Tags

Type your tag names separated by a space and hit enter

Effects of fixed or self-titrated dosages of Sativex on cannabis withdrawal and cravings.
Drug Alcohol Depend. 2016 Apr 01; 161:298-306.DA

Abstract

BACKGROUND

There is currently no pharmacological treatment approved for cannabis dependence. In this proof of concept study, we assessed the feasibility/effects of fixed and self-titrated dosages of Sativex (1:1, Δ(9)-tetrahydrocannabinol (THC)/cannabidiol (CBD)) on craving and withdrawal from cannabis among nine community-recruited cannabis-dependent subjects.

METHODS

Participants underwent an 8-week double-blind placebo-controlled trial (an ABACADAE design), with four smoke as usual conditions (SAU) (A) separated by four cannabis abstinence conditions (B-E), with administration of either self-titrated/fixed doses of placebo or Sativex (up to 108 mg THC/100 mg CBD). The order of medication administration during abstinence conditions was randomized and counterbalanced. Withdrawal symptoms and craving were assessed using the Cannabis Withdrawal Scale (CWS), Marijuana Withdrawal Checklist (MWC) and Marijuana Craving Questionnaire (MCQ). Medication use was assessed during the study by means of self-reports, vial weight control, toxicology and metabolite analysis. Cannabis use was assessed by means of self-reports.

RESULTS

High fixed doses of Sativex were well tolerated and significantly reduced cannabis withdrawal during abstinence, but not craving, as compared to placebo. Self-titrated doses were lower and showed limited efficacy as compared to high fixed doses. Participants reported a significantly lower "high" following Sativex or placebo as compared to SAU conditions. Cannabis/medication use along the study, as per self-reports, suggests compliance with the study conditions.

CONCLUSIONS

The results found in this proof of concept study warrant further systematic exploration of Sativex as a treatment option for cannabis withdrawal and dependence.

Authors+Show Affiliations

Translational Addiction Research Laboratory, Campbell Family Mental Health Research Institute, Centre for Addiction and Mental Health (CAMH), Toronto, Canada.Translational Addiction Research Laboratory, Campbell Family Mental Health Research Institute, Centre for Addiction and Mental Health (CAMH), Toronto, Canada.Social and Epidemiological Research Department, CAMH, Toronto, Canada; Addiction Policy, Dalla Lana School of Public Health, University of Toronto, Toronto, Canada; Institute of Medical Science, University of Toronto, Faculty of Medicine, Toronto, Canada; Department of Psychiatry, University of Toronto, Canada; Institute of Clinical Psychology and Psychotherapy & Center of Clinical Epidemiology and Longitudinal Studies (CELOS), Technische Universität Dresden, Dresden, Germany.Department of Psychiatry, University of Toronto, Canada; Addictions Division, CAMH, Toronto, Canada; Department of Family and Community Medicine, University of Toronto, Canada.Translational Addiction Research Laboratory, Campbell Family Mental Health Research Institute, Centre for Addiction and Mental Health (CAMH), Toronto, Canada; Department of Medical Sciences, Institute of Environmental Studies and Research, Ain Shams University, Cairo, Egypt; Directorate of Poison Control Centres, MOH, Riyadh, Saudi Arabia.Social and Epidemiological Research Department, CAMH, Toronto, Canada; Department of Psychiatry, University of Toronto, Canada; Centre for Applied Research in Mental Health & Addiction, Faculty of Health Sciences, Simon Fraser University, Vancouver, Canada.Chemistry and Drug Metabolism, National Institute on Drug Abuse (NIDA), National Institutes of Health (NIH), Baltimore, USA.Chemistry and Drug Metabolism, National Institute on Drug Abuse (NIDA), National Institutes of Health (NIH), Baltimore, USA.Translational Addiction Research Laboratory, Campbell Family Mental Health Research Institute, Centre for Addiction and Mental Health (CAMH), Toronto, Canada; Addictions Division, CAMH, Toronto, Canada. Electronic address: bernard.lefoll@camh.ca.

