Mariani John J, Pavlicova Martina, Mamczur Agnieszka K, Bisaga Adam, Nunes Edward V, Levin Frances R
New York State Psychiatric Institute, Division of Substance Abuse , New York .
Am J Drug Alcohol Abuse. 2014 Jul;40(4):280-4. doi: 10.3109/00952990.2014.884102.
There are no efficacious pharmacotherapies for cannabis dependence. The effects of quetiapine are well matched to the symptoms of cannabis withdrawal and could be useful in the treatment of cannabis dependence.
To evaluate quetiapine for the treatment of cannabis dependence and determine the optimal dosing.
In an eight-week open-label outpatient pilot trial, we evaluated the feasibility of quetiapine treatment for cannabis dependence in 15 outpatients. Quetiapine was gradually titrated to 600 mg or the maximum tolerated dose.
The mean study retention was 6.5 weeks (±2.3), with 67% of participants completing all eight weeks of the trial. The mean maximum dose achieved was 197 mg/day (range: 25-600 mg/day). Only two of the 15 participants were able to achieve the target dose of 600 mg daily. There were no serious adverse events and no participants were discontinued from the trial due to adverse effects. The most common reported adverse effects were fatigue (80% of participants) and somnolence (47%). From baseline to week 8, the modeled overall decrease in daily dollar value of marijuana was 76.3% (CI: 63.4%, 84.7%). Over the eight weeks of the study, there was a 46.9% (CI: 11%, 68.3%) decrease in urine tetrahydrocannabinol-9-carboxylic acid (THCOOH) levels.
These preliminary results are promising in that quetiapine treatment was tolerated by cannabis-dependent patients and associated with decreased cannabis use. The recommended maximum target dose for cannabis-dependent patients is 300 mg daily. These preliminary data support further evaluation of quetiapine as a treatment for cannabis dependence.
目前尚无治疗大麻依赖的有效药物疗法。喹硫平的作用与大麻戒断症状相匹配,可能对治疗大麻依赖有用。
评估喹硫平治疗大麻依赖的效果并确定最佳剂量。
在一项为期八周的开放标签门诊试点试验中,我们评估了15名门诊患者使用喹硫平治疗大麻依赖的可行性。喹硫平逐渐滴定至600毫克或最大耐受剂量。
平均研究持续时间为6.5周(±2.3),67%的参与者完成了全部八周的试验。达到的平均最大剂量为197毫克/天(范围:25 - 600毫克/天)。15名参与者中只有两名能够达到每日600毫克的目标剂量。没有严重不良事件,也没有参与者因不良反应而退出试验。报告的最常见不良反应是疲劳(80%的参与者)和嗜睡(47%)。从基线到第8周,大麻每日货币价值的模型总体下降率为76.3%(置信区间:63.4%,84.7%)。在研究的八周内,尿中四氢大麻酚-9-羧酸(THCOOH)水平下降了46.9%(置信区间:11%,68.3%)。
这些初步结果很有前景,因为大麻依赖患者能够耐受喹硫平治疗,且该治疗与大麻使用减少相关。大麻依赖患者的推荐最大目标剂量为每日300毫克。这些初步数据支持进一步评估喹硫平作为治疗大麻依赖的方法。