Abstract
Background: Cannabis use disorder (CUD) is setting an increasing demand on health services. Although there are objective physical symptoms of cannabis dependence, there is no validated pharmacotherapy for CUD treatment, which is mainly based on behavioral interventions. The goal of such pharmacotherapies in CUD may be abstinence or consumption reduction. Besides, a growing literature tests the efficacy of different drugs that have already been validated for other diseases, thus opening up possibilities for their off-label use. Here we led a systematic literature review to examine the level of evidence of their efficacy, indications and safety for off-label use to treat CUD.
Methods: Systematic review via the PubMed, Web of Science, and ScienceDirect databases.
Results: Although 43 relevant articles were found, only 13 were double-blind, randomized placebo-controlled trials, and only 4 of these 13 trials had positive results. These trials concerned dronabinol, nabiximols, N-acetylcysteine and gabapentin.
Conclusion: Given the small number of positive trials for each drug, there is no indication for routine off-label prescription in CUD. However, off-label prescribing may be an option in cases where behavioral therapies have failed. Benefit-risk balance is acceptable for N-acetylcysteine but remains to be confirmed for gabapentin, dronabinol and nabiximols.
Keywords: Cannabis, cannabis use disorder, dronabinol, gabapentin, N-acetylcysteine, nabiximols, off-label, pharmacotherapy.
Current Pharmaceutical Design
Title:Is There a Place for Off-Label Pharmacotherapy in Cannabis Use Disorder? A Review on Efficacy and Safety
Volume: 21 Issue: 23
Author(s): Vincent Laprevote, Raymund Schwan, Thomas Schwitzer, Benjamin Rolland and Johannes Thome
Affiliation:
Keywords: Cannabis, cannabis use disorder, dronabinol, gabapentin, N-acetylcysteine, nabiximols, off-label, pharmacotherapy.
Abstract: Background: Cannabis use disorder (CUD) is setting an increasing demand on health services. Although there are objective physical symptoms of cannabis dependence, there is no validated pharmacotherapy for CUD treatment, which is mainly based on behavioral interventions. The goal of such pharmacotherapies in CUD may be abstinence or consumption reduction. Besides, a growing literature tests the efficacy of different drugs that have already been validated for other diseases, thus opening up possibilities for their off-label use. Here we led a systematic literature review to examine the level of evidence of their efficacy, indications and safety for off-label use to treat CUD.
Methods: Systematic review via the PubMed, Web of Science, and ScienceDirect databases.
Results: Although 43 relevant articles were found, only 13 were double-blind, randomized placebo-controlled trials, and only 4 of these 13 trials had positive results. These trials concerned dronabinol, nabiximols, N-acetylcysteine and gabapentin.
Conclusion: Given the small number of positive trials for each drug, there is no indication for routine off-label prescription in CUD. However, off-label prescribing may be an option in cases where behavioral therapies have failed. Benefit-risk balance is acceptable for N-acetylcysteine but remains to be confirmed for gabapentin, dronabinol and nabiximols.
Export Options
About this article
Cite this article as:
Laprevote Vincent, Schwan Raymund, Schwitzer Thomas, Rolland Benjamin and Thome Johannes, Is There a Place for Off-Label Pharmacotherapy in Cannabis Use Disorder? A Review on Efficacy and Safety, Current Pharmaceutical Design 2015; 21 (23) . https://dx.doi.org/10.2174/1381612821666150619093940
DOI https://dx.doi.org/10.2174/1381612821666150619093940 |
Print ISSN 1381-6128 |
Publisher Name Bentham Science Publisher |
Online ISSN 1873-4286 |
Call for Papers in Thematic Issues
"Tuberculosis Prevention, Diagnosis and Drug Discovery"
The Nobel Prize-winning discoveries of Mycobacterium tuberculosis and streptomycin have enabled an appropriate diagnosis and an effective treatment of tuberculosis (TB). Since then, many newer diagnosis methods and drugs have been saving millions of lives. Despite advances in the past, TB is still a leading cause of infectious disease mortality ...read more
Current Pharmaceutical challenges in the treatment and diagnosis of neurological dysfunctions
