Depression

[Midnight toker]

<span class=postbold>See Also:</span> <ul class=postlist><li>Against Depression, a Sugar Pill Is Hard to Beat - 7 May 2002, The Washington Post</li><li>Cannabis and Depression, and Bipolar Disorder - Dr. Jay Canavnaugh, Ph.D.</li><li>The Use of Cannabis as a Mood Stablizer in Bi-Polar Disorder - Lester Grinspoon, Associate Profesor, Harvard School of Medicine</li><li>Ignorance and mental health issues. - by Tod H. Mikuriya, 11 Jun 2006</li><li>Anxiety Disorders. Neurobiology: Never fear, Cannabinoids are here - Pankaj Sah.</li><li>For the Sake of the Children The Message of Medical Cannabis - Dr. Jay Cavanaugh, Ph.D., September 2002.</li><li>Marijuana and the Treatment of an 8-year-old Child with Multiple Psychiatric Diagnoses - Debbie Jeffries.</li></ul>

Study Finds No Casual Link Between Marijuana Use And Depression

September 28, 2006 - Baltimore, MD, USA
NORML


Baltimore, MD: Marijuana use by adults is not a statistically significant predictor of depression, according to the results of an ongoing longitudinal study to be published in the October issue of the journal Addiction.

Investigators at John Hopkins University in Baltimore and at the Bloomberg School of Public Health in Santa Monica assessed the association between self-reported marijuana use and current depression in 8,759 adults (age range 29-37 years) over a 17-year period. Investigators concluded, "After adjusting carefully for baseline differences between adults who subsequently use marijuana and those who abstain, the significant associations that are initially present between ongoing marijuana use and depression are substantially reduced, if not eliminated."

They added, "The findings reported in this paper suggest that the associations observed between marijuana use and subsequent depression status may be attributable not to continued marijuana use, per se, but to third (common) factors associated with both the decision to use marijuana and to depression."

A separate study co-authored by NORML Advisory Board Member Dr. Mitch Earleywine and published last year in the journal Addictive Behaviors determined that adults who use cannabis report suffering from less severe incidents and/or symptoms of depression than non-users.

"Despite comparable ranges of scores on all depression subscales, those [respondents] who used cannabis once per week or less had less depressed mood, more positive affect, and fewer somatic (physical) complaints than non-users," authors wrote. "These data suggest that adults apparently do not increase their risk for depression by using marijuana."

Commenting on the most recent study, Earleywine said, "This new data is actually markedly stronger than my earlier work because the investigators utilized a large, representative sample and conducted long-term follow up research. If marijuana use caused depression, this design model would have revealed it by showing the development of symptoms in users. There's simply no support for the idea."

<hr class=postrule>
<small>For more information, please contact <a href=mailto:paul@norml.org>Paul Armentano</a>, NORML Senior Policy Analyst, at (202) 483-5500. Full text of the study, "Marijuana use and depression among adults: testing for causal association," appears in the October issue of Addiction. To listen to an interview with Dr. Mitch Earleywine about the study, please download the September 27, 2006 edition of the NORML Audiostash.</small>

[palmspringsbum]

Cannabis shows anti-depression benefits, but too much has reverse effect

Canadian Press
October 23rd, 2007
by Sidhartha Banerjee


Cannabis in small doses has some beneficial effects for curbing depression, but too much of the drug can cause the polar opposite effect, a new study suggests.

The neurobiological study conducted jointly by McGill University and a research institute affiliated with the Universite de Montreal indicates cannabis in low doses increased serotonin levels in the brains of laboratory rats.

The depletion of serotonin, a neurotransmitter that controls moods, leads to depression. Anti-depression drugs work by increasing the serotonin in the brain.

However, when the doses were increased on the rats, the effect was described as completely reversed, even devastating. Serotonin levels dropped significantly.

"We know from anecdotal evidence that (human) smokers of marijuana experience good effects ... but they also experience unwanted effects," said McGill PhD student Francis Bambico, who authored the study, which is to be published Wednesday in the Journal of Neuroscience.

"Some smokers experience anxiety, agitation. But at very high doses and in certain circumstances, it leads into depression-enhancing effects, particularly if you take in a lot of cannabis at very high doses."

Humans using cannabis as an anti-depressant is problematic since it's hard to control the dosage when it is smoked in the form of marijuana joints, says lead researcher Dr. Gabriella Gobbi.

"Our research shows that excessive cannabis use in people with depression poses a high risk of psychosis," Gobbi said in a telephone interview from Italy.

