![[dr. bob]](/dr-bob-sm.gif)
Dr. Bob is Robert Hsiung, MD,
bob@dr-bob.orgShown: posts 1 to 9 of 9. This is the beginning of the thread.
Posted by sweetmarie on September 4, 2001, at 14:01:54
I`ve been trying to find out stuff on cannabis/hashish and how it affects depression.
I did a search just now (on this site) and found quite a lot of info, but couldn`t actually find anything `definitive`. This is most probably because it`s not possible to define exactly what effect it has.
What I want to know is - does smoking it mess up medication levels? In other words, being on anti-depressant medication means that you can`t take certain other medications (as I found out when I wanted to get a de-congestant for my interminable cold). Does this apply to cannabis/hashish?
Also, what actual psychological effects can it have (good, bad or indifferent)?
I do not smoke it regularly, by any means - just now and then over the years. But, I want to know whether to rule it out altogether - which is what I will do if it has an adverse effect on my depression. That probably sounds wierd - obviously I`d know whether it has a bad effect or not, and the answer is that it doesn`t - at least, not one that I notice. What I`m trying to find out is whether or not continued use can exaccerbate depression. I hope that this makes sense.
I`ll be glad of any info anyone can offer.
Thanks,
Anna.
Posted by kid_A on September 4, 2001, at 14:20:01
In reply to Cannabis and Depression, posted by sweetmarie on September 4, 2001, at 14:01:54
I think the reason that there has never been any conclusive answers is that there hasnt been any study done on the effects of cannabis use and depression. I have read that using it while taking ssri's can have some unwanted sexual dysfunction for male users, but I dont have any scientific paper to back that up...Regardless, I do think that there is a greater than average agreement that prolonged use can cause depression, but you have to ask yourself if this applies to non depression-afinative types.
I dont think you are going to get an answer that is going to be provable by any study or medical consensus, you may get the answer you want, like "didn't cause me any problems", but thats just one person's oppinion, and your own milleage may vary...
I stopped using it because it vastly fucked w/ my emotions while taking effexor... I think the choice you need to make should be based on your own experiences, but also realise that if you are allready taking behaviour modification drugs, do you really want to skew them by taking another drug who's total effects on the body are unknown even to the medical community?
Of course if this is a once in a while thing, I can't see how it matters all that much... I've forgotten to take my medication for days in a row, but I cope somehow...
Posted by AVR on September 4, 2001, at 14:36:16
In reply to Re: Cannabis and Depression, posted by kid_A on September 4, 2001, at 14:20:01
This is my experience with cannabis and depression. I started using cannabis heavily while on paxil. I would smoke it constantly every day and loved it for months and months. But something happened and whenever I smoked i would get anxiety attacks very very bad anxiety attacks and couldn't talk to anyone when smoking. I recently stopped smoking it for good and stopped the paxil. I think it exaberated my depression after using it so much and for so long. I never smoked cannabis without being on paxil so I don't know what it does to me when I'm not on an AD. I think it would make me more anxious. But yes smokin dope can trigger depression.
Posted by JohnL on September 4, 2001, at 16:21:32
In reply to Cannabis and Depression, posted by sweetmarie on September 4, 2001, at 14:01:54
Just based on my own experiences and comments from others, I do believe chronic cannabis use can worsen depression, even to the point where medication doesn't do anything to fix it. I think the important thing with cannabis, if one is to use it at all, is to use it maximum once a week. Any more than that can severely interfere with medication, and can easily lead down the slippery slope of using it more frequently. When I used to smoke daily, after a while I would get very depressed. And smoking didn't fix it. I would just be stoned and depressed instead of just depressed, and then I would get even more depressed each time. A very disturbing cycle to fall in to. It was real bad. The only way to break the cycle was to go cold turkey and live through hell for about 3 days. Then all was back to normal.
I don't think there is any proof that cannabis interferes with medication, but just based on anecdotal observations I think it does.
I have no problem with someone using cannabis as a recreation drug, sex enhancer, sleep aid, or whatever, but I strongly feel it should be used no more than once in a week's period. The risks and unknowns are just too great otherwise.
John> I`ve been trying to find out stuff on cannabis/hashish and how it affects depression.
>
> I did a search just now (on this site) and found quite a lot of info, but couldn`t actually find anything `definitive`. This is most probably because it`s not possible to define exactly what effect it has.
>
> What I want to know is - does smoking it mess up medication levels? In other words, being on anti-depressant medication means that you can`t take certain other medications (as I found out when I wanted to get a de-congestant for my interminable cold). Does this apply to cannabis/hashish?
>
> Also, what actual psychological effects can it have (good, bad or indifferent)?
