Can medical cannabis be used in patients with depression?
Kevin P. Hill, MD: That is a tricky issue. A lot of patients will say that they want medical cannabis to treat depression because they think that when they use cannabis and they have the euphoric feeling associated with it, their mood is better.
In general, though, that is not a great strategy to treat depression simply because we know a few things about cannabis and depression. Number one, if you are using cannabis, you are more likely to develop a depressive disorder. Number two, if you already have a depressive disorder, cannabis will likely exacerbate that depressive disorder.
In terms of using medical cannabis to treat depression itself, there really are no studies, there are zero RCTs, randomized controlled trials, of medical cannabis for depression at this point.
If a patient came to me and they were asking to use medical cannabis to treat depression, then I would try to steer them towards either behavioral interventions, like cognitive behavioral therapy, that we know are effective for depression or one of the many medications that we have.
I think that is one of the major points that we want to make about medical cannabis. Even if you as a physician are not comfortable with it, or you do not believe in it, or you do not believe the evidence, it is always better to have a discussion with your patient about why they might want it, because therefore you might be in a position where you are able to get them into treatment that they would not otherwise get into because they are interested in medical cannabis. That is a discussion that we always encourage doctors to have with their patients.