Posts Tagged ‘insomnia’

PTSD (Post Traumatic Stress Disorder) and Medical Marijuana; A supplemental Treatment Approach

Posted By Dr. Sean Breen on July 20th, 2010

Lately I have been seeing more and more patients with PTSD looking to medical marijuana as an alternative to the medications that their psychiatrists have prescribed.   Because I have an office in Long Beach next to the VA and also take care of many Marines from Camp Pendleton I am seeing more and more how cannabis is helping them.

Let me make one point that is very important for PTSD patients to understand.  Medical Marijuana is not going to cure your symptoms. You will still need ongoing therapy and psychiatric counseling to REALLY get past this time in your life.   What medical marijuana can do if help you reduce your dependence on drugs like Trazodone/Xanax/Ambien for sleep and reduce your dependence on mood stabilizers like paxil/prozac/seroquel.  Often these medications have side effects that do not justify the benefit of taking them daily.    Many of my patients tell me that one or two doses using a vaporizer when they come home from work helps them relax and get a good nights rest.

Being a combat veteran myself I understand the stresses that our veterans go though and what they experience when they get home.  I spent 9 months with an infantry unit (1/4 out of Camp Horno, 1MARDIV) in Iraq from Jan-Sept 2003.   I definitely witnessed my share of casualties and had more than one RPG sent my way.   I have lost Navy Corpsman to bullets and covered a KIA marine with a US flag in the heat of battle.   There is nothing more terrifying than the thought of being killed on a regular basis.

I do not take this medication lightly and want to make sure that our military leadership and veterans understand that medical marijuana is an option for them to consider.   It make work and it may not.  But I think it is worth discussing and you should be willing to give it a try if you are frustrated with your current treatment plan.

I have offices in Long Beach and Irvine and see patients 5 days per week.   Our office number is 877-721-0047 or contact us through the web at www.mcsocal.com

Semper fi,

Dr. Breen

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Medical Marijuana and Withdrawal Symptoms;

Posted By Dr. Sean Breen on July 14th, 2010

As medical director for Medical Cannabis of Southern California I often evaluate patients who had used cannabis extensively for a long period of time prior to using it as a medication.   Many of these patients do in fact discuss similar withdrawal symptoms if they abruptly stop medicating.    Common complaints are irritability, anxiety, insomnia and difficulty focusing. Although cannabis as a medication is generally very safe I think these withdrawal symptoms warrant discussion.

Cannabinoids (the medically active ingredients in the plant) work by entering our body and bind to receptors on individual cells in the nervous and immune system.    Once the medicine binds to the receptor it causes changes to occur in the cell.   What can happen over time is that when receptors are constantly being bombarded(stimulated) by cannabis they can become less responsive to the cannabinoids (almost like “oh its you again… what do you want this time).  We see this in patients who develop diabetes.  High blood sugars lead to an increase and continuous release of insulin (which binds to cells and tells the cell to eat up the sugar) which bombard insulin receptors.  Over time these receptors are less responsive to the insulin and patients have hhigh blood sugar levels.

Although much more research needs to be done it makes sense that a similar situation occurs with cannabis.  The receptors most likely get fatigued and become less responsive to the cannabinoids.   The question becomes what happens if you stop using cannabis.  What makes sense is that these receptors are so used to becoming stimulated daily that the body reacts on a cellular level causing the symptoms people describe.    This is very similar to SSRI’s that patients take for depression.  Abruptly stoping them causes A LOT of issues.  THis is why patients are told to taper off slowly over time.

What I recommend for patients who regularly use cannabis is to give their bodies a break pretty frequently is possible.   Once a month go 3-5 days without it and let you body adjust naturally.   If you find that you are still having symptoms of withdrawal then maybe take breaks more frequently.

Whenever you use a medication you always have to weigh the benefits and risks.  If you are using cannabis for pain and your symptoms improve but you have to deal with mind withdrawal symptoms if you stop for a few days then it is probably worth it to continue.  You ultimately have to determine if the benefits outweigh the risks.