A psychiatrist by trade, Gobbi says she was prompted to conduct the research after noticing several of her patients suffering from depression used to be cannabis smokers.

Rats were injected with a synthesized cannabinoid which worked as a potent anti-depressant at low levels, varying from 0.05 to 0.2 milligrams per kilogram.

But higher doses showed the opposite effects that "totally undid" the anti-depression effects, Bambico said.

Bambico said researchers are focusing their research on a new class of drugs which enhance the effects of the brain's natural endo-cannabinoids - natural substances in the brain that are released during high stress or pain, without the anti-depressive side-effects.

Cannabis has a chemical similarity to endo-cannabinoids.

"It's entirely possible to produce drugs that enhance endo-cannabinoids for the treatment of pain, anxiety and depression," Gobbi said.

[palmspringsbum]

October 24, 2007

Cannabinoids Elicit Antidepressant-Like Behavior and Activate Serotonergic Neurons through the Medial Prefrontal Cortex

The Journal of Neuroscience

Francis Rodriguez Bambico,¹ Noam Katz,^1,2 Guy Debonnel,¹ and Gabriella Gobbi^1,2

¹Neurobiological Psychiatry Unit, Department of Psychiatry, McGill University, Montréal, Quebec, Canada H3A 1A1, and
²Department of Psychiatry, Centre de Recherche Fernand Seguin, Hôpital L.H. Lafontaine, Université de Montréal, Quebec, Canada H1N 3V2

Correspondence should be addressed to Dr. Gabriella Gobbi, Neurobiological Psychiatry Unit, Department of Psychiatry, Research and Training Building, McGill University, 1033 Pine Avenue West, Montréal, Quebec, Canada H3A 1A1. Email: gabriella.gobbi@mcgill.ca


<span class=postbold>ABSTRACT</span>

Preclinical and clinical studies show that cannabis modulates mood and possesses antidepressant-like properties, mediated by the agonistic activity of cannabinoids on central CB1 receptors (CB1Rs). The action of CB1R agonists on the serotonin (5-HT) system, the major transmitter system involved in mood control and implicated in the mechanism of action of antidepressants, remains however poorly understood. In this study, we demonstrated that, at low doses, the CB1R agonist WIN55,212-2 [R(+)-[2,3-dihydro-5-methyl-3-[(morpholinyl)]pyrrolo[1,2,3-de]-1,4-benzoxazinyl]-(1-naphthalenyl) methanone mesylate] exerts potent antidepressant-like properties in the rat forced-swim test (FST). This effect is CB1R dependent because it was blocked by the CB1R antagonist rimonabant and is 5-HT mediated because it was abolished by pretreatment with the 5-HT-depleting agent parachlorophenylalanine. Then, using in vivo electrophysiology, we showed that low doses of WIN55,212-2 dose dependently enhanced dorsal raphe nucleus 5-HT neuronal activity through a CB1R-dependent mechanism. Conversely, high doses of WIN55,212-2 were ineffective in the FST and decreased 5-HT neuronal activity through a CB1R-independent mechanism. The CB1R agonist-induced enhancement of 5-HT neuronal activity was abolished by total or medial prefrontocortical, but not by lateral prefrontocortical, transection. Furthermore, 5-HT neuronal activity was enhanced by the local microinjection of WIN55,212-2 into the ventromedial prefrontal cortex (mPFCv) but not by the local microinjection of WIN55,212-2 into the lateral prefrontal cortex. Similarly, the microinjection of WIN55,212-2 into the mPFCv produced a CB1R-dependent antidepressant-like effect in the FST. These results demonstrate that CB1R agonists possess antidepressant-like properties and modulate 5-HT neuronal activity via the mPFCv.

[palmspringsbum]

There are proven side-effects to ECT treatment, including short-term confusion or memory disturbance in some patients. In rare cases, patients lose pieces of their memory that never come back, said Dr. Michael Frankel, executive director of ECT treatment at Northridge Hospital.

Dukakis argues that although there can be memory side effects, the alternative treatment, medication, also has "debilitating side effects" and doesn't work in many cases.

Electroconvulsive therapy has an 80 percent success rate, Frankel said. But Dukakis is one of only about 100,000 people who use ECT to treat clinical depression - though more than 20 million people in the U.S. today suffer with the illness, according to the National Institute of Mental Health.

Cannabis has no 'debilitating side-effects', except that it's illegal.

Anne Marie, a four-year patient of Frankel's, chose ECT after years of battling impulse control, thoughts of suicide and a dependence on marijuana and alcohol.