Pub Type(s)

Journal Article
Randomized Controlled Trial
Research Support, Non-U.S. Gov't

Language

eng

PubMed ID

26925704

Citation

Trigo, Jose M., et al. "Effects of Fixed or Self-titrated Dosages of Sativex On Cannabis Withdrawal and Cravings." Drug and Alcohol Dependence, vol. 161, 2016, pp. 298-306.
Trigo JM, Lagzdins D, Rehm J, et al. Effects of fixed or self-titrated dosages of Sativex on cannabis withdrawal and cravings. Drug Alcohol Depend. 2016;161:298-306.
Trigo, J. M., Lagzdins, D., Rehm, J., Selby, P., Gamaleddin, I., Fischer, B., Barnes, A. J., Huestis, M. A., & Le Foll, B. (2016). Effects of fixed or self-titrated dosages of Sativex on cannabis withdrawal and cravings. Drug and Alcohol Dependence, 161, 298-306. https://doi.org/10.1016/j.drugalcdep.2016.02.020
Trigo JM, et al. Effects of Fixed or Self-titrated Dosages of Sativex On Cannabis Withdrawal and Cravings. Drug Alcohol Depend. 2016 Apr 1;161:298-306. PubMed PMID: 26925704.
* Article titles in AMA citation format should be in sentence-case
TY - JOUR T1 - Effects of fixed or self-titrated dosages of Sativex on cannabis withdrawal and cravings. AU - Trigo,Jose M, AU - Lagzdins,Dina, AU - Rehm,Jürgen, AU - Selby,Peter, AU - Gamaleddin,Islam, AU - Fischer,Benedikt, AU - Barnes,Allan J, AU - Huestis,Marilyn A, AU - Le Foll,Bernard, Y1 - 2016/02/23/ PY - 2015/05/22/received PY - 2016/02/08/revised PY - 2016/02/10/accepted PY - 2016/3/2/entrez PY - 2016/3/2/pubmed PY - 2016/11/4/medline KW - Cannabidiol KW - Cannabis KW - Clinical trials.gov ID# NCT01748799 KW - Marijuana KW - THC KW - Withdrawal SP - 298 EP - 306 JF - Drug and alcohol dependence JO - Drug Alcohol Depend VL - 161 N2 - BACKGROUND: There is currently no pharmacological treatment approved for cannabis dependence. In this proof of concept study, we assessed the feasibility/effects of fixed and self-titrated dosages of Sativex (1:1, Δ(9)-tetrahydrocannabinol (THC)/cannabidiol (CBD)) on craving and withdrawal from cannabis among nine community-recruited cannabis-dependent subjects. METHODS: Participants underwent an 8-week double-blind placebo-controlled trial (an ABACADAE design), with four smoke as usual conditions (SAU) (A) separated by four cannabis abstinence conditions (B-E), with administration of either self-titrated/fixed doses of placebo or Sativex (up to 108 mg THC/100 mg CBD). The order of medication administration during abstinence conditions was randomized and counterbalanced. Withdrawal symptoms and craving were assessed using the Cannabis Withdrawal Scale (CWS), Marijuana Withdrawal Checklist (MWC) and Marijuana Craving Questionnaire (MCQ). Medication use was assessed during the study by means of self-reports, vial weight control, toxicology and metabolite analysis. Cannabis use was assessed by means of self-reports. RESULTS: High fixed doses of Sativex were well tolerated and significantly reduced cannabis withdrawal during abstinence, but not craving, as compared to placebo. Self-titrated doses were lower and showed limited efficacy as compared to high fixed doses. Participants reported a significantly lower "high" following Sativex or placebo as compared to SAU conditions. Cannabis/medication use along the study, as per self-reports, suggests compliance with the study conditions. CONCLUSIONS: The results found in this proof of concept study warrant further systematic exploration of Sativex as a treatment option for cannabis withdrawal and dependence. SN - 1879-0046 UR - https://www.unboundmedicine.com/medline/citation/26925704/Effects_of_fixed_or_self_titrated_dosages_of_Sativex_on_cannabis_withdrawal_and_cravings_ L2 - https://linkinghub.elsevier.com/retrieve/pii/S0376-8716(16)00095-8 DB - PRIME DP - Unbound Medicine ER -