on August 1, 2009, at 3:05:49
>It still baffles me that you think marijuana is >harmless. At least that is the impression I am >getting. Let me guess, you smoke regularly.
I would propose you are going from one extreme to another to try and prove a point. I never said marijuanna was harmeless. No pharmacological treatment for depression / anxiety is harmless.
Linkadge
Posted by linkadge on August 1, 2009, at 16:41:49
In reply to Re: Marijuana for depression/anxiety,good or bad idea?, posted by morganpmiller on August 1, 2009, at 3:22:33
"The researchers caution that the study is preliminary and does not demonstrate that marijuana use causes the brain abnormalities."For instance, people who use antidepressants may have smaller hippocampal volumes. This does not imply that the AD's caused hippocampal volume loss. Infact the opposite may be true.
The third article doesn't say a whole lot. We already know that marijuanna constituents remain stored in the fatty cells of the brain for a month or more. So the fact that some evidence of cognative impairment a month later is present is not unreasonable. Also, there may be neurochemical imbalences that last for a while after stopping smoking, but this doesn't necessarily indicate actual structural brain damage.
Also worth noting, patients with ADHD and schizophrenia demonstrate the same patterns of cerebral blood flow i.e. increased parietal activity and reduced prefrontal cortex activity. Since this study did not include brain scans of the participants before using there is no way that it can rule out the possibility of preexisting neurologic impairments. Blood flow changes are also not necessarily indicative of brain damage.
Linkadge
Posted by morganpmiller on August 1, 2009, at 16:53:43
In reply to Re: Marijuana for depression/anxiety,good or bad idea?, posted by linkadge on August 1, 2009, at 16:13:04
I was sure I had read(maybe it was on a news show, can't remember) something about someone who smoked marijuana(without any other drug use/abuse)for 10 years or so and had the holes in the brain that I was talking about. I will admit, the verdict is out on whether marijuana use really causes any kind of permanent brain damage.
You bring up many good points.
I am more for the use of marijuana for pain or to increase appetite. Using it for depression and anxiety just does not make sense to me.
Posted by morganpmiller on August 1, 2009, at 16:55:37
In reply to Re: Marijuana for depression/anxiety,good or bad idea?, posted by linkadge on August 1, 2009, at 16:29:13
True
Posted by morganpmiller on August 1, 2009, at 16:56:10
In reply to Re: Marijuana for depression/anxiety,good or bad idea?, posted by linkadge on August 1, 2009, at 16:41:49
And true again
Posted by linkadge on August 2, 2009, at 10:49:49
In reply to Re: Marijuana for depression/anxiety,good or bad idea?, posted by morganpmiller on August 1, 2009, at 16:56:10
I agree with you that there really needs to be more research done on the effects of marijuanna on depression before it could ever be recomended.
However, think that for some people, there can be theraptutic aspects to MJ use that need to be earnestly explored and not simply engulfed in a wave of dogmatic anti-drug propeganda.
Posted by SLS on August 2, 2009, at 11:08:00
In reply to Re: Marijuana for depression/anxiety,good or bad idea?, posted by linkadge on August 2, 2009, at 10:49:49
> I agree with you that there really needs to be more research done on the effects of marijuanna on depression before it could ever be recomended.
>
> However, think that for some people, there can be theraptutic aspects to MJ use that need to be earnestly explored and not simply engulfed in a wave of dogmatic anti-drug propeganda.Allosteric drugs of the future might be able to target endocannibinoid receptors and make them more or less receptive to endogenous ligands. In this way, receptors can be modulated rather than fully occupied by a foreign substance.
I have nothing against marijuana. However, I think that there are substances other than THC that can be exploited.
- Scott
Posted by linkadge on August 2, 2009, at 14:08:26
In reply to Re: Marijuana for depression/anxiety,good or bad idea?, posted by SLS on August 2, 2009, at 11:08:00
In that list of drugs in the pipeline is an FAAH inhibitor. It was strange that it was indicated for depression in the elderly. I wonder why a drug like this would specifically be marketed for depression in the elderly.
Linkadge
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