"Before, every morning I would wake up and say, `Damn, I'm alive,' " she says. "ECT gives me days that I'm happy."

Maybe you should have tried cannabis without the alcohol. Cannabis amplifies the depressive effect of alcohol.

Kitty Dukakis makes her case for shock therapy

The Daily Breeze
By Carley Dryden Staff Writer
Article Launched: 03/24/2008 10:26:13 AM PDT


Kitty and Michael Dukakis "I'm Kitty Dukakis and I'm a drug addict and an alcoholic."

So reads the opening line of the former Massachusetts first lady's debut book, "Now You Know," published in 1992.

Dukakis, now 71, the wife of former governor and presidential candidate Michael Dukakis, took her first diet pill at 19, after years of feeling inadequate, she says, due to her mother's push for perfectionism. She liked the way the pills made her feel. so she took them for 25 years.

"Any alcoholic or drug addict knows we fool the world," she said during a recent visit to Northridge Hospital Medical Center to discuss her latest book, "Shock," in which she details the electroconvulsive therapy she says saved her life. "I never escalated my use of diet pills so there was nothing different in my behavior from the time (Michael) met me until the time I decided to get help."

That time came in 1982, when she chose to end her dependency on amphetamines. The minute those pills stopped, the depression started, she said. Soon after, her husband lost his 1988 presidential bid and Kitty Dukakis turned to alcohol, which provided the only relief from her severe bouts of depression.

Over the next 20 years, she was in and out of drug-treatment and psychiatric centers and often, when home, ingested any form of self-remedy she could find: rubbing alcohol, nail polish remover, even a bottle of hair spray. Seven years ago, she said, she lost hope and turned to the only treatment she felt was left for her depression - electroconvulsive therapy.

"ECT was a miracle in our lives," she said to the hospital gathering, her coffee-colored eyes glowing as her lips crept into a smile.

For Dukakis, like many Americans, her only exposure to the therapy was in movies such as 1975's "One Flew Over the Cuckoo's Nest." She admitted she was apprehensive when she checked herself in for treatment.

"Tragically, (the movie) gave people a very negative view of this treatment," she said. "And it wasn't even ECT that was given to Jack Nicholson, it was a lobotomy. That's what is so frustrating."

During an ECT procedure, one or both sides of the patient's brain receive electrical currents, causing brief seizures.

Dukakis underwent her first ECT treatment June 20, 2001, her 38th wedding anniversary. When her husband walked into the hospital room 15 minutes after her treatment, she recalled, "I was smiling. I said, `Let's go out for dinner. After all, it's our anniversary.' "

Though Dukakis still suffers from bouts of depression, often in nine or 10-month cycles, she has found a treatment that works.

"When I begin to feel a depression coming on, I don't wait very long, maybe a couple of days," she said.

The first ECT treatment will stop the downward cycle, she said, and with each succeeding treatment, the depression gets less intense and easier to handle.

Dukakis receives most of her treatments in Boston, arriving for the ECT at 7:30 a.m. Her temperature is taken, she is administered an electrocardiogram to test the electrical activity of her heart, and she is given a muscle relaxant and sodium pentothal as an anesthetic.

A seizure is induced for about 60 seconds - the only visual sign being a slight twitch of a toe. Fifteen minutes later, Dukakis said, she wakes up, and in another 15 minutes she heads home.

There are proven side-effects to ECT treatment, including short-term confusion or memory disturbance in some patients. In rare cases, patients lose pieces of their memory that never come back, said Dr. Michael Frankel, executive director of ECT treatment at Northridge Hospital.

Dukakis argues that although there can be memory side effects, the alternative treatment, medication, also has "debilitating side effects" and doesn't work in many cases.

Electroconvulsive therapy has an 80 percent success rate, Frankel said. But Dukakis is one of only about 100,000 people who use ECT to treat clinical depression - though more than 20 million people in the U.S. today suffer with the illness, according to the National Institute of Mental Health.

"It may not be for everyone, but shouldn't it be an option in cases that often end in tragedy?" she asked her Northridge Hospital audience.

Anne Marie, a four-year patient of Frankel's, chose ECT after years of battling impulse control, thoughts of suicide and a dependence on marijuana and alcohol.

"Before, every morning I would wake up and say, `Damn, I'm alive,' " she says. "ECT gives me days that I'm happy."

Dukakis said it's impossible to measure her identity post-ECT, compared to who she was before she began treatments. But she provides one telling clue:

"I am an Obama nut," she said. "I have the TV on all the time. If I was still depressed, I wouldn't have those kinds of feelings for the (presidential) campaign."