>
> I do not smoke it regularly, by any means - just now and then over the years. But, I want to know whether to rule it out altogether - which is what I will do if it has an adverse effect on my depression. That probably sounds wierd - obviously I`d know whether it has a bad effect or not, and the answer is that it doesn`t - at least, not one that I notice. What I`m trying to find out is whether or not continued use can exaccerbate depression. I hope that this makes sense.
>
> I`ll be glad of any info anyone can offer.
>
> Thanks,
>
> Anna.
Posted by sweetmarie on September 4, 2001, at 17:21:57
In reply to Re: Cannabis and Depression, posted by JohnL on September 4, 2001, at 16:21:32
Thanks for your replies, they were all helpful. I used to smoke it quite a bit in my late teens, early 20s, and then occasionally after that. I did actually make the decision not to smoke it anymore because it had started making me very paranoid and anxious - not a lot of fun, really. I guess that this was probably as a result of my depression, but whatever the reason, it was no longer having a nice effect.
However, I did smoke it again recently, and it actually had a good effect (I`m pretty depressed at the minute). So, that`s why I ask - i.e. am I being foolish by starting up again.
Anyway, that`s it really. I think that the `once a week` idea is a good one, but I really don`t want anything to screw up my meds, which are JUST starting to do something after 3 months. It wouldn`t be a good plan to scupper this.
Thanks again,
Anna.
Posted by paxvox on September 5, 2001, at 12:05:47
In reply to Re: Cannabis and Depression, posted by sweetmarie on September 4, 2001, at 17:21:57
OK, I wasn't going to respond to this post, but I will. First the science: THC delta 9, the main pyschoactive constituent of cannabis, has so many metabolites that I believe it would take years of study to discern what, if any, drug interactions it might have. THC is technically a hallucinagenic by definition (if you don't believe it is, eat about 2 TBS.(preferably cooked in a food) and wait about an hour.Now some subjective observations: THC clearly affects time perception, and sense of "self". It is generally a mood enhancer, in that it expands whatever mood one is in before partaking....good or bad. It can make you VERY paranoid and cause panic/anxiety problems. On the other hand, it has a tendency to expand sensual perception, especially in hearing and vision and artistic expression. Try listening to some music on headphones, you will hear sounds you never noticed. Again, this suggests the hallucinagenic nature of THC. Does it affect depressive illness? I don't know. I DO know that it's panic/anxiety tendencies did not make me feel any less depressed. I do not recommend chronic dope smoking for anyone, let alone one already chemically imbalanced. Final thoughts? Too subjectively sensitive (i.e. it affects different people in different ways) to have any across-the-board medical benefits in mental disorders. No extant science exists (that I'm aware of) to suggest otherwise. Your mileage may vary.
PAX
Posted by Mitchell on September 5, 2001, at 21:14:09
In reply to Cannabis and Depression, posted by sweetmarie on September 4, 2001, at 14:01:54
(Sweetmarie)
> Also, what actual psychological effects can it have (good, bad or indifferent)?Cannibas (marijuana) is used by patients who find it useful in the treatment of their bipolar disorder. A Harvard Department of Psychiatry study found some used it to treat mania, depression, or both. (1) Patients "stated that it was more effective than conventional drugs, or helped relieve the side effects of those drugs." (Grinspoon L, Bakalar JB) Because the law has practically forbid the study of marijuana as an antidressant, most evidence remains antidotal. The Harvard study concluded that "The potential for cannabis as a treatment for bipolar disorder unfortunately can not be fully explored in the present social circumstances." (ibid) Other investigators have found "Cannabis has a potential for clinical use often obscured by unreliable and purely anecdotal reports" (2)
> What I want to know is - does smoking it mess up medication levels?
One study has suggested that Bupropion (Wellbutrin) worsens mood during cannibas withdrawal. (3) Though my comments here hardly represent a comprehensive review of literature, it is possible that other conclusions about the interaction between cannibas and other prescribed psychoactive drugs might be based on personal experience, political indoctrination or social preferences, but not on science.
> What I`m trying to find out is whether or not continued use can exaccerbate depression.
One study concluded that "Adult frequency of marijuana use is not significantly associated with increased depression in adulthood." (4) While Green and Ritter found that marijuana initiation appears to be weakly associated with increased depression in adulthood, the effect is mediated by educational attainment, employment status, marital status, and other drug use, notably alcohol and tobacco use. Of most relevence to your querry, and to the other advice in this thread, the Ohio State sociologists suggested that cannibas users who rely on the drug as an alternative to other coping mechanisms are more depressed than users who do not use as a method of coping with problems.
