Nielsen Suzanne, Sabioni Pamela, Gowing Linda, Le Foll Bernard
Monash Addiction Research Centre, Monash University, Peninsula Campus, Frankston, VIC, Australia.
Translational Addiction Research Laboratory, Campbell Family Mental Health Research Institute, Centre for Addiction and Mental Health, Toronto, ON, Canada.
Handb Exp Pharmacol. 2020;258:355-372. doi: 10.1007/164_2019_258.
This chapter reviews pharmacotherapies that have been trialled for cannabis dependence, identifying those that warrant further research and those of little or uncertain value. A diverse range of medicines have been tested, representing a broad range of pharmacological strategies. These include tetrahydrocannabinol preparations, various types of antidepressant, anxiolytics, a glutamatergic modulator and the neuropeptide oxytocin. Cannabinoid agonists warrant further research. For the FAAH inhibitor PF-04457845, oxytocin, varenicline and gabapentin, although there is a signal to indicate further research is warranted, these medications do not yet have sufficient evidence to support clinical use, and larger, longer-term trials are needed in representative treatment-seeking populations. Special populations that warrant consideration are those with cannabis dependence and concurrent mental health conditions and those that develop dependence through therapeutic use.
本章回顾了已针对大麻依赖进行试验的药物疗法，确定了那些值得进一步研究的疗法以及价值不大或存在不确定性的疗法。已经测试了各种各样的药物，代表了广泛的药理学策略。这些药物包括四氢大麻酚制剂、各类抗抑郁药、抗焦虑药、一种谷氨酸能调节剂和神经肽催产素。大麻素激动剂值得进一步研究。对于脂肪酸酰胺水解酶（FAAH）抑制剂PF-04457845、催产素、伐尼克兰和加巴喷丁，尽管有迹象表明有必要进行进一步研究，但这些药物尚无足够证据支持临床使用，需要在有代表性的寻求治疗的人群中开展更大规模、更长期的试验。需要考虑的特殊人群包括患有大麻依赖和并发精神健康状况的人群，以及通过治疗用途而产生依赖的人群。
