A Renewed Call for Research: Study on Medical Efficacy of Cannabis for Patients Treated for Depression

By Dr. Julian Wichmann, MD

In the last decade, the world has seen a dramatic increase in the legalization of medical cannabis and the overall acceptance of cannabis as medicine. In 2022, the medical cannabis market boomed to $11.6 billion USD and is projected to increase to $40.48 billion market by 2032, according to Towards Healthcare’s recent report. There has been an increase in awareness of therapeutic applications of medical cannabis for patients’ various conditions, including, but not limited to, management of chronic pain, anxiety and sleeping disorders, as well as side effects of chemotherapy.

Realizing the importance of research to further enhance and underscore this acceptance of medical cannabis to treat more symptoms effectively, such as chronic depression, my colleagues and I have co-authored a study titled “Effectiveness of Medical Cannabis for the Treatment of Depression: A Naturalistic Outpatient Study” with research conducted by Germany-based psychiatric hospital, LVR University Hospital Essen, in collaboration with Algea Care, Europe’s leading telehealth platform for medical cannabis.

Depression and Current Prescription Treatments and Their Limitations

Major depression is considered one of the most common mental disorders in the U.S. According to the National Institute of Mental Health (NIMH), in 2021, about 14.5 million U.S. adults (5.8% of all U.S. adults) have had at least one episode of major depression with an impairment that impacted their home management, work, close relationships with others or social life.

The numbers for depressive symptoms are even more prevalent within Germany. According to a fact sheet released by the Journal of Health Monitoring, a survey revealed that 10.1% of German adults had experienced depressive symptoms within the past two weeks. These symptoms included depressed mood or irritability, decreased interest or pleasure, significant weight change or change in appetite, change in sleep, psychomotor agitation or reduction, fatigue or loss of energy, guilt or worthlessness and diminished ability to concentrate.

Adults suffering from major depression symptoms are commonly prescribed an antidepressant which typically includes serotonin-norepinephrine reuptake inhibitors (SNRIs) or selective reuptake inhibitors (SSRIs). While the treatment efficacy of SNRIs and SSRIs can vary,  side effects of long-term use are common and include sexual dysfunction, weight gain and sleep disturbance, among others. Antidepressants vary in their effectiveness for patients, and some do not respond to the treatment at all. According to the Journal of Clinical Psychiatry, 10%-15% of patients do not respond to an adequate pharmacological therapy, and an additional 30%-40% have only a partial remission. For this reason, more treatment options are needed to provide relief of major depression in patients.

Study: Effectiveness of Medical Cannabis for the Treatment of Depression

In the study, conducted over 18 weeks, patients diagnosed with chronic clinical depression were treated with medical cannabis prescribed by physicians through a telehealth platform for their symptoms. To be eligible for the study, patients had to have been priorly prescribed antidepressant medication as treatment for their clinical depression with unsatisfactory treatment response and persistence of symptoms.

Age of included patients ranged from 20-54 years and the symptoms of their condition were measured on a 0-10 rating scale. The mean base of the severity of depression reported by the patients decreased from 6.9 points on the scale to 3.8 points at the end of the 18-week study. By week 18, about half the patients reported that the severity of their depression had decreased by 50 percent. Only one-third of patients shared that they experienced side effects from the medical cannabis treatment, and none of the symptoms were considered severe. There was a 22% dropout rate at the conclusion of the study.

Results: Effectiveness of Medical Cannabis for the Treatment of Depression

According to the results of the study, medical cannabis was tolerated well by patients suffering from clinical depression. There was a dropout rate comparable to those in antidepressant medical clinical trials. The patients who were prescribed medical cannabis reported that there was a significant reduction in the symptoms associated with their clinical depression condition. The findings of this study suggest that more research should be conducted on the efficacy and effectiveness of medical cannabis as a treatment option, particularly when prior medication did not result in sufficient alleviation of symptoms.

Challenges Medical Cannabis Studies Face

Despite the widespread public interest in furthering cannabis research and its applications across industries, often, there are challenges to bringing these trials to fruition. According to “The Health Effects of Cannabis and Cannabinoids: The Current State of Evidence and Recommendations for Research,” the study’s committee stated that conducting basic, clinical and population health research on cannabis and cannabinoids was often impeded by ​​regulations and policies that restrict access to the cannabis products that are used by an increasing number of consumers and patients in state-regulated markets, funding limitations, and numerous methodological challenges. These circumstances further emphasize the relevance of studies focused on real-world evidence, including ours.

How Industry Leaders Can Serve as Advocates for Future Research and Clinical Trials

As business leaders and medical experts within a burgeoning global cannabis market, we have a responsibility to advocate for further research into the applications of cannabis in medical and scientific settings. One of the best ways to champion further research in this area is for countries to legalize the entire value chain of cannabis and ease the regulations around the research and implementation of the plant for patients. For some countries, like the U.S., this would require a rescheduling of cannabis as a non-narcotic, similar to what Germany will implement this year with the passage of the CanG bill. Regarding the fact that clinical trials from phases 1-3 are highly expensive and the question of how to monetize an IP on a plant-based natural medicine limits spending, it’s important to find intelligent solutions to use real-world data most efficiently.

Medical experts should lead conversations, spread awareness and help educate patients and the general public about the benefits of cannabis and its health potential. It’s important for medical professionals to provide evidence-based factual information to the public that can help ease outdated stigmas and myths surrounding cannabis. They should also take a firm hand in helping to guide regulatory leaders and professionals within the scientific and medical communities as they seek to ease regulations surrounding the research of cannabis for patients.