(Paxvox) > THC is technically a hallucinagenic by definition (if you don't believe it is, eat about 2 TBS.(preferably cooked in a food)
Cannibas is defined by law in some states as a hallucinogen, but it is technically a cannabimemetic, and an anandaminergic. The actual phsychopharmacological effects of cannibas were unknown until about the past 10 years. Appreciation of a unique class of cannabimemetics began to unfold in 1990 with identification, cloning and expression of a selective cannabinoid receptor (5), soon followed by isolation of an endogenous cannabinoid ligand, anandamine (6) and in 1994 synthesis of a selective anandaminergic antagonist SR141716a [N-(piperidine-1-yl)-5-(4-chlorophenyl)-1-(2,4-dichlorophenyl)-4-methyl-1H-pyrazole-S-carboxamind hydrochloride].
The psychoactive properties of cannibas are enhanced when cooked and eaten, according to cannibas advocates, primarily because injestion delays onset of psychotropic effect and allows the user to titrate a larger dose before effect mediates titration. Even then, the psyhcoactive properties are a product of the balance of cannabinoids in the available supply, and while perception of both internal and external stimulus might be increased, the effect is seldom described as hallucinogenic, with the possible exception of consumption of large amounts of hashish, the isolated cannabinoid rich polem of the cannibas flower. IMO, the perception of cannibas as a hallucinagen might be related to its disruption of short term memory by action on the anandaminergic pathways, thereby interupting *usual* sensory stimuls and allowing users to experience unique perceptions. However, uncooked cannibas, or cannibas tea might have little psychoactive effect because cannabinoids are usually only converted to psychoactive THC when exposed to heat, and because the oil-soluble cannabinoids are not easily suspended in water.
paxvox > It is generally a mood enhancer, in that it expands whatever mood one is in before partaking....good or bad. It can make you VERY paranoid and cause panic/anxiety problems.
The balance of psyhoactive effects experienced by cannibas users, according to recent reports, is a product of the balance of cannabinoids in the available supply. Cannibas advocates and other researchers have focused on the balance between tetrahydrocannabinol (delta9-THC) and cannabidiol (CBD). Identification of specific cannabinoids has tended to confirm reports of users that some types of cannibas produce more of a high, with a sense of euphoria, while others produce more of a "stony" sensation, which includes drowsiness, and even headaches. CDB rich plants, generally regarded by users as lower quality or even as "ditch weed" tend to have far more CDB than TCH, whereas better cannibas is rich in THC with little or no CDB. The anxiety-producing effect, and development of tolerance also tends to be specific to the balance of cannabinoids in a supply.
Beyond its unknown psychoactive properties, cannibas use is contraindicated because smoking introduces pyrolitic substances, including carbon monoxide and tars. Waterpipes and moderate use of only high-quality THC rich cannibas flowers has been suggested by cannibas advocates as a way of reducing risks associated with pyrolitic substances. Cannibas use also introduces social problems, that might result from psychoactive properties, but clearly can result from the drugs status as a banned substance.
Scores of studies are available about the psychoactive properties and mechanisms, and several about the role of cannibas in depression, but I am reaching the limits of my capacity for absorbing and citing material in this setting. According to Williamson and Evans, Centre for Pharmacognosy, The School of Pharmacy, University of London, England:
"Cannabis is frequently used by patients with multiple sclerosis (MS) for muscle spasm and pain, and in an experimental model of MS low doses of cannabinoids alleviated tremor. Most of the controlled studies have been carried out with THC rather than cannabis herb and so do not mimic the usual clincal situation. Small clinical studies have confirmed the usefulness of THC as an analgesic; CBD and CBG also have analgesic and antiinflammatory effects, indicating that there is scope for developing drugs which do not have the psychoactive properties of THC. Patients taking the synthetic derivative nabilone for neurogenic pain actually preferred cannabis herb and reported that it relieved not only pain but the associated depression and anxiety. Cannabinoids are effective in chemotherapy-induced emesis and nabilone has been licensed for this use for several years. Currently, the synthetic cannabinoid HU211 is undergoing trials as a protective agent after brain trauma. Anecdotal reports of cannabis use include case studies in migraine and Tourette's syndrome, and as a treatment for asthma and glaucoma. Apart from the smoking aspect, the safety profile of cannabis is fairly good."(7)
IMHO, the nocioceptive properties of cannibas and some of its psychoactive components, along with their disruption of short-term memory (8) might hold a clue as to why it is so popular as an anti-depressent. By disrupting immediate recent memory of dysthymia, while producing as a end result dopamineric stimulation, a dose of quality cannibas might lift a user out of a "funk," at least for the duration of the dose. The nocioceptive property of cannibas might be unique from other analgesics in that it blocks or impairs awareness of perceptions of emotionally painful stimulus near where neuropathways loop nocioception and emotional affect. I'm thinking out loud, now, at least in this paragraph.
