Despite the joy of contributing to the care and recovery of patients with covid-19, many health professionals suffer from the fear of taking the virus home, sadness of dealing daily with the imminence of death, impotence due to the lack of beds, in addition to tiredness by the routine in the shifts. This reality can trigger problems such as emotional exhaustion, anxiety, depression and the so-called burnout syndrome or professional burnout.
Research has evaluated the effect of cannabidiol (CBD) on symptoms of these conditions. It is the substance extracted from the plant cannabis sativa and that has already been applied for therapeutic purposes in different contexts.
In the study, it was shown that it also has good potential for treating mental exhaustion and burnout in those on the front lines of the pandemic. “The result is important, as there is still no established pharmacological treatment for these conditions”, says Professor José Alexandre Crippa of the USP Ribeirão Preto Medical School (FMRP), leader of the research published in the journal Jama (Journal of the American Medical Association) with open access.
The researchers selected and followed 120 physicians, nurses and physiotherapists from the Hospital das Clínicas of FMRP who worked in the patient care wards with covid-19 between June and November 2020.
For comparison, they were divided into two groups: for 28 days, 61 people received a daily dose of 300 milligrams (mg) of cannabidiol plus the standard treatment with guidance, motivational videos and exercise suggestion; in the same period, 59 people received only the standard treatment.
Because they do not have a biological marker, such as the blood glucose level to know who has diabetes, for example, psychiatric conditions need to be identified in other ways. Thus, the researchers carried out two assessments with the participants: a first subjective stage, through the volunteers’ responses in a questionnaire, and the other objective phase, based on a structured interview carried out by physicians.
At the suggestion of the ethics committee that authorized the research, and considering the challenging context, during the pandemic, to develop a study of this type, there was no “placebo group” that received a substance without activity.
Thus, the participants who received cannabidiol were aware of this, which represents a limitation of the study as it can influence their perception of improvement. Despite this, Professor Crippa points out that the interview evaluators were ‘blind’, that is, they did not know who was in which group of volunteers. “That way we were able to minimize the subjectivity of the evaluations”, he says.
The results showed a 60% reduction in symptoms of anxiety, 50% in depression and 25% in burnout among volunteers who took the standard treatment plus the use of cannabidiol compared to those who only took the standard treatment. “The analyzed data indicated a significant decrease after 14 and 28 days of using the drug”, explains the researcher.
Cannabidiol alone does not have the psychoactive properties that are typical of the plant cannabis sativa. In the scientific context, the medicinal use of this substance has already been evaluated in diseases such as epilepsy, anxiety disorders, sleep disorders, Parkinson’s and schizophrenia.
Among the results that characterize the originality of the work is the isolated profile of the side effects of cannabidiol. In other words, in this study, it was possible to evaluate its use without association with other medications.
Although other researches have already assured that the drug is safe, five of the 120 volunteers had adverse effects considered serious, with an increase in liver enzymes and pharmacoderma, which is an adverse skin reaction to drugs. However, all had full recovery after discontinuing the drug.
“Cannabidiol must be prescribed by a doctor who will be able to monitor the side effects through interviews and laboratory tests”, emphasizes the professor at USP.
What is burnout?
Burnout syndrome or professional burnout syndrome is an emotional disorder that causes symptoms of extreme exhaustion, stress and physical exhaustion generated by exhausting work situations that demand a lot of competitiveness or responsibility.
“The syndrome is a disorder that does not have a specific medication for treatment. In addition, other medications currently used can cause sedation or take a long time to induce a response, as in the case of antidepressants”, says Crippa.
The study Efficacy and Safety of Cannabidiol Plus Standard Care vs Standard Care Alone for the Treatment of Emotional Exhaustion and Burnout Among Frontline Health Care Workers During the COVID-19 Pandemic is part of the doctorate of José Diogo Souza, a student of the Postgraduate Program in Mental Health at FMRP.
In addition to Professor Crippa e Souza, the article featured researchers from FMRP, National Institute of Translational Science and Technology in Medicine, Hebrew University of Jerusalem, McMaster University, Federal University of Rio Grande do Sul, University of Michigan Medical School, Federal University of São Paulo and Chromatox Laboratory.