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大麻素在精神病学中的治疗应用

[Therapeutical use of the cannabinoids in psychiatry].

作者信息

Crippa José Alexandre S, Zuardi Antonio Waldo, Hallak Jaime E C

机构信息

Departamento de Neurociências e Ciências do Comportamento, Faculdade de Medicina de Ribeirão Preto, Universidade de São Paulo, Ribeirão Preto, SP, Brasil.

出版信息

Braz J Psychiatry. 2010 May;32 Suppl 1:S56-66.

Abstract

OBJECTIVE

To review the main advances related to the potential therapeutic use of cannabinoid compounds in psychiatry.

METHOD

A search was performed in the online databases PubMed, ScieELO, and Lilacs for studies and literature reviews concerning therapeutic applications of cannabinoids in psychiatry, especially cannabidiol, rimonabant, Delta(9)-tetrahydrocannabinol, and their analogues.

RESULTS

Cannabidiol was found to have therapeutic potential with antipsychotic, anxiolytic, and antidepressant properties, in addition to being effective in other conditions. Delta(9)-tetrahydrocannabinol and its analogues were shown to have anxiolytic effects in the treatment of cannabis dependence and to function as an adjuvant in the treatment of schizophrenia, although additional studies are necessary to support this finding. Rimonabant was effective in the treatment of the subjective and physiological symptoms of cannabis intoxication and functioned as an adjuvant in the treatment of tobacco addiction. The potential to induce adverse reactions such as depression and anxiety restrained the clinical use of this CB(1) antagonist.

CONCLUSION

Cannabinoids may be of great therapeutic interest to psychiatry; however, further controlled trials are necessary to confirm the existing findings and to establish the safety of such compounds.

摘要

目的

综述大麻素类化合物在精神病学领域潜在治疗用途的主要进展。

方法

在在线数据库PubMed、ScieELO和Lilacs中进行检索,查找有关大麻素在精神病学治疗应用的研究和文献综述,特别是大麻二酚、利莫那班、Δ⁹-四氢大麻酚及其类似物。

结果

发现大麻二酚除在其他病症中有效外,还具有抗精神病、抗焦虑和抗抑郁特性的治疗潜力。Δ⁹-四氢大麻酚及其类似物在治疗大麻依赖方面显示出抗焦虑作用,并在精神分裂症治疗中作为辅助药物,不过需要更多研究来支持这一发现。利莫那班在治疗大麻中毒的主观和生理症状方面有效,并在治疗烟草成瘾中作为辅助药物。但其诱导抑郁和焦虑等不良反应的可能性限制了这种CB₁拮抗剂的临床应用。

结论

大麻素可能对精神病学具有重大治疗意义;然而,需要进一步的对照试验来证实现有发现并确定此类化合物的安全性。

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