Because cannibas is the most widely used illegal drug in the world, and because it has a long history of use for controlling mood, discussion of the effects and the mechanisms of those effects might be of great interest to this forum. Perhaps others can offer additional insight based on recent studies from the post-anandamine-discovery era.
1) Grinspoon L, Bakalar JB. J Psychoactive Drugs 1998 Apr;30(2):171-177
The use of cannabis as a mood stabilizer in bipolar disorder: anecdotal evidence and the need for clinical research.2) Drugs 2000 Dec;60(6):1303-1314
Cannabinoids in clinical practice.
Williamson EM, Evans FJ.3) Haney M, Ward AS, Comer SD, Hart CL, Foltin RW, Fischman MW.
Bupropion SR worsens mood during marijuana withdrawal in humans.
Psychopharmacology (Berl). 2001 May;155(2):171-9.4) Marijuana use and depression. Green BE, Ritter C.Department of Sociology, Ohio State University, Columbus 43210, USA. green.446@osu.edu
5) Matsuda et al, Nature 346, 561-564, 1990
6) Devane et al, Science 258:1946-1949, 1992
7) Drugs 2000 Dec;60(6):1303-1314,
Cannabinoids in clinical practice.
Williamson EM, Evans FJ.8) Cannabimemetic disrupt learning in rats through stimulation of the cannabinoid receptor, but the anandaminergic system might not be tonically involved in learning.
Brodkin and Moerschebaecher (JPET 282, 1526-1532, 1997)
http://www.druglibrary.org/crl/receptors/agonists/Brodkin%20et.al%2097%20Learning_%20JpharmacolExpTher.pdf
Posted by paxvox on September 6, 2001, at 12:35:42
In reply to Re: Cannabis and Depression, posted by Mitchell on September 5, 2001, at 21:14:09
A very nice follow-up, Mitchell. I hope you caught the fact that I was providing subjective info,and not the "last word" on the subject. I think to ignore any potential medical use of plants, herbs etc.. is short-sighted. I found from my personal experience that marijuana causes me more "ills than thrills", and that chronic use as a teenager in the 70's did little to promote my overall well-being, rather an escape to a separate reality.
PAX
Posted by Mitchell on September 6, 2001, at 19:04:01
In reply to Re: Cannabis and Depression » Mitchell, posted by paxvox on September 6, 2001, at 12:35:42
> A very nice follow-up, Mitchell.
Thank you.
>I found from my personal experience that marijuana causes me more "ills than thrills", and that chronic use as a teenager in the 70's did little to promote my overall well-being, rather an escape to a separate reality.
> PAXA group of studies I would like to assess in this context, but have not, deal with teenage use as relates to aggression, depression and social success (of the mainstream variety). I didn't include them in that essay because I couldn't get my mind around the topic of teen drug use in the limited time I wanted to spend adding to this thread last night, but they are interesting studies. Of course, no amount of research can provide a definitive last word over an individual's experience. I recognize the credibility of your experience and its potential usefulness to others seeking guidence in related situations. I suspect a prescription for amphetamines and some focused, goal-directed counseling might have produced different results in my teen experience, but the experiences I encountered were productive in their own way. But I was more of a thinker than a thrill seeker. I stood to gain little from the thrill of academic success. To the contrary, I could readily attest that academic performance was a symptom of participation in a system I considered ill.
If anything, I would suggest that for some people, including people being treated for mood disorders, frequent use - as often as two or three times a day - seems helpful. For others, even occasional use can be problematic or counterproductive. At this point, neither the law nor the available science provides a reliable guidepost, and personal experiences can tend to shed a dim light on the boundaries, both indicative and contraindicative, of the relative usefulness of this old and extremely popular medicine. Use alone probably cannot, scientifically, be considered a morbid symptom. Heavy use or even light use of this or any other substance *might* be problematic, not necessarily for their pharmacological risks, but for their role as a diversion from confronting real social and personal problems.
Also, so sorry about the pathetic spelling in parts of that post.
This is the end of the thread.
Psycho-Babble Medication | Extras | FAQ
Dr. Bob is Robert Hsiung, MD,
bob@dr-bob.org
Script revised: February 4, 2008
URL: http://www.dr-bob.org/cgi-bin/pb/mget.pl
Copyright 2006-17 Robert Hsiung.
Owned and operated by Dr. Bob LLC and not the University of Chicago.