Neurological dysfunctions (MND, ALS, MS, PD, AD, HD, ALS, Autism, OCD etc..) present significant challenges in both diagnosis and treatment, often necessitating innovative approaches and therapeutic interventions. This thematic issue aims to explore the current pharmaceutical landscape surrounding neurological disorders, shedding light on the challenges faced by researchers, clinicians, and ...read more
Emerging and re-emerging diseases
Faced with a possible endemic situation of COVID-19, the world has experienced two important phenomena, the emergence of new infectious diseases and/or the resurgence of previously eradicated infectious diseases. Furthermore, the geographic distribution of such diseases has also undergone changes. This context, in turn, may have a strong relationship with ...read more
Melanoma and Non-Melanoma Skin Cancer Treatment: Standard of Care and Recent Advances
In this thematic issue, we aim to provide a standard of care of the diagnosis and treatment of melanoma and non-melanoma skin cancer. The editor will invite authors from different countries who will write review articles of melanoma and non-melanoma skin cancers. The Diagnosis, Staging, Surgical Treatment, Non-Surgical Treatment all ...read more
- Author Guidelines
- Graphical Abstracts
- Fabricating and Stating False Information
- Research Misconduct
- Post Publication Discussions and Corrections
- Publishing Ethics and Rectitude
- Increase Visibility of Your Article
- Archiving Policies
- Peer Review Workflow
- Order Your Article Before Print
- Promote Your Article
- Manuscript Transfer Facility
- Editorial Policies
- Allegations from Whistleblowers
- Announcements
Related Articles
-
The Effect of Adult and Pediatric Cardiopulmonary Bypass on Pharmacokinetic and Pharmacodynamic Parameters
Current Clinical Pharmacology The Role of P-Glycoprotein in Psychiatric Disorders: A Reliable Guard of the Brain?
Central Nervous System Agents in Medicinal Chemistry Novel Neuroendocrine and Metabolic Mechanism Provides the Patented Platform for Important Rejuvenation Therapies: Targeted Therapy of Telomere Attrition and Lifestyle Changes of Telomerase Activity with the Timing of Neuron-Specific Imidazole-Containing Dipeptide-Dominant Pharmaconutrition Provision
Recent Patents on Endocrine, Metabolic & Immune Drug Discovery Herbal Medicine of the 21st Century: A Focus on the Chemistry, Pharmacokinetics and Toxicity of Five Widely Advocated Phytotherapies
Current Topics in Medicinal Chemistry Immunotherapy of Pancreatic Carcinoma
Reviews on Recent Clinical Trials An Evidence-Based Systematic Review of Stevia by the Natural Standard Research Collaboration
Cardiovascular & Hematological Agents in Medicinal Chemistry Iron Chelators in Medicinal Applications - Chemical Equilibrium Considerations in Pharmaceutical Activity
Current Medicinal Chemistry Use of Paediatric Xylometazoline Nasal Drop is not a Child’s Play in Hypertensive Patients on Bisoprolol: A Case Report
Current Drug Safety Scintigraphic Imaging of Inflammatory Processes
Medicinal Chemistry Reviews - Online (Discontinued) Is there a Teratogenicity Risk Associated with Cannabis and Synthetic Cannabimimetics’ (‘Spice’) Intake?
CNS & Neurological Disorders - Drug Targets Sedation in PACU: Indications, Monitoring, Complications
Current Drug Targets Renin-angiotensin System Blockade at the Level of the Angiotensin Converting Enzyme or the Angiotensin Type-1 Receptor: Similarities and Differences
Current Topics in Medicinal Chemistry Synthesis of New α-Amino Phosphonates Containing 3-Amino-4(3H) Quinazolinone Moiety as Anticancer and Antimicrobial Agents: DFT, NBO, and Vibrational Studies
Current Organic Synthesis Evaluating Drug Safety in Children and Adolescents with Bipolar Disorder
Current Drug Safety Natural Fused Heterocyclic Flavonoids: Potent Candidates as Anti- Inflammatory and Anti-Allergic Agents in the Treatment of Asthma
Current Bioactive Compounds Endocannabinoids and Their Receptors: Physiology, Pathology and Pharmacology
Immunology, Endocrine & Metabolic Agents in Medicinal Chemistry (Discontinued) TRYCAT Pathways Link Peripheral Inflammation, Nicotine, Somatization and Depression in the Etiology and Course of Parkinson’s Disease
CNS & Neurological Disorders - Drug Targets The Vernakalant Story: How Did It Come to Approval in Europe and What is the Delay in the U.S.A?
Current Cardiology Reviews Atypical Presentation Of Anti-Retroviral Therapy Induced Lactic Acidosis as Acute Right Ventricular Failure And Severe Pulmonary Hypertension
New Emirates Medical Journal Kinins as Therapeutic Agents in Cardiovascular and Renal Diseases
Current Pharmaceutical Design