Journal Article

Effects of zolpidem alone and in combination with nabilone on cannabis withdrawal and a laboratory model of relapse in cannabis users

Cooper, Ziva D., Comer, Sandra D., Haney, Margaret, Foltin, Richard W., Bedi, Gillinder, Reed, Stephanie C., Herrmann, Evan S., Ramesh, Divya

2016

Overview

Rationale Each year, over 300,000 individuals in the USA enter treatment for cannabis use disorder (CUD). The development of effective pharmacotherapy for CUD is a priority. Objective This placebo-controlled study examined the effects of zolpidem alone and in combination with nabilone on cannabis withdrawal and a laboratory measure of relapse. Methods Eleven daily, non-treatment-seeking cannabis users completed three, 8-day inpatient phases; each phase tested a different medication condition in counter-balanced order. On the first day of each phase, participants were administered placebo capsules t.i.d. and smoked experimenter-administered active cannabis (5.6 % Δ 9 -tetrahydrocannabinol (THC)). On days 2–8, the participants were administered capsules containing either placebo (0 mg at 0900, 1800, and 2300 hours), zolpidem (0 mg at 0900 and 1800, and 12.5 mg at 2300), or zolpidem (12.5 mg at 2300) and nabilone (3 mg at 0900 and 1800). Cannabis withdrawal, subjective capsule effects, and cognitive performance were examined on days 3–4, when only inactive cannabis (0.0 % THC) was available for self-administration. “Relapse” was measured on days 5–8, when participants could self-administer active cannabis. Results Both medication conditions decreased withdrawal-related disruptions in sleep, but only zolpidem in combination with nabilone decreased withdrawal-related disruptions in mood and food intake relative to placebo. Zolpidem in combination with nabilone, but not zolpidem alone, decreased self-administration of active cannabis. Zolpidem in combination with nabilone also produced small increases in certain abuse-related subjective capsule ratings, while zolpidem alone did not. Neither medication condition altered cognitive performance. Conclusions Clinical testing of nabilone, either alone, or in combination with zolpidem is warranted.

• Publisher: Springer Berlin Heidelberg,Springer,Springer Nature B.V
• Subject: Adult / Affect - drug effects / Anti-Anxiety Agents - therapeutic use / Biomedical and Life Sciences / Biomedicine / Cognition - drug effects / Combination drug therapy / Dosage and administration / Dose-Response Relationship, Drug / Double-Blind Method / Dronabinol - analogs & derivatives / Dronabinol - pharmacology / Drug therapy / Drug Therapy, Combination / Eating - drug effects / Female / Health aspects / Humans / Hypnotics and Sedatives - pharmacology / Male / Marijuana / Marijuana Abuse - drug therapy / Marijuana Abuse - psychology / Marijuana Smoking - drug therapy / Methods / Middle Aged / Nabilone / Neurosciences / Original Investigation / Patient outcomes / Pharmacology/Toxicology / Placebo effect / Psychiatry / Pyridines - pharmacology / Sleep - drug effects / Studies / Substance withdrawal syndrome / Substance Withdrawal Syndrome - drug therapy / Substance Withdrawal Syndrome - psychology / Young Adult / Zolpidem