Document Detail


A randomized double-blind, placebo-controlled trial of venlafaxine-extended release for co-occurring cannabis dependence and depressive disorders.
MedLine Citation:
PMID:  23297841     Owner:  NLM     Status:  MEDLINE    
Abstract/OtherAbstract:
AIM: To evaluate whether venlafaxine-extended release (VEN-XR) is an effective treatment for cannabis dependence with concurrent depressive disorders.
DESIGN: This was a randomized, 12-week, double-blind, placebo-controlled trial of out-patients (n = 103) with DSM-IV cannabis dependence and major depressive disorder or dysthymia. Participants received up to 375 mg VEN-XR on a fixed-flexible schedule or placebo. All patients received weekly individual cognitive-behavioral psychotherapy that primarily targeted marijuana use.
SETTINGS: The trial was conducted at two university research centers in the United States.
PARTICIPANTS: One hundred and three cannabis-dependent adults participated in the trial.
MEASUREMENTS: The primary outcome measures were (i) abstinence from marijuana defined as at least two consecutive urine-confirmed abstinent weeks and (ii) improvement in depressive symptoms based on the Hamilton Depression Rating Scale.
FINDINGS: The proportion of patients achieving a clinically significant mood improvement (50% decrease in Hamilton Depression score from baseline) was high and did not differ between groups receiving VEN-XR (63%) and placebo (69%) (χ1 (2)  = 0.48, P = 0.49). The proportion of patients achieving abstinence was low overall, but was significantly worse on VEN-XR (11.8%) compared to placebo (36.5%) (χ1 (2)  = 7.46, P < 0.01; odds ratio = 4.51, 95% confidence interval: 1.53, 13.3). Mood improvement was associated with reduction in marijuana use in the placebo group (F1,179  = 30.49, P < 0.01), but not the VEN-XR group (F1,186  = 0.02, P = 0.89).
CONCLUSIONS: For depressed, cannabis-dependent patients, venlafaxine-extended release does not appear to be effective at reducing depression and may lead to an increase in cannabis use.
Authors:
Frances R Levin; John Mariani; Daniel J Brooks; Martina Pavlicova; Edward V Nunes; Vito Agosti; Adam Bisaga; Maria A Sullivan; Kenneth M Carpenter
Publication Detail:
Type:  Journal Article; Multicenter Study; Randomized Controlled Trial; Research Support, N.I.H., Extramural     Date:  2013-03-21
Journal Detail:
Title:  Addiction (Abingdon, England)     Volume:  108     ISSN:  1360-0443     ISO Abbreviation:  Addiction     Publication Date:  2013 Jun 
Date Detail:
Created Date:  2013-05-10     Completed Date:  2013-12-17     Revised Date:  2014-06-03    
Medline Journal Info:
Nlm Unique ID:  9304118     Medline TA:  Addiction     Country:  England    
Other Details:
Languages:  eng     Pagination:  1084-94     Citation Subset:  IM    
Copyright Information:
© 2013 Society for the Study of Addiction.
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MeSH Terms
Descriptor/Qualifier:
Adult
Antidepressive Agents, Second-Generation / administration & dosage*,  adverse effects
Cognitive Therapy / methods
Combined Modality Therapy
Cyclohexanols / administration & dosage*,  adverse effects
Delayed-Action Preparations
Depressive Disorder, Major / drug therapy*,  etiology
Double-Blind Method
Dronabinol / urine
Female
Humans
Male
Marijuana Abuse / drug therapy*,  psychology,  urine
Medication Adherence
Recurrence
Serotonin Uptake Inhibitors / administration & dosage*,  adverse effects
Treatment Failure
Grant Support
ID/Acronym/Agency:
K02 DA000465/DA/NIDA NIH HHS; K24 DA022412/DA/NIDA NIH HHS; K24 DA022412/DA/NIDA NIH HHS; K24 DA029647/DA/NIDA NIH HHS; K24 DA029647/DA/NIDA NIH HHS; KO2 000465//PHS HHS; R01 DA015451/DA/NIDA NIH HHS; R01DA15451/DA/NIDA NIH HHS
Chemical
Reg. No./Substance:
0/Antidepressive Agents, Second-Generation; 0/Cyclohexanols; 0/Delayed-Action Preparations; 0/Serotonin Uptake Inhibitors; 7J8897W37S/Dronabinol; GRZ5RCB1QG/venlafaxine
Comments/Corrections

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