Be blessed,

Dr. Breeen

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Concerta, ADD/ADHD, and Marijuana (Cannabis); Reducing side effects

Posted By Dr. Sean Breen on June 3rd, 2010

As medical director of Medical Cannabis of Southern California I often evaluate patients suffering from ADD/ADHD who are taking stimulants like Concerta and want  a medical marijuana recommendation to combat its side effects.   Today I evaluated a 21 year old male college student who had been taking Concerta for the past year but had to stop because it was causing a significant lack of appetite, weight loss and insomnia.  These are very common complaints from patients who are treated with stimulants.  Although he said he could focus slightly more the insomnia and lack of appetite was causing more difficulties than the ADHD itself.    He had been using cannabis for the past month with excellent results and wanted to speak with me about getting a medical marijuana recommendation.

When I was going over his experience with using cannabis he stated that it really helped him focus for the 24 hour period following his use.  He typically used it prior to going to sleep because he was sleeping 8 hours when using a strong indica strain.  It also helped stimulate his appetite.   Because of regular small doses with cannabis he was able to stop using concerta completely and was getting excellent grades.

I have seen more and more students come in for marijuana evaluations because they are tired of taking adderal, concerta and ritalin.   Cannabis is an excellent alternative and worth a try.  It has very few unwanted side effects an as long as patients are using it responsibly (not driving or operating heavy machinery) it is pretty benign.   I also have found that students report using less alcohol because they are able to medicate which in turn is leading to more productivity and less lost time at work.

If you are taking stimulants for ADHD and would like to see if cannabis can supplement or replace your existing treatment plan feel free to make an appointment by calling 877-721-0047.   I look forward to seeing you.

Respectfully,

Dr. Sean Breen

Medical Diretor, MCSoCal, www.mcsocal.com

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Marijuana (Cannabis) as alternative treatment for menopause; Medical Marijuana Doctors

Posted By Dr. Sean Breen on June 2nd, 2010

Today at my Irvine office I evaluated a 51 year old women who wanted an evaluation to see if medical marijuana could provide relief for some of the symptoms she has been experience as a result of menopause.   Specifically she had been suffering from severe hot flashes which caused secondary insomnia.   As a result of not being able to sleep well she was “always tired” during the day.  Her ob/gyn had tried prescribing paxil and ambien to help relieve her symptoms but the side effects were worse than what she was trying to relieve.    A few weeks back a friend of hers that had a medical marijuana card for chronic pain gave her some marijuana to try to improve her sleep.  The results “were amazing” she told me.

The first night she vaporized (inhaled smoke free) one pinch of a cannabis strain called OG Kush.  She described lying down and falling asleep almost immediately.  Prior to that she would “toss and turn” for a few hours before finally falling asleep.  She reported that she slept 8 hours for the first time in 2 years!   As a result she woke up feeling rested and was able to be more productive the next day.  She plans on using marijuana for the duration of her menopausal symptoms and is “so relieved” that she has a “more natural alternative.”

Menopause occurs because of decreasing estrogen levels in the womens body.   It typically occurs around the age of 51.   Many women experience hot flashes, vaginal dryness and nights sweats.   Many women also report feeling anxious or even depressed.   It can be a very difficult time for women as there reproductive organs “shut down” for good.   Typically doctos try giving their patients SSRI’s (antidepressants such as Paxil), Ambien to improve sleep and benzodiazepines to treat anxiety.   Hormone replacement therapy used to be the gold standard to reduce the typical symptoms but recent studies showed an increased risk of cardiovascular disease and breast cancer.

I see many women who get great results by using small amounts of cannabis in the evening to reduce their symptoms.  Because cannabis is such a benign medication (very little unwanted side effects) I believe that it is a great alternative to try.   It is not addictive, is not toxic to any major organ system and be used as often as necessary.  In addition if vaporized (vs smoked) there are no harmful side effects from smoke which limits most patients from even trying it.

