A Proof-of-Concept Randomized Controlled Study of Gabapentin: Effects on Cannabis Use, Withdrawal and Executive Function Deficits in Cannabis-Dependent Adults

Mason, Barbara J.; Crean, Rebecca D.; Goodell, Vivian; Light, John M.; Quello, Susan; Shadan, Farhad F.; Buffkins, Kimberly; Kyle, M V; Adusumalli, Murali; Begovic, Adnan; Rao, Subramanyeshwar

doi:10.1038/npp.2012.14

Cited by 197 publications

(160 citation statements)

References 41 publications

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“…Previous evidence for deficits in attention after chronic cannabis exposure was mixed, but more recent studies provide some clarity. Numerous studies report impairment in adolescent and adult cannabis users with a wide range of exposure as well as former users abstinent for several weeks on measures of sustained and divided attention, processing speed, rapid visual information processing, visual search, tracking, trail making, and paced serial addition (46,54,55,57,61,(91)(92)(93)(94). Users abstinent for 23 days remained impaired relative to control subjects despite improvements in sustained and divided attention with increasing abstinence (91) with poor attentional performance associated with younger age of onset in this study (91) and another study of adolescents abstinent for 30 days (95).…”

Section: Attentionmentioning

confidence: 99%

“…Seven were prospective studies, assessing cannabis users at baseline and at follow-up (with some intervening measures) over periods ranging from 21 days to 4-8 years of abstinence. Although this is a stronger design, there remains a conspicuous paucity of these studies, as two were confounded by concomitant pharmacologic treatments (63,93).…”

Section: Persistence or Recovery Of Function With Abstinencementioning

confidence: 99%

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Acute and Chronic Effects of Cannabinoids on Human Cognition—A Systematic Review

Broyd

Hell

Beale

et al. 2016

Biological Psychiatry

538

395

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Cannabis use has been associated with impaired cognition during acute intoxication as well as in the unintoxicated state in long-term users. However, the evidence has been mixed and contested, and no systematic reviews of the literature on neuropsychological task-based measures of cognition have been conducted in an attempt to synthesize the findings. We systematically review the empirical research published in the past decade (from January 2004 to February 2015) on acute and chronic effects of cannabis and cannabinoids and on persistence or recovery after abstinence. We summarize the findings into the major categories of the cognitive domains investigated, considering sample characteristics and associations with various cannabis use parameters. Verbal learning and memory and attention are most consistently impaired by acute and chronic exposure to cannabis. Psychomotor function is most affected during acute intoxication, with some evidence for persistence in chronic users and after cessation of use. Impaired verbal memory, attention, and some executive functions may persist after prolonged abstinence, but persistence or recovery across all cognitive domains remains underresearched. Associations between poorer performance and a range of cannabis use parameters, including a younger age of onset, are frequently reported. Little further evidence has emerged for the development of tolerance to the acutely impairing effects of cannabis. Evidence for potential protection from harmful effects by cannabidiol continues to increase but is not definitive. In light of increasing trends toward legalization of cannabis, the knowledge gained from this body of research needs to be incorporated into strategies to minimize harm. Review Acute and Chronic Effects of Cannabinoids on Human Cognition-A Systematic ReviewSamantha J. Broyd, Hendrika H. van Hell, Camilla Beale, Murat Yücel, and Nadia Solowij ABSTRACT Cannabis use has been associated with impaired cognition during acute intoxication as well as in the unintoxicated state in long-term users. However, the evidence has been mixed and contested, and no systematic reviews of the literature on neuropsychological task-based measures of cognition have been conducted in an attempt to synthesize the findings. We systematically review the empirical research published in the past decade (from January 2004 to February 2015) on acute and chronic effects of cannabis and cannabinoids and on persistence or recovery after abstinence. We summarize the findings into the major categories of the cognitive domains investigated, considering sample characteristics and associations with various cannabis use parameters. Verbal learning and memory and attention are most consistently impaired by acute and chronic exposure to cannabis. Psychomotor function is most affected during acute intoxication, with some evidence for persistence in chronic users and after cessation of use. Impaired verbal memory, attention, and some executive functions may persist after prolonged abstinence, but persistenc...

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Section: Attentionmentioning

confidence: 99%

Section: Persistence or Recovery Of Function With Abstinencementioning

confidence: 99%

Acute and Chronic Effects of Cannabinoids on Human Cognition—A Systematic Review

Broyd

Hell

Beale

et al. 2016

Biological Psychiatry

538

395

View full text Add to dashboard Cite

show abstract

“…Similarly, gabapentin has been indicated for the treatment/ management of drug (e.g. opiates [41]; cannabis [42]), behavioural [43] and alcohol [44] addictions.…”

Section: Gabapentinoids As a Treatment For Addiction?mentioning

confidence: 99%

Misuse and Abuse of Pregabalin and Gabapentin: Cause for Concern?

