Nabilone significantly reduced PTSD nightmares in treatment-resistant military veterans — leading the Canadian military to adopt cannabinoids for PTSD treatment
In 10 military PTSD patients whose nightmares had not responded to standard treatment, nabilone produced significantly greater nightmare reduction than placebo (CAPS: -3.6 vs -1.0, p=0.03), with 50% rated much improved vs 11% on placebo.
Quick Facts
What This Study Found
CAPS Recurring Dream scores: nabilone -3.6 (±2.4) vs placebo -1.0 (±2.1), p=0.03. CGI-C: nabilone 1.9 (much improved) vs placebo 3.2 (minimally improved), p=0.05. 50% much improved on nabilone vs 11% on placebo. General wellbeing: +20.8 vs -0.4, p=0.04. No severe adverse events.
Key Numbers
How They Did This
Randomized, double-blind, placebo-controlled crossover trial. 10 male Canadian military personnel with PTSD and treatment-resistant nightmares. Nabilone started at 0.5 mg, titrated to max 3.0 mg. 7-week treatment periods with 2-week washout. Assessed with CAPS dream subscale, CGI-C, and General Well Being Questionnaire. Registered with Health Canada.
Why This Research Matters
This was the first double-blind placebo-controlled RCT of a cannabinoid for PTSD nightmares in military personnel. Despite the tiny sample, all three outcomes reached significance. The Canadian Armed Forces subsequently adopted nabilone for PTSD nightmares — one of the first military organizations to incorporate cannabinoids into mental health treatment.
The Bigger Picture
This tiny trial opened a door that changed military psychiatry. The Canadian Armed Forces' adoption of nabilone for PTSD was driven by clinical necessity — veterans had exhausted standard treatments and were unable to sleep. The finding that cannabinoids can suppress trauma nightmares through REM modulation has implications far beyond the military, affecting the millions of civilians with PTSD worldwide.
What This Study Doesn't Tell Us
Only 10 subjects. All male military personnel — cannot generalize to female veterans, civilian PTSD, or sexual trauma. Short duration (7 weeks per period). No comparison to prazosin. No data on long-term dependence or REM rebound. Nabilone is synthetic — unclear generalizability to plant cannabis. No large-scale replication.
Questions This Raises
- ?Would nabilone work in a larger, more diverse PTSD population?
- ?How does it compare to prazosin head-to-head?
- ?What are the long-term effects of chronic REM suppression on cognition and emotional processing?
- ?Does plant cannabis produce similar nightmare reduction?
- ?Can cannabinoids facilitate fear extinction rather than just suppressing REM?
Trust & Context
- Key Stat:
- PTSD nightmare scores dropped 3.6x more on nabilone than placebo (p=0.03) — 50% much improved vs 11%
- Evidence Grade:
- Double-blind, randomized, placebo-controlled crossover design — strong methodology. But only 10 subjects, no large-scale replication, and short duration.
- Study Age:
- Published in 2015. Canadian military has used nabilone for PTSD clinically since. No large-scale RCT has been published as of 2026.
- Original Title:
- The efficacy of nabilone, a synthetic cannabinoid, in the treatment of PTSD-associated nightmares: A preliminary randomized, double-blind, placebo-controlled cross-over design study.
- Published In:
- Psychoneuroendocrinology, 51, 585-588 (2015)
- Authors:
- Jetly, Rakesh, Heber, Alexandra, Fraser, George, Boisvert, Denis
- Database ID:
- RTHC-08900
Evidence Hierarchy
Participants are randomly assigned to treatment or placebo groups to test cause and effect.
What do these levels mean? →Frequently Asked Questions
Can nabilone help with PTSD nightmares?
In this small trial, nabilone significantly reduced nightmare frequency and severity versus placebo in treatment-resistant military PTSD. The Canadian Armed Forces now use it clinically.
What is nabilone?
A synthetic cannabinoid (brand name Cesamet) that mimics THC's effects. Approved for chemo nausea. Used off-label for PTSD nightmares.
Will nightmares come back when I stop?
Likely temporarily. REM rebound after stopping cannabinoids produces vivid dreams. Many patients use nabilone long-term to maintain nightmare suppression.
Read More on RethinkTHC
Cite This Study
https://rethinkthc.com/research/RTHC-08900APA
Jetly, Rakesh; Heber, Alexandra; Fraser, George; Boisvert, Denis. (2015). The efficacy of nabilone, a synthetic cannabinoid, in the treatment of PTSD-associated nightmares: A preliminary randomized, double-blind, placebo-controlled cross-over design study.. Psychoneuroendocrinology, 51, 585-588. https://doi.org/10.1016/j.psyneuen.2014.11.002
MLA
Jetly, Rakesh, et al. "The efficacy of nabilone, a synthetic cannabinoid, in the treatment of PTSD-associated nightmares: A preliminary randomized, double-blind, placebo-controlled cross-over design study.." Psychoneuroendocrinology, 2015. https://doi.org/10.1016/j.psyneuen.2014.11.002
RethinkTHC
RethinkTHC Research Database. "The efficacy of nabilone, a synthetic cannabinoid, in the tr..." RTHC-08900. Retrieved from https://rethinkthc.com/research/jetly-2015-nabilone-for-ptsdrelated-nightmares
Access the Original Study
Study data sourced from PubMed, a service of the U.S. National Library of Medicine, National Institutes of Health.
This study breakdown was produced by the RethinkTHC research team. We analyze and report published research findings without making health recommendations. All interpretations are based solely on the published abstract and study data.