Division on Substance Abuse, New York State Psychiatric Institute and Department of Psychiatry, College of Physicians and Surgeons of Columbia University, New York, NY, USA.
Addict Biol. 2013 Nov;18(6):993-1002. doi: 10.1111/j.1369-1600.2012.00461.x. Epub 2012 Jun 28.
Marijuana withdrawal contributes to the high relapse rates in individuals seeking treatment for marijuana-use disorders. Quetiapine, an atypical antipsychotic, reduces characteristic symptoms of marijuana withdrawal in a variety of psychiatric conditions, including mood lability, sleep disruption and anorexia. This human laboratory study investigated the effectiveness of quetiapine to decrease marijuana withdrawal and relapse to marijuana use in non-treatment-seeking marijuana smokers. Volunteers were maintained on placebo or quetiapine (200 mg/day) in this double-blind, counter-balanced, within-subject study consisting of two 15-day medication phases, the last 8 days of which were in-patient. On the first in-patient day, active marijuana [6.2% delta (9)-tetrahydrocannabinol (THC)] was repeatedly smoked under controlled conditions. For the next 3 days, inactive marijuana (0.0% THC) was available for self-administration (withdrawal). On the subsequent 4 days, active marijuana (6.2% THC) was available for self-administration (relapse). Volunteers (n = 14) who smoked an average of 10 marijuana cigarettes/day, 7 days/week, completed the study. Under placebo, withdrawal was marked by increased subjective ratings of negative mood, decreased sleep quality, and decreased caloric intake and weight loss. Compared with placebo, quetiapine improved sleep quality, increased caloric intake and decreased weight loss. However, quetiapine increased marijuana craving and marijuana self-administration during the relapse phase. These data do not suggest that quetiapine shows promise as a potential treatment for marijuana dependence.
大麻戒断导致寻求大麻使用障碍治疗的个体复发率居高不下。喹硫平是一种非典型抗精神病药,可减少各种精神疾病中与大麻戒断相关的特征性症状,包括情绪不稳定、睡眠中断和厌食。这项人体实验室研究调查了喹硫平降低非治疗寻求大麻吸食者大麻戒断和复吸大麻的有效性。在这项双盲、平衡、个体内研究中,志愿者接受安慰剂或喹硫平(200mg/天)治疗,该研究包括两个 15 天的药物阶段,最后 8 天为住院期。在第一个住院日,在受控条件下反复吸食活性大麻[6.2%的 Δ(9)-四氢大麻酚(THC)]。接下来的 3 天,可自行摄入非活性大麻(0.0%THC)(戒断)。随后的 4 天,可自行摄入活性大麻(6.2%THC)(复吸)。平均每天吸食 10 支大麻香烟、每周吸食 7 天的 14 名志愿者完成了这项研究。在安慰剂条件下,戒断表现为负面情绪主观评分增加、睡眠质量下降以及热量摄入减少和体重减轻。与安慰剂相比,喹硫平改善了睡眠质量,增加了热量摄入,减少了体重减轻。然而,喹硫平增加了大麻渴求感和复吸阶段的大麻自我摄入。这些数据表明,喹硫平不太可能成为大麻依赖的潜在治疗方法。