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A randomized double‐blind, placebo‐controlled trial of venlafaxine‐extended release for co‐occurring cannabis dependence and depressive disorders
Author(s) -
Levin Frances R.,
Mariani John,
Brooks Daniel J.,
Pavlicova Martina,
Nunes Edward V.,
Agosti Vito,
Bisaga Adam,
Sullivan Maria A.,
Carpenter Kenneth M.
Publication year - 2013
Publication title -
addiction
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 2.424
H-Index - 193
eISSN - 1360-0443
pISSN - 0965-2140
DOI - 10.1111/add.12108
Subject(s) - placebo , cannabis dependence , abstinence , randomized controlled trial , medicine , psychology , cannabis , venlafaxine , psychiatry , depression (economics) , mood , odds ratio , placebo controlled study , major depressive disorder , double blind , anxiety , antidepressant , cannabidiol , alternative medicine , macroeconomics , pathology , economics
Abstract 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 U nited S tates. 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 H amilton D epression R ating S cale. 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%) (χ 1 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%) (χ 1 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 ( F 1,179 = 30.49, P < 0.01), but not the VEN ‐ XR group ( F 1,186 = 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.