2014

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Gabapentinoids (e.g. pregabalin and gabapentin) are widely used in neurology, psychiatry and primary healthcare but are increasingly being reported as possessing a potential for misuse. In fact, increasing levels of both prescriptions and related fatalities, together with an anecdotally growing black market, have been reported from a range of countries. This article reviews the current evidence base of this potential, in an attempt to answer the question of whether there is cause for concern about these drugs. Potent binding of pregabalin/gabapentin at the calcium channel results in a reduction in the release of excitatory molecules. Furthermore, gabapentinoids are thought to possess GABA-mimetic properties whilst possibly presenting with direct/indirect effects on the dopaminergic 'reward' system. Overall, pregabalin is characterized by higher potency, quicker absorption rates and greater bioavailability levels than gabapentin. Although at therapeutic dosages gabapentinoids may present with low addictive liability levels, misusers' perceptions for these molecules to constitute a valid substitute for most common illicit drugs may be a reason of concern. Gabapentinoid experimenters are profiled here as individuals with a history of recreational polydrug misuse, who self-administer with dosages clearly in excess (e.g. up to 3-20 times) of those that are clinically advisable. Physicians considering prescribing gabapentinoids for neurological/psychiatric disorders should carefully evaluate a possible previous history of drug abuse, whilst being able to promptly identify signs of pregabalin/gabapentin misuse and provide possible assistance in tapering off the medication. Key pointsGabapentinoids are thought to possess GABAmimetic properties, whilst possibly presenting with direct/indirect effects on the dopaminergic 'reward' system.Gabapentinoid experimenters are profiled here as individuals with a history of recreational polydrug misuse, who self-administer with dosages clearly in excess (e.g. up to 3-20 times) of those that are clinically advisable.Physicians considering prescribing gabapentinoids for neurological/psychiatric disorders should carefully evaluate for a possible previous history of drug abuse, whilst being able to promptly identify signs of pregabalin/gabapentin misuse and provide possible assistance in tapering off the medication.

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“…44 Gabapentin at 1200 mg per day improved withdrawal symptoms in a small study of adults and improved cognitive functioning. 45 In adolescents, emerging evidence seems to point to a role of Nacetyl-cysteine (NAC) in establishing abstinence. 46 More research is required to look at its role in maintaining abstinence.…”

Section: Treatment Of Withdrawalmentioning

confidence: 99%

Cannabis Use Disorders in Primary Care: Screening and Treatment Suggestions

Turner

Nader

Graves

2017

MRAJ

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Abstract:Objective: To review, through case-based learning, the screening for and treatment of cannabis use disorders in primary care.Harm reduction modalities as it pertains to cannabis use are also reviewed. Methods:PubMed was searched for studies on cannabis use disorders with a specific focus on screening and treatment modalities. The literature cited was reviewed for those relevant studies identified through PubMed.Results: Problematic cannabis use can be screened for with a single question. A positive screening question can lead to more intensive screening with a validated questionnaire. A high score on a validated questionnaire may lead to examination of the DSMV criteria. Withdrawal symptoms can be treated with synthetic cannabinoids. Maintenance may involve cannabinoids or other medications but the evidence is more mixed for this setting.Harm reduction techniques may be useful in those that are not interested in cutting down or in those that are willing to reduce but not stop cannabis consumption. Brief intervention may be effective in the primary care setting. There are patients who should not use cannabis. Conclusion:Primary care providers should screen for cannabis use disorders with a single question in those patients presenting with problems that could be related to substance use. More in-depth screening is triggered by a positive response. Withdrawal management, maintenance therapy and harm reduction are all within the scope of primary care providers and should be explored with the patients. If these interventions are unsuccessful, the patient can be referred to an addiction medicine specialist.

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A Proof-of-Concept Randomized Controlled Study of Gabapentin: Effects on Cannabis Use, Withdrawal and Executive Function Deficits in Cannabis-Dependent Adults

Cited by 197 publications

References 41 publications

Acute and Chronic Effects of Cannabinoids on Human Cognition—A Systematic Review

Acute and Chronic Effects of Cannabinoids on Human Cognition—A Systematic Review

Misuse and Abuse of Pregabalin and Gabapentin: Cause for Concern?

Cannabis Use Disorders in Primary Care: Screening and Treatment Suggestions

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