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Summary
March 2008, Vol. 8, No. 3, Pages 479-491
, DOI 10.1586/14737175.8.3.479
(doi:10.1586/14737175.8.3.479)
Review Pharmacotherapy and psychotherapy in cannabis withdrawal and dependence Amine Benyamina†, Marie Lecacheux, Lisa Blecha, Michel Reynaud and Michael Lukasiewcz † Author for correspondence Cannabis has long been perceived as a drug causing questionable dependence. Only recently has a clinically recognized withdrawal syndrome been described, thus laying the foundations for specific treatment evaluations. Six different pharmacotherapies have been studied in cannabis withdrawal. Of these, only oral tetrahydrocannabinol, and perhaps mirtazapine, have shown some promise in the specific treatment of withdrawal symptoms. In cannabis dependence, rimonabant, and perhaps buspiron, have shown promising results. Clinical trials of oral tetrahydrocannabinol were less convincing. Cognitive and behavioral therapies and motivational enhancement therapies have proven their efficacy in several randomized controlled trials. Brief therapies have also been associated with good compliance and efficacy. Combinations with voucher incentives in certain populations have been associated with improved treatment compliance and reduced cannabis use. Only two studies have analyzed the cost–efficacy of psychotherapies. It would seem that brief combined cognitive and behavioral therapies, and motivational enhancement therapies are the most cost effective. For the moment, it is uncertain whether the additional treatment costs associated with voucher incentives are proportional to the accrued abstinence duration.
Cited byArpana Agrawal, Leah Wetherill, Danielle M. Dick, Xiaoling Xuei, Anthony Hinrichs, Victor Hesselbrock, John Kramer, John I. Nurnberger, Marc Schuckit, Laura J. Bierut, Howard J. Edenberg, Tatiana Foroud. (2009) Evidence for association between polymorphisms in the cannabinoid receptor 1 (CNR1) gene and cannabis dependence. American Journal of Medical Genetics Part B: Neuropsychiatric Genetics 150B:5, 736-740 Online publication date: 5-Aug-2009. CrossRef Ryan Vandrey, Margaret Haney. (2009) Pharmacotherapy for Cannabis Dependence. CNS Drugs 23:7, 543-553 Online publication date: 1-Aug-2009. CrossRef Shailendra Kapoor. (2009) Rimonabant: a rapidly expanding role in the management of metabolic and systemic disorders besides polycystic ovarian syndrome. Clinical Endocrinology 70:2, 339-339 Online publication date: 1-Mar-2009. CrossRef Iván D. Montoya, Frank Vocci. (2008) Novel medications to treat addictive disorders. Current Psychiatry Reports 10:5, 392-398 Online publication date: 1-Nov-2008. CrossRef Christian Giroud, Marc Bollmann, Aurélien Thomas, Patrice Mangin, Bernard Favrat. (2008) Consommation de cannabis: quels sont les risques ?. Annales de Toxicologie Analytique 20:4, 183-205 Online publication date: 1-Feb-2008. CrossRef
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