If you are in menopause or would like more information on whether you could benefit from using cannabis feel free to make an appointment at 877-721-0047.  There is NO FEE if you do not qualify or decide not to use it.

Respectfully,

Dr. Breen

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Veterans and Medical Marijuana; A Special need

Posted By Dr. Sean Breen on June 1st, 2010

As medical director of Medical Cannabis of Southern California I often meet patients who are combat veterans and are in need of help.   One of the blessings in my life was the opportunity to serve along side the Marines of 1st Battalion 4th Marines in Iraq from January-September 2003. I witnessed combat from the front lines and experienced the buffet of emotions that our troops go through on a daily basis.   Now that I am honorably discharged I can openly discuss the benefits of using cannabis to take care of:

1. The anxiety they experience.

2. The anger they may feel at times.

3. The depression, isolation and loneliness they feel.

4. The chronic pain that they are suffering from.

It is quite an honor and a privilege to be able to sit down with them and TRULY understand what they are going though.   Most of them need ongoing therapy which hopefully they get through the VA.  However instead of having to take oxycontin for pain, xanax for anxiety, ambien for insomnia and lexepro for depression they can simply try medicating with cannabis to regulate all of these symptoms.   I have had great success with many veterans over the past two years and really enjoy working with them.  They truly are the few and the proud.   They simply need help.

If you are a veteran and would like to discuss the benefits and risks of using cannabis for medicinal purposes feel free to make an appointment.  call 877-721-0047 or send me an email and I will answer your questions.

Semper fi,

Dr. Breen

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PMS (Premenstrual Syndrome), PMDD (premenstrual dysphoric disorder) and Marijuana (Cannabis): An alternative treatment

Posted By Dr. Sean Breen on April 26th, 2010

As medical director for Medical Cannabis of Southern California I often evaluate women who suffer from pre-menstrual syndrome (PMS).  They often complain of headache, pelvic pain, breast pain, difficulty sleeping, bloating, irritability, anxiety, depression and an inability to concentrate.   Typically the standard treatment that their doctors prescribe do not work well enough and they would like to try cannabis.   I have seen amazing results with women who vaporize cannabis to treat their PMS.

Standard treatment for many of these women are SSRI’s (anti-depressants) to treat any of their mood symptoms (irritability, depression and anxiety), high dose NSAIDS (naprosyn/motrin) for pain, spirinolactone for edema, ambien for sleeping difficulties and occasionally other no pharmaceutical therapies (Calcium and Magnesium Supplements)  The problem is that these treatment modalities come with many unwanted side effects…. and/or do not provide adequate relief.   SSRI’s can cause apathy and affect patients sex drive.  NSAIDS can cause dangerous gastro-intestinal bleeding, ambien can be addicting and often makes patients extremely groggy upon awakening and spirinolactone can cause electrolyte disturbances.

Studies have shown that up to 75% of women suffer from PMS/PMDD on some level.  That is an enormous amount of people that are taking a lot of different medications that are not only ineffective but can be very dangerous if taken regularly.

Once patients understand how cannabis works in the body they are much more comfortable trying it for their PMS symptoms.  Cannabis can be extremely relaxing, elevate patients moods and assist with sleep.  (good bye SSRI and Ambien).  It is amazing at relieving pelvic pain and headaches (good bye NSAIDS) and can increase a patients libido.

What I tell my patients is that it is definitely worth giving it a try.  If it works…GREAT!  If not…. simply don’t use it.   In the meantime it is not going to damage your liver, kidneys or cause GI bleeding.  You can not overdose on it and there is an extremely low potential for physical or psychological addiction.

Lastly, you can easily avoid smoking it by using a vaporizer which allows you to inhale the medicine SMOKE FREE!

