Researchers at Charité – Universitätsmedizin Berlin have demonstrated the potential for using THC, the psychoactive component in cannabis, to treat or even eliminate debilitating nightmares associated with post-traumatic stress disorder (PTSD).
The researchers behind the findings said that THC did not reduce other PTSD symptoms, such as the condition’s severity or depression. However, they plan to further explore its ability to treat nightmares, including the potential safety and efficacy associated with long-term use.
PTSD Nightmares Cause Sleep Deprivation and Fear of Going to Sleep
According to a statement from the Charité team, people who survive or witness extreme experiences such as abuse, war, disasters, or other acts of violence can become overwhelmed and unable to consciously process their experience. As a result, many experience what researchers term an “echo,” where the subconscious tries to process the trauma. The more common term for the experience is post-traumatic stress disorder, or PTSD.
People suffering from this condition often report nightmares as one of the most persistent and debilitating symptoms. Along with the horror associated with continuously reliving their traumas, sometimes on a nightly basis, sufferers also experience severe sleep deprivation. These problems are then compounded by a fear of going to sleep and experiencing nightmares repeatedly.
Attempts to treat PTSD related nightmares have found mixed results. For example, some doctors have prescribed antidepressants or blood pressure-lowering medications to treat the symptoms. However, the research team notes that pharmacological treatments are only partially effective, and “often fail to adequately relieve” PTSD-related nightmares.
There is one medication specifically approved for treating PTSD-induced nightmares. However, the team notes, it is not yet widely available, including in Germany where the study was performed.
Exploring Alternative Treatments
To explore alternative treatment solutions, Prof. Stefan Röpke, who conducts research on trauma-related disorders at the Department of Psychiatry and Neurosciences on the Benjamin Franklin Campus of Charité, and colleagues designed experiments around tetrahydrocannabinol, or THC.
Although widely used for recreational purposes, cannabis has shown some promise for treating a wide variety of medical and psychological conditions. Still, until recently, the drug’s legal status has limited its medical applications, offering researchers a potentially untapped source of PTSD nightmare relief.
For this study, Professor Röpke and colleagues were interested in THC’s established interactions with the human body’s endocannabinoid system. That’s because this system plays a role in sleep regulation, stress, and the processing of emotional memories.
For example, the professor explained, some evidence suggests that THC reduces activity during REM sleep. Known as the dream state, REM sleep is an intense dream phase during which “the brain processes experiences and regulates emotions.
“THC reduces dream activity and thereby alleviates nocturnal stress responses,” the professor explained.
More Than a Third Report Complete Elimination of Nightmares
To start, the team enlisted more than 170 study participants. Critically, all participants suffered from PTSD and intense nightmares, resulting in sleep deprivation and a fear of going to sleep. Instead of smoking cannabis, the researchers administered a form of cannabis-derived THC drops called Dronabinol. As a legal medication, this form of THC is considered clinically safe.
During the ten-week study period, each participant was instructed to take the drops before bedtime. Half of the participants received THC drops, while the others received cannabis-flavored placebo drops. To maintain double-blind study integrity, neither the participants nor the researchers knew who received which treatment.
After the trial period finished, the researchers discovered several positive results. Most notably, the THC group reported a significant decrease in nightmares compared to the placebo group.
According to the study authors, when ranking a participant’s “nightmare burden” on a scale of zero to eight points, participants’ scores dropped by an average of 3.7 points. For comparison, the placebo group experienced an average drop of 2.2 points.
Perhaps even more significant, Professor Röpke said that “more than a third” of the THC patients reported a complete absence of nightmares after the ten-week period concluded. The professor also noted that 21 percent of the study participants reported that their nightmare burden had been at least cut in half. Finally, the professor said that five out of six study participants in the THC group “felt their health had markedly improved.”
Exploring the Safety and Efficacy of Long-Term THC Use
Although the study results offer some possible hope for relief from nightmares and improved sleep, the researchers said the THC treatments did not affect all PTSD symptoms. For example, they observed that a participant’s PTSD severity and any accompanying depression “did not change conclusively.”
No severe side effects were reported by the THC group. However, the researchers did observe some minor complaints, such as headaches, dizziness, or increased appetite. Participants did not report any withdrawal symptoms after the cessation of the treatment period.
Moving forward, the team will explore the safety and effectiveness of long-term nightly THC treatments. They also hope to explore whether patients develop a tolerance to THC’s nightmare-abating effects over time.
The study “Dronabinol for nightmares in post-traumatic stress disorder: a randomized controlled trial” was published in Nature Medicine.
Christopher Plain is a Science Fiction and Fantasy novelist and has spent the last six years as Associate News Editor and Head Science Writer at The Debrief. Follow and connect with him on X, learn about his books at plainfiction.com, or email him at christopher@thedebrief.org