Comparative Review: Pharmacological Mental Health Medications vs Medicinal Cannabis in Supporting Mental Health

A lack of accessible, comprehensive information comparing the risks and benefits of psychiatric medications versus endocannabinoid-based therapies has prevented the Department of Veterans Affairs from approving the use of medicinal cannabis for veterans mental health conditions. 

The No More Zombie Veterans movement has developed a Comparative Review of Pharmacological Mental Health Medications vs. Medicinal Cannabis and the Endocannabinoid System (ECS). This review highlights the severe side effects of traditional medications, including dependency and heightened suicide risks, while showcasing the potential of medicinal cannabis to alleviate PTSD, TBI, and related mental health conditions. By modulating the ECS, medicinal cannabis helps regulate mood, reduce stress, and improve emotional well-being—key factors in lowering suicide risk.

1. Safety Profile

2. Efficacy

  • Pharmacological Medications:

    • Studies show some effectiveness for acute symptom relief but associated with limited long-term efficacy in addressing underlying conditions.

    • Studies show evidence that the long-term use of antidepressants, antipsychotics, and benzodiazepines is often accompanied by worsening of symptoms or withdrawal challenges.

  • Medicinal Cannabis:

    • Emerging evidence supports its role in reducing PTSD symptoms, alleviating anxiety, improving sleep, and mitigating neuropathic pain.

    • Enhances ECS signaling, supporting natural stress responses and reducing inflammation.

3. Mental Health Outcomes

  • Pharmacological Medications:

    • Studies show while effective for some, the prevalence of severe side effects, dependency, and reduced quality of life leads to challenges in adherence and satisfaction.

    • Elevated suicide risks associated with benzodiazepines Z-drugs, antidepressants, anticonvulsants and antipsychotics raise ethical concerns.

  • Medicinal Cannabis:

    • Patients report improved quality of life, fewer debilitating side effects, and better symptom management without the significant risks of cognitive or physical decline seen in traditional medications.

Conclusion

The evidence suggests that medicinal cannabis, through its ECS-modulating effects, particularly when dosed appropriately and tailored to individual needs, offers a promising alternative to conventional pharmacological treatments for mental health conditions. Compared to traditional medications, it shows a more favorable safety profile with fewer severe long-term side effects, especially when used responsibly and under medical supervision. 

Endocannabinoid experts suggest careful dosing—starting low and gradually titrating to achieve therapeutic effects. Studies and evidence show how medicinal cannabis can provide significant relief for conditions such as PTSD, anxiety, and psychosis, while minimizing risks of adverse effects. Proper education on dosing and access to high-quality, regulated products are key to optimizing its benefits and ensuring patient safety.