Department of Behavioral Science.
Department of Psychiatry.
Exp Clin Psychopharmacol. 2022 Oct;30(5):560-574. doi: 10.1037/pha0000464. Epub 2021 May 13.
No medications are approved for cannabis use disorder (CUD), though a small clinical trial demonstrated that the voltage-dependent calcium channel (VDCC) ligand gabapentin reduced cannabis use in treatment seekers. VDCCs are modulated by cannabinoid (CB) ligands, and there are shared effects between CB agonists and VDCC ligands. This overlapping neuropharmacology and the initial clinical results supported the evaluation of pregabalin, a "next-generation" VDCC ligand, as a CUD medication. Two separate placebo-controlled, double-blind, counterbalanced, within-subjects human laboratory studies tested placebo and 300 ( = 2 females, 11 males; Experiment [EXP] 1) or 450 ( = 3 females, 11 males; EXP 2) mg/day pregabalin in cannabis users who were not seeking treatment or trying to reduce/quit their cannabis use. The protocol consisted of two outpatient maintenance phases (11 days in EXP 1 and 15 days in EXP 2) that concluded with four experimental sessions within each phase. During experimental sessions, maintenance continued, and participants completed two 2-day blocks of sampling and self-administration sessions to determine the reinforcing effects of smoked cannabis (0% and 5.9% delta⁹-tetrahydrocannabinol [THC]), as well as subjective, attentional bias, performance, and physiological responses. In addition, naturalistic cannabis use, side effects, sleep quality, craving, and other self-reported substance use were measured during pregabalin maintenance. Cannabis was self-administered and produced prototypical effects, but pregabalin generally did not impact the effects of cannabis or alter naturalistic use. These human laboratory results in cannabis users not trying to reduce/quit their use do not support the efficacy of pregabalin as a stand-alone pharmacotherapy for CUD. (PsycInfo Database Record (c) 2022 APA, all rights reserved).
目前尚无药物获批用于治疗大麻使用障碍（CUD），尽管一项小型临床试验表明，电压门控钙通道（VDCC）配体加巴喷丁可减少寻求治疗者的大麻使用量。VDCC 受大麻素（CB）配体调节，CB 激动剂和 VDCC 配体之间存在共同作用。这种重叠的神经药理学和最初的临床结果支持评估普瑞巴林，一种“下一代”VDCC 配体，作为 CUD 药物。两项独立的安慰剂对照、双盲、平衡、被试内的人类实验室研究测试了安慰剂和 300（=2 名女性，11 名男性；实验 [EXP] 1）或 450（=3 名女性，11 名男性；EXP 2）mg/天普瑞巴林在不寻求治疗或试图减少/戒除大麻使用的大麻使用者中的作用。该方案包括两个门诊维持阶段（EXP 1 为 11 天，EXP 2 为 15 天），在每个阶段的四个实验会话结束。在实验会话期间，维持治疗继续进行，参与者完成了两个为期 2 天的采样和自我给药阶段，以确定吸食大麻（0%和 5.9%Δ9-四氢大麻酚 [THC]）的强化作用，以及主观、注意力偏向、表现和生理反应。此外，在普瑞巴林维持期间还测量了自然发生的大麻使用、副作用、睡眠质量、渴望和其他自我报告的物质使用情况。大麻是自我给药的，并产生了典型的效果，但普瑞巴林通常不会影响大麻的效果或改变自然发生的使用情况。这些在不试图减少/戒除大麻使用的大麻使用者中的人体实验室结果不支持普瑞巴林作为 CUD 单一药物治疗的疗效。（PsycInfo 数据库记录（c）2022 APA，保留所有权利）。
