The endocannabinoid system and posttraumatic stress disorder (PTSD): A new narrative

The endocannabinoid system has been proposed as a promising candidate for treating posttraumatic stress disorder (PTSD). Despite a proliferation of preclinical and healthy human research, there is currently sparse endocannabinoid and cannabinoid research involving individuals with PTSD. Current evidence suggests discrepancies in the relationship between endocannabinoids and PTSD between basic (preclinical, healthy human) and clinical research. Specifically, more research is needed to understand how extreme stress and trauma exposure influence circulating concentrations of endocannabinoids acutely, as well what occurs to endocannabinoid tone and reactivity in the aftermath of trauma (e.g., 6 months following trauma). More information is also needed to understand how genotypes identified in basic research correlate with PTSD symptomology and fear-conditioning performance, as well as how treatment with cannabinoid compounds affects PTSD treatment outcomes. The current review discusses each of these issues in a comprehensive review of available evidence and suggests critical areas of future research.