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Efficacy and tolerability of high-dose dronabinol maintenance in HIV-positive marijuana smokers: a controlled laboratory study.
Psychopharmacology (Berl). 2010 Dec; 212(4):675-86.P

Abstract

RATIONALE

Dronabinol (Δ(9)tetrahydrocannabinol) is approved for HIV-related anorexia, yet, little is known about its effects in HIV-positive marijuana smokers. HIV-negative marijuana smokers require higher than recommended dronabinol doses to experience expected effects.

OBJECTIVES

Employing a within-subjects, double-blind, placebo-controlled design, we assessed the effects of repeated high-dose dronabinol in HIV-positive marijuana smokers taking antiretroviral medication.

METHODS

Participants (N = 7), who smoked marijuana 4.2 ± 2.3 days/week, resided in a residential laboratory for two 16-day stays, receiving dronabinol (10 mg QID) in one stay and placebo in the other. Efficacy was assessed with objectively verified food intake and body weight. Tolerability was measured with sleep, subjective, and cognitive assessments. For analyses, each inpatient stay was divided into two phases, days 1-8 and 9-16; we compared dronabinol's effects with placebo in each 8-day phase to investigate tolerance.

RESULTS

Despite sustained increases in self-reported food cravings, dronabinol only increased caloric intake in the initial 8 days of dosing. Similarly, sleep quality was improved only in the first 8 days of dosing. Dronabinol's mood-enhancing effects were sustained across the 16-day inpatient stay. Dronabinol was well tolerated, causing few negative subjective or cognitive effects.

CONCLUSIONS

In HIV-positive marijuana smokers, high dronabinol doses safely and effectively increased caloric intake. However, repeated high-dose dronabinol appeared to result in selective tolerance to these effects. These findings indicate that HIV-positive individuals who smoke marijuana may require higher dronabinol doses than are recommended by the FDA. Future research to establish optimal dosing regimens, and reduce the development of tolerance, is required.

Authors+Show Affiliations

Department of Psychiatry, College of Physicians and Surgeons of Columbia University, New York, NY, USA.No affiliation info availableNo affiliation info availableNo affiliation info availableNo affiliation info availableNo affiliation info availableNo affiliation info availableNo affiliation info available

Pub Type(s)

Controlled Clinical Trial
Journal Article
Research Support, N.I.H., Extramural

Language

eng

PubMed ID

20824270

Citation

Bedi, Gillinder, et al. "Efficacy and Tolerability of High-dose Dronabinol Maintenance in HIV-positive Marijuana Smokers: a Controlled Laboratory Study." Psychopharmacology, vol. 212, no. 4, 2010, pp. 675-86.
Bedi G, Foltin RW, Gunderson EW, et al. Efficacy and tolerability of high-dose dronabinol maintenance in HIV-positive marijuana smokers: a controlled laboratory study. Psychopharmacology (Berl). 2010;212(4):675-86.
Bedi, G., Foltin, R. W., Gunderson, E. W., Rabkin, J., Hart, C. L., Comer, S. D., Vosburg, S. K., & Haney, M. (2010). Efficacy and tolerability of high-dose dronabinol maintenance in HIV-positive marijuana smokers: a controlled laboratory study. Psychopharmacology, 212(4), 675-86. https://doi.org/10.1007/s00213-010-1995-4
Bedi G, et al. Efficacy and Tolerability of High-dose Dronabinol Maintenance in HIV-positive Marijuana Smokers: a Controlled Laboratory Study. Psychopharmacology (Berl). 2010;212(4):675-86. PubMed PMID: 20824270.
* Article titles in AMA citation format should be in sentence-case
TY - JOUR T1 - Efficacy and tolerability of high-dose dronabinol maintenance in HIV-positive marijuana smokers: a controlled laboratory study. AU - Bedi,Gillinder, AU - Foltin,Richard W, AU - Gunderson,Erik W, AU - Rabkin,Judith, AU - Hart,Carl L, AU - Comer,Sandra D, AU - Vosburg,Suzanne K, AU - Haney,Margaret, Y1 - 2010/09/08/ PY - 2010/04/26/received PY - 2010/08/09/accepted PY - 2010/9/9/entrez PY - 2010/9/9/pubmed PY - 2011/2/26/medline SP - 675 EP - 86 JF - Psychopharmacology JO - Psychopharmacology (Berl) VL - 212 IS - 4 N2 - RATIONALE: Dronabinol (Δ(9)tetrahydrocannabinol) is approved for HIV-related anorexia, yet, little is known about its effects in HIV-positive marijuana smokers. HIV-negative marijuana smokers require higher than recommended dronabinol doses to experience expected effects. OBJECTIVES: Employing a within-subjects, double-blind, placebo-controlled design, we assessed the effects of repeated high-dose dronabinol in HIV-positive marijuana smokers taking antiretroviral medication. METHODS: Participants (N = 7), who smoked marijuana 4.2 ± 2.3 days/week, resided in a residential laboratory for two 16-day stays, receiving dronabinol (10 mg QID) in one stay and placebo in the other. Efficacy was assessed with objectively verified food intake and body weight. Tolerability was measured with sleep, subjective, and cognitive assessments. For analyses, each inpatient stay was divided into two phases, days 1-8 and 9-16; we compared dronabinol's effects with placebo in each 8-day phase to investigate tolerance. RESULTS: Despite sustained increases in self-reported food cravings, dronabinol only increased caloric intake in the initial 8 days of dosing. Similarly, sleep quality was improved only in the first 8 days of dosing. Dronabinol's mood-enhancing effects were sustained across the 16-day inpatient stay. Dronabinol was well tolerated, causing few negative subjective or cognitive effects. CONCLUSIONS: In HIV-positive marijuana smokers, high dronabinol doses safely and effectively increased caloric intake. However, repeated high-dose dronabinol appeared to result in selective tolerance to these effects. These findings indicate that HIV-positive individuals who smoke marijuana may require higher dronabinol doses than are recommended by the FDA. Future research to establish optimal dosing regimens, and reduce the development of tolerance, is required. SN - 1432-2072 UR - https://www.unboundmedicine.com/medline/citation/20824270/Efficacy_and_tolerability_of_high_dose_dronabinol_maintenance_in_HIV_positive_marijuana_smokers:_a_controlled_laboratory_study_ L2 - https://dx.doi.org/10.1007/s00213-010-1995-4 DB - PRIME DP - Unbound Medicine ER -