Pharmacological interventions in the treatment of the acute effects of cannabis: a systematic review of literature

<p>Abstract</p> <p>Background</p> <p>Cannabis intoxication is related to a number of physical and mental health risks with ensuing social costs. However, little attention has been given to the investigation of possible pharmacological interactions in this condition.</p> <p>Objective</p> <p>To review the available scientific literature concerning pharmacological interventions for the treatment of the acute effects of cannabis.</p> <p>Methods</p> <p>A search was performed on the <it>Pubmed</it>, <it>Lilacs</it>, and <it>Scielo </it>online databases by combining the terms <it>cannabis, intoxication, psychosis, anxiety</it>, and <it>treatment</it>. The articles selected from this search had their reference lists checked for additional publications related to the topic of the review.</p> <p>Results</p> <p>The reviewed articles consisted of case reports and controlled clinical trials and are presented according to interventions targeting the physiological, psychiatric, and cognitive symptoms provoked by cannabis. The pharmacological interventions reported in these studies include: beta-blockers, antiarrhythmic agents, antagonists of CB-1 and GABA-benzodiazepine receptors, antipsychotics, and cannabidiol.</p> <p>Conclusion</p> <p>Although scarce, the evidence on pharmacological interventions for the management of cannabis intoxication suggests that propanolol and rimonabant are the most effective compounds currently available to treat the physiological and subjective effects of the drug. Further studies are necessary to establish the real effectiveness of these two medications, as well as the effectiveness of other candidate compounds to counteract the effects of cannabis intoxication, such as cannabidiol and flumazenil.</p

Cannabidiol Reduces the Anxiety Induced by Simulated Public Speaking in Treatment-Naïve Social Phobia Patients

Generalized Social Anxiety Disorder (SAD) is one of the most common anxiety conditions with impairment in social life. Cannabidiol (CBD), one major non-psychotomimetic compound of the cannabis sