The largest systematic review of medicinal cannabis for psychiatric conditions has identified three critical clinical takeaways. First, there is no proven benefit for anxiety, PTSD, or depression—with depression notably absent from any randomized controlled trial to date, despite being a primary reason patients seek cannabis treatment. Second, only two psychiatric conditions show modest evidence: insomnia (measured by sleep duration) and Tourette’s syndrome (tic severity), both with moderate to low certainty ratings.
Third, and perhaps most important for clinical decision-making, cannabis users face a 75% increased risk of adverse events compared to placebo. Given that 27% of North American adults cite mental health reasons for medical cannabis use, these findings underscore the need for patient education and shared decision-making. Clinicians should discuss the limited evidence base and elevated safety risks before recommending cannabis for most psychiatric indications.
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