Unit of Research "Neurobehavioural mechanisms and endophenotypes of addictive behavior", Department of Psychobiology, University of Valencia, Avda. Blasco Ibañez 21, 46010 Valencia, Spain.
Department of Psychology and Sociology, University of Zaragoza, 44003 Teruel, Spain.
Molecules. 2019 Jul 16;24(14):2583. doi: 10.3390/molecules24142583.
Currently, there are no approved pharmacotherapies for addiction to cocaine and other psychostimulant drugs. Several studies have proposed that cannabidiol (CBD) could be a promising treatment for substance use disorders. In the present work, the authors describe the scarce preclinical and human research about the actions of CBD on the effects of stimulant drugs, mainly cocaine and methamphetamine (METH). Additionally, the possible mechanisms underlying the therapeutic potential of CBD on stimulant use disorders are reviewed. CBD has reversed toxicity and seizures induced by cocaine, behavioural sensitization induced by amphetamines, motivation to self-administer cocaine and METH, context- and stress-induced reinstatement of cocaine and priming-induced reinstatement of METH seeking behaviours. CBD also potentiated the extinction of cocaine- and amphetamine-induced conditioned place preference (CPP), impaired the reconsolidation of cocaine CPP and prevented priming-induced reinstatement of METH CPP. Observational studies suggest that CBD may reduce problems related with crack-cocaine addiction, such as withdrawal symptoms, craving, impulsivity and paranoia (Fischer et al., 2015). The potential mechanisms involved in the protective effects of CBD on addiction to psychostimulant drugs include the prevention of drug-induced neuroadaptations (neurotransmitter and intracellular signalling pathways changes), the erasure of aberrant drug-memories, the reversion of cognitive deficits induced by psychostimulant drugs and the alleviation of mental disorders comorbid with psychostimulant abuse. Further, preclinical studies and future clinical trials are necessary to fully evaluate the potential of CBD as an intervention for cocaine and methamphetamine addictive disorders.
目前，还没有批准的药物疗法可用于治疗可卡因和其他苯丙胺类兴奋剂成瘾。有几项研究提出，大麻二酚 (CBD) 可能是治疗物质使用障碍的一种有前途的方法。在目前的工作中，作者描述了 CBD 对兴奋剂药物（主要是可卡因和甲基苯丙胺 (METH)）作用的罕见临床前和人体研究。此外，还回顾了 CBD 治疗兴奋剂使用障碍的潜在机制。CBD 逆转了可卡因引起的毒性和癫痫发作、安非他命引起的行为敏感化、可卡因和 METH 的自我给药动机、可卡因和应激引起的复吸以及 METH 寻求行为的启动诱导复吸。CBD 还增强了可卡因和安非他命诱导的条件位置偏好 (CPP) 的消退，损害了可卡因 CPP 的再巩固，并防止了 METH CPP 的启动诱导复吸。观察性研究表明，CBD 可能减少与快克可卡因成瘾相关的问题，如戒断症状、渴望、冲动和偏执（Fischer 等人，2015 年）。CBD 对苯丙胺类兴奋剂成瘾的保护作用所涉及的潜在机制包括预防药物引起的神经适应性变化（神经递质和细胞内信号通路变化）、消除异常的药物记忆、逆转兴奋剂药物引起的认知缺陷以及缓解与兴奋剂滥用共病的精神障碍。此外，还需要进行临床前研究和未来的临床试验，以充分评估 CBD 作为可卡因和甲基苯丙胺成瘾障碍干预措施的潜力。
