Furious Seasons

July 28, 2008

Is Marinol (Pot Pill) An Anti-Depressant?

A recent case report from the journal Cannabinoids identifies two patients with depression and "burnout syndrome" (I'll not even get into the irony of that term in reference to cannabis) who had not been well-treated by conventional anti-depressants and were instead given a daily dose of Marinol, the so-called pot pill, for several years and this successfully treated the patients. So here pot is established as having anti-depressant effects. The doctor is working in Austria, which explains why you've not heard of this before. You can read the report here and draw your own conclusions.

Obviously, all the usual cautions around case reports apply--limited sample size, no controls, no randomization, etc. But then, at least in the US, the government has worked for decades to block clinical trials of marijuana and various pill derivatives for use in treating depression and just about anything else, so case reports here and there are almost all we have to go on.

Here's how the Austrian doctor assesses some of the evidence. The clinical trials he refers to were conducted in patients suffering from other conditions such as AIDS and cancer.

"In several clinical studies, during which subjective parameters were monitored, cannabinoids not only improved physical symptoms but also improved well-being and produced measurable antidepressant effects . A study by Musty (2002) with healthy volunteers, smoking cannabis showed a positive correlation with the ratings on a scale of depression (MMPI), indicating an antidepressant effect. These indications of a therapeutic potential of symptoms of depression encouraged the author to start administering dronabinol [Marinol] to select patients suffering from depression."

The MMPI isn't exactly a clinical scale of depression, so I'd be more impressed with results measured with the HAM-D or other scales, but still it's suggestive of some level of effect.

And apparently there are all manner of effects. In one of the cases, the doctor reports that not only did his patient's depression abate, but that the patient was able to break their benzo dependence.

Let me just say, once again, that given how much depression--and burnout syndrome for that matter--we have in this country, and given how poorly and unpredictably officially-sanctioned anti-depressants work, then it makes sense that the feds should stop blocking researchers from using marijuana, or whatever pill form of cannabis molecule makes sense, in research into treating depression. NIMH has already been allowed to use ketamine is some trials of depression treatment, so why not pot too?

Maybe we can one day get the good folks at Eli Lilly back into the cannabis tincture business and out of the SSRI/SNRI business.

Posted by Philip Dawdy at July 28, 2008 11:42 AM

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Comments

I haven't followed the history with Marinol. Has there been some federal effort to block study of it as an antidepressant and is there any reason it couldn't be prescribed off-label?

Posted by: Dr X at July 28, 2008 12:03 PM

Thank you for staying at it.
I enjoy your posts,but I understand how you felt ,so dont make yourself ill and only carry on if you feel you're up to it.
Cynders.
Cornwall UK.

Posted by: cynders at July 28, 2008 12:09 PM

Hey Philip,

Have you read any of the research looking at the other psychoactive components of marijuana? Though THC is the main psychoactive component, there is another cannabinoid called cannabidol (CBD), which may mute the anxiety some people experience as a result of THC. It is interesting.

PS - There is an article in Elle Magazine this month about the exact topic of medical marijuana and mental health. It's good to see it being brought to attention.

PPS - The receptors in the brain for cannabinoids are called "anandamide receptors". As a person with some background in sanskrit, "ananda" is sanskrit for bliss. I thought you'd find that interesting :)

Natalie

Posted by: NAP at July 28, 2008 01:52 PM

"Maybe we can one day get the good folks at Eli Lilly back into the cannabis tincture business and out of the SSRI/SNRI business."

They make enough cash off these businesses, what is their motivation to start a new one....
It's not like they are in business to help us or something...

Posted by: Thomas P at July 28, 2008 06:42 PM

thomas, i can assure you i was joking about the eli lilly part.

Posted by: Philip Dawdy at July 28, 2008 07:57 PM

Wow there, what if it turns out that pot worked all along and, as they say, it doesn't make you want to do anything crazier than watch sit-coms and order pizza? Nah, it's too cheap.

Posted by: Sally at July 29, 2008 02:53 AM

Philip, I knew you were joking (you understand what's going on), but they are still called health care companies by the masses, and that just boggles my mind.

Posted by: Thomas P at July 29, 2008 08:53 AM

Excellent news Philip,

Hardly shocking for those in the know.

I have made no secret of my own success at treating both mania and depression with marijuana.

At one point I had only tried the stuff three times as a young adult. I even told my friends, I did not mind it but I was scared of the brain cell death.

