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Pharmacotherapies for cannabis dependence.

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Area of Science:

  • Pharmacology
  • Addiction Medicine
  • Clinical Trials

Background:

  • Cannabis is the world's most common illicit drug, with rising demand for treatment.
  • No approved pharmacotherapies currently exist for cannabis use disorders.

Purpose of the Study:

  • To evaluate pharmacotherapies for cannabis use disorder.
  • Assessed effectiveness and safety against placebo or supportive care.
  • Aimed to reduce withdrawal symptoms and promote cessation or reduced use.

Main Methods:

  • Systematic review of randomized and quasi-randomized controlled trials.
  • Searched multiple databases (CENTRAL, MEDLINE, EMBASE, PsycINFO) and trial registries.
  • Included 14 trials with 958 participants, assessing various medications.

Main Results:

  • Tetrahydrocannabinol (THC) preparations showed moderate evidence for increased treatment completion.
  • THC was associated with reduced withdrawal symptoms and craving.
  • Other medications (SSRIs, mixed-action antidepressants, bupropion) showed little evidence of effectiveness for cannabis abstinence.

Conclusions:

  • Incomplete evidence exists for most pharmacotherapies; quality often limited by small sample sizes and bias.
  • THC preparations show potential but are considered experimental.
  • Further research on THC, gabapentin, and N-acetylcysteine is warranted.