If you suffer from PMS/PMDD and would like to discuss using cannabis to treat your symptoms feel free to give us a call at 877-721-0047.  Or you can simply pre-qualify for FREE at www.mcsocal.com

Be blessed,

Dr. Breen


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Cannabis (Marijuana) and our Combat Veterans

Posted By Dr. Sean Breen on April 6th, 2010

As medical director for Medical Cannabis of Southern California I have many patients who are combat veterans from the Iraq and Afghanistan wars.  Unfortunately the military has a ZERO tolerance towards any drug use and does not recognize cannabis as a medicine.   The majority of these patients have made the decision to use medicine for one of two things:

1. Chronic pain secondary to injuries sustained while on active duty.

2. Post Traumatic Stress Syndrome, Depression or Chronic Anxiety/Insomnia.

VA physicians are not allowed to discuss the use of cannabis with their patients.  However there are doctors like myself who are willing to discuss this treatment option.   I understand first hand what these men and women are going through.   I spent 9 months in 2003 with 1st battalion 4th marines in Iraq during the initial push of Operation Iraqi Freedom.

I have already discussed in previous blogs the advantages of using cannabis to treating chronic pain.   It also will help with sleep, anxiety and depression.  ONE THING I DO WANT TO STRESS IS THAT IT IS VERY IMPORTANT THAT PATIENTS WHO SUFFER FROM PTSD, DEPRESSION AND CHRONIC ANXIETY RECEIVE ONGOING TREATMENT FROM THE THERAPIST OR PSYCHIATRIST!   Cannabis should not replace these other treatment modalities but merely compliment them.

If you are a veteran and would like to speak to a former military combat physician about the use of cannabis feel free to call me at 877-721-0047  I would be happy to speak with you.

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Marijuana (Cannabis) and PTSD (post traumatic stress disorder)

Posted By Dr. Sean Breen on March 31st, 2010

Today in my Irvine clinic I had two patients who were suffering from Post Traumatic Stress Disorder (PTSD).  One was unfortunately physically and verbally abused by her boss and the second was involved in a very traumatic car accident where he lost one of his best friends.   Both of these patients experienced a combination of difficulty sleeping, recurring nightmares, avoidance and depression.

The first step in their recovery process involved psychotherapy which both were receiving.  One of them had started group therapy as well.   These two treatment modalities are pretty standard for patients who suffer from PTSD.

At this point many of you reading this may be wondering why and how they ended up in my office?  The reason is because each was started on 4 medications and for one a 5th was added.   One stated that they “felt like a zombie” and the others emotions “were completely dulled”.   Here is the list of medications that they brought in.

1) Trazodone: is an anti-depressant which affects the serotonin levels in your brain: in these cases it was being used to assist with insomnia.

2) Ambien: is a drug used to induce sleep as well.  It works similar to benzodiazepines in that it binds to the GABA receptors in the brain.  Patients often are worried about the addiction potential and complain of feeling very groggy upon awakening with daytime drowsiness that can affect work performance.

3) Lorazepam (Ativan): is a drug used to treat acute anxiety and insomnia.  Is a benzodiazepine and affects the GABA receptors in the brain.  Patients often worry about its addiction potential and increasing tolerance and dependence.

4) Prozac (Fluoxetine): is a drug most commonly used to treat depression.  It affects the serotonin receptors in the brain.   Many patients complain about it’s side effects.  Specifically, it can affect a patients sex drive and sexual performance.

5) Seroquel (quetiapine): is a drug often used to treat schizophrenia and bipolar disorder.  Often I have seen patients prescribed this to assist with insomnia as well.

The problem that these patients had with their psychiatrists treatment plan is the  amount of medications that they were taking throughout the day.  They literally felt like walking zombies; out of touch with their personal relationships.  They also experience unwanted side effects.  This is a very common theme that I hear from patients.

