Lithium carbonate in the management of cannabis withdrawal: a randomized placebo-controlled trial in an inpatient setting

被引:25
作者
Johnston, Jennifer [1 ]
Lintzeris, Nicholas [1 ,2 ,3 ]
Allsop, David J. [1 ,4 ]
Suraev, Anastasia [4 ]
Booth, Jessica [4 ]
Carson, Dean S. [4 ]
Helliwell, David [5 ]
Winstock, Adam [6 ]
McGregor, Iain S. [4 ]
机构
[1] Univ Sydney, Discipline Addict Med, Camperdown, NSW 2050, Australia
[2] Langton Ctr, Drug Serv, Surry Hills, NSW 2010, Australia
[3] Langton Ctr, Alcohol Serv, Surry Hills, NSW 2010, Australia
[4] Univ Sydney, Sch Psychol, Sydney, NSW 2006, Australia
[5] Riverlands Drug & Alcohol Ctr, Lismore, NSW 2480, Australia
[6] Kings Coll London, Inst Psychiat, London SE5 8AF, England
基金
英国医学研究理事会;
关键词
Cannabinoids; Lithium; Oxytocin; Cannabis withdrawal; Abstinence; Cannabis; Marijuana; DEPENDENCE SCALE SDS; MULTIPLE IMPUTATION; PLASMA OXYTOCIN; ALCOHOL-USE; USERS; SEVERITY; RELIABILITY; ADOLESCENT; DISORDERS; VALIDITY;
D O I
10.1007/s00213-014-3611-5
中图分类号
Q189 [神经科学];
学科分类号
071006 ;
摘要
Preclinical studies suggest that lithium carbonate (lithium) can reduce precipitated cannabinoid withdrawal in rats by stimulating release of the neuropeptide oxytocin, while two open-label studies indicate lithium may ameliorate cannabis withdrawal symptoms in humans. This study was conducted to examine the efficacy and safety of lithium in the inpatient management of cannabis withdrawal and to determine whether lithium affects plasma oxytocin and the rate of elimination of plasma cannabinoids during abstinence. Treatment-seeking cannabis-dependent adults (n = 38) were admitted for 8 days to an inpatient withdrawal unit and randomized to either oral lithium (500 mg) or placebo given twice a day under double-blind randomized controlled trial (RCT) conditions. Primary outcomes included withdrawal severity [cannabis withdrawal scale (CWS)], rates of detoxification completion, and adverse events. Plasma cannabinoids, plasma oxytocin and serum lithium levels were measured repeatedly over admission. Follow-up research interviews were conducted at 14, 30, and 90 days postdischarge. Lithium did not significantly affect total CWS scores relative to placebo, although it significantly reduced individual symptoms of "loss of appetite," "stomach aches," and "nightmares/strange dreams." No significant group differences were found in treatment retention or adverse events. Lithium did not increase plasma oxytocin levels nor influence the rate of elimination of cannabinoids. Both placebo- and lithium-treated participants showed reduced levels of cannabis use (verified by urinalysis) and improved health and psychosocial outcomes at 30- and 90-day follow-up relative to pretreatment baselines. Despite the strong rationale for the present study, the efficacy of lithium over placebo in the management of cannabis withdrawal was not demonstrated.
引用
收藏
页码:4623 / 4636
页数:14
相关论文
共 53 条
  • [1] AIHW, 2012, AIHW SER, V18
  • [2] Changes in cigarette and alcohol use during cannabis abstinence
    Allsop, David J.
    Dunlop, Adrian J.
    Sadler, Craig
    Rivas, Gonzalo R.
    McGregor, Lain S.
    Copeland, Jan
    [J]. DRUG AND ALCOHOL DEPENDENCE, 2014, 138 : 54 - 60
  • [3] Nabiximols as an Agonist Replacement Therapy During Cannabis Withdrawal A Randomized Clinical Trial
    Allsop, David J.
    Copeland, Jan
    Lintzeris, Nicholas
    Dunlop, Adrian J.
    Montebello, Mark
    Sadler, Craig
    Rivas, Gonzalo R.
    Holland, Rohan M.
    Muhleisen, Peter
    Norberg, Melissa M.
    Booth, Jessica
    McGregor, Iain S.
    [J]. JAMA PSYCHIATRY, 2014, 71 (03) : 281 - 291
  • [4] Quantifying the Clinical Significance of Cannabis Withdrawal
    Allsop, David J.
    Copeland, Jan
    Norberg, Melissa M.
    Fu, Shanlin
    Molnar, Anna
    Lewis, John
    Budney, Alan J.
    [J]. PLOS ONE, 2012, 7 (09):
  • [5] The Cannabis Withdrawal Scale development: Patterns and predictors of cannabis withdrawal and distress
    Allsop, David J.
    Norberg, Melissa M.
    Copeland, Jan
    Fu, Shanlin
    Budney, Alan J.
    [J]. DRUG AND ALCOHOL DEPENDENCE, 2011, 119 (1-2) : 123 - 129
  • [6] [Anonymous], 2012, ANN REP 2012 STAT DR
  • [7] [Anonymous], ADV PSYCHIAT TREATME
  • [8] [Anonymous], 2000, DIAGN STAT MAN MENT, DOI DOI 10.1176/APPI.BOOKS.9780890425787
  • [9] [Anonymous], 2004, WHO QUALITY LIFE WHO
  • [10] Bell ML, 2013, STAT METHODS MED RES, V19