title: Toward a translational approach to targeting the endocannabinoid system in posttraumatic stress disorder: a critical review of preclinical research.
abstract: Despite the lack of clinical research, marijuana and synthetic cannabinoids have been approved to treat posttraumatic stress disorder (PTSD) in several states in the United States. This review critically examines preclinical research on the endocannabinoid system (ECS) in order to evaluate three key questions that are relevant to PTSD: (1) Does ECS dysfunction impact fear extinction? (2) Can stress-related symptoms be prevented by ECS modulation? (3) Is the ECS a potential target for enhancing PTSD treatment? Disruption of the ECS impaired fear extinction in rodents, and ECS abnormalities have been observed in PTSD. Targeting fear memories via the ECS had mixed results in rodents, whereas augmented cannabinoid receptor activation typically facilitated extinction. However, the translational value of these findings is limited by the paucity and inconsistency of human research. Further investigation is necessary to determine whether incorporating cannabinoids in treatment would benefit individuals with PTSD, with cautious attention to risks.
authors.affiliation: New York State Psychiatric Institute, 1051 Riverside Drive, New York, NY, 10032, USA; City College of New York, 160 Convent Avenue, New York, NY, 10031, USA; Columbia University Medical Center, W. 168th Street, New York, NY, 10032, USA.
authors.forename: Santiago
authors.initials: S
authors.lastname: Papini
authors.affiliation: New York State Psychiatric Institute, 1051 Riverside Drive, New York, NY, 10032, USA; Columbia University Medical Center, W. 168th Street, New York, NY, 10032, USA.
authors.forename: Gregory M
authors.initials: GM
authors.lastname: Sullivan
authors.affiliation: New York State Psychiatric Institute, 1051 Riverside Drive, New York, NY, 10032, USA; City College of New York, 160 Convent Avenue, New York, NY, 10031, USA; Columbia University Medical Center, W. 168th Street, New York, NY, 10032, USA.
authors.forename: Denise A
authors.initials: DA
authors.lastname: Hien
authors.affiliation: New York State Psychiatric Institute, 1051 Riverside Drive, New York, NY, 10032, USA; Columbia University Medical Center, W. 168th Street, New York, NY, 10032, USA.
authors.forename: Erel
authors.initials: E
authors.lastname: Shvil
authors.affiliation: New York State Psychiatric Institute, 1051 Riverside Drive, New York, NY, 10032, USA; Columbia University Medical Center, W. 168th Street, New York, NY, 10032, USA. Electronic address: ny126@columbia.edu.
authors.forename: Yuval
authors.initials: Y
authors.lastname: Neria
mesh_terms: D002186:Cannabinoids / Q000494:pharmacology / Q000627:therapeutic use*; D063388:Endocannabinoids / Q000378:metabolism*; D005108:Extinction, Psychological / Q000187:drug effects* / Q000502:physiology; D005239:Fear / Q000187:drug effects* / Q000502:physiology; D006801:Humans; D013313:Stress Disorders, Post-Traumatic / Q000188:drug therapy* / Q000378:metabolism
chemical_list: D002186:Cannabinoids; D063388:Endocannabinoids
keywords: Cannabinoids; Endocannabinoid; Exposure Therapy; Fear extinction; Marijuana; PTSD; Reconsolidation; Trauma