So where does cannabis come into play?  For one I think the goal is to get these patients off there medications used to treat the anxiety and insomnia.  For these patients the goal was to eliminate the need for the Ambien, Ativan and Trazodone IMMEDIATELY.

I encourage them to continue the prozac if it is helping with their mood.  As long as the side effects are not too bad I think this is a reasonable medication for them to stay on until the therapy allows them to cope without any medications.

Many times the goal for my patients is to substitute cannabis for one or more of the medications that they currently take.  Cannabis, if used appropriately, can replace many varieties of medication.  It can assist with falling asleep, decreasing anxiety, improving mood, stimulating appetite  and also decreasing patients use of other drugs such as alcohol.

I will follow up with them in a few weeks and blog about how they are doing. Stay tuned!

If you would like more information on seeing if cannabis can improve the quality of your life please feel free to call my staff and schedule an appointment to come in.  I would be happy to take care of you.

Visit us at www.mcsocal.com or call 877-721-0047

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Tired of Side Effects of Prednisone? Try Cannabis

Posted By Dr. Sean Breen on March 27th, 2010

As medical director for medical cannabis of southern california I often evaluate patients who take regular high doses of prednisone.  Prednisone is the atomic bomb for inflammatory conditions such as crohns, ulcerative colitis, sever asthma and many other medical conditions.   Unfortunately it’s effects do not come without significant side effects.  Many patients can get relief of these side effects by using cannabis.

Typically patients who have to take prednisone experience sleeping irregularities, abdominal pain and bloating, appetite issues, nervousness and restlessness.  Many times it can cause an acute and temporary psychosis.   Prolonged use can cause weight gain, headaches, muscle pain and severe restlessness.

Unfortunately many patients who take prednisone have few other options.

ENTER CANNABIS.

Patients who use cannabis to combat some the more common side effects of prednisone typically respond and do much better.  In addition, because cannabinoids have anti-inflammatory properties it can relieve the inflammation and decrease the amount of prednisone that patients have to use.

I recently followed up with a 42 women with severe colitis (inflammation of the digestive tract) who within 6 months was able to stop her use of prednisone completely!  She is sleeping better, has an increased appetite (she was losing weight secondary to not eating…not good) and has less abdominal pain and indigestion.

This is common with many patients that I evaluate.  If you or someone you know is taking prednisone regularly and would like an evaluation to see if cannabis can help please feel free to contact my office at 877-721-0047 and schedule an appointment.

Be blessed and have a great day!

Dr. Breen, Medical Director www.MCSoCal.com

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Can’t sleep? Economy, Family, Health

Posted By Dr. Sean Breen on March 25th, 2010

As medical director for medical cannabis of southern california I am amazed at the amount of patients who have difficulty falling asleep or wake up throughout the night.   One of my 10 commandments when it comes to perfect health is “Thou shall get sleep.  As your sleep goes so does your health.” You can eat perfectly and exercise all day but if you are getting adequate rest you will be prone to illness mostly secondary to a compromised immune system.

On a very basic level all of cells require glucose (nutrition) oxygen and a method of removing waste (lymphatic system).   Our body rests, cleanses and rejuvinates when we get sound sleep.

I won’t go into detail of the various stages of sleep and the brain waves that we can measure.  But what I will do is make it very simple and break this down BARNEY STYLE.

CANNABIS HELPS YOU FALL ASLEEP, STAY ASLEEP AND WAKE UP FEELING RESTED.

Unlike many sleeping aids such as Ambien (which is similar to a benzodiazepene ie. valium) which makes patients feel extremely groggy and tired the next morning, cannabis generally has little to no associated morning grogginess.

I can not tell you how many patients are using cannabis to treat acute and chronic insomnia!  I am glad that I can help improve the quality of their lives!

If you would like to find out if cannabis can improve the quality of your life please feel free to call my staff at 877-721-0047 and schedule an appointment to come to my Irvine or Long Beach office.

Respectfully,

Dr. Sean Breen

mcsocal@me.com

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