You know the commercials from the 80s. This is your brain on drugs, eggs in a frying pan.

Then my friend quipped, well my uncle has been a stoner for 30 years and passed the mensa exam a few years ago.

His uncle was one of the most intelligent people I had ever met.

So I said, ok pass that thing over here.

Turns out once I got passed one or two tokes, into the five tokes or more region, the voices in my head spontaneously shut up for once.

I had stumbled upon nature's own antipsychotic.

If that was not enough, as the medications blood level reached therapeutic effects I started laughing spontaneously at things that were normally unfunny to me.

It helped me realize how serious I took everything and relax a bit.

Just a little bit of laughter went a long way in making me happier and easier to be around as a person.

I find myself too depressed to get out of bed.

Smoke a joint and voila, I am humming along with music, I smile about something I read in the news and suddenly I am up doing stuff around the house.

So pot brought me up when I was down by making life less serious and easier to bear.

Then pot quieted the voices in my head. Without the voices all the really crazy things I did or said abated.

So there we have a drug that keeps me totally level. It brought me down from the manias and brought me up from the depressions while quieting the voices in my head.

That is exactly what the combination of lithium and trilafon was supposed to do but failed at miserably.

Pot didn't give me TD, ataxia, sleep walking, drooling, shuffling gait, 100 extra pounds and recurring UTIs from peeing all the time.

Pot totally beat down lithium and trilafon for a BiPD/SZ med.

It unleashed my creativity rather than hampering it.

Big Pharma has been unable to make anything like it on their own with the exception of MDMA so they make marinol by synthesizing certain ingrediants in THc.

Pot was my wonder drug in my late teens and early 20s. I smoked tons of the stuff. It helped me keep my job by disarming my temper so I did not go off on the other employees or become combative with customers.

One of the main reasons I moved to California was because it was decriminalized. When I realized I was going to rely on marijuana for years to maintain my sanity I took steps to make sure my use would not effect others.

I did not have kids. I told my potential suitors from the start that I was a stoner and why. I sold my car. I would not endanger people or get in trouble for driving under the influence.

Later Californians made life even easier for marijuana users by treating pot as alternative medicine and users as patients.

You don't have to page your dealer or comb the shady streets for a connection.

You just get a marijuana patient ID and a prescription from your doctor. Then you have access to clubs where this stuff is grown by other patients and sold in dozens of varieties in clean, well lit stores.

Heck we even pay sales tax on it.

If you think that smoking it makes you a burnout or some such cultural silliness you can just drink it as creamer, as a soda pop (made without HFCS too)

You can eat it as a carrot cake, blueberry muffin or banana bread.

This stuff was around before big pharma, lobbying from big pharma and conservative social norms coupled with some Nixon era pseudoscience hysteria from the government are why this stuff is not growing outside everyone's yard.

Here in California you are a patient not a criminal and you can buy and use this stuff without shame, stigma or harassment from police.

Californians can legally choose pot over psych meds or narcotics for mental or physical pains, it's high time the rest of the country step to it.

Posted by: Jane at July 29, 2008 11:34 AM

I have personally watched the effect of Marinol on a bi-polar, ADHD, ADD person. Along with Lamictal this person stabilized in a way I would not have believed possible. Problem....The Federal government does not back the use of Marinol for Bi-polar. There is now a generic Marinol available. Still Very expensive...much more than a little the old fashioned way. Need to get NAMI behind the use of Marinol for Psych problems that it will help. Think I will tell this person to move to California and LIVE.

Posted by: MaryK at July 30, 2008 12:15 AM

Pot oil cures many cancers as well. See video at http://www.youtube.com/chrychek

Posted by: Bonita Poulin at August 4, 2008 03:30 PM

I was just prescribed Marinol for a few reasons. A few years back I landed on my tail bone after hitting a jump on the slopes. I noticed that when I smoked pot, I didn't need Lortab. Marijuana acts like an antidepressant, an analgesic, and helps me focus. At one point in time I was taking Adderall, Lamictal, Xanax and Lortab. Today I just need Xanax on occasion, and Lortab on occasion. I have smoked marijuana more than half my life, it is nice that it is finally being recognized as a tool, rather than taboo. The only reason smoked marijuana ever gave me anxiety, was because of it's legal status. No one likes the feeling of breaking the law. I hope the Marinol free's me from that anxiety. I will start taking it tomorrow and report back my results.

Posted by: Carlo D at February 19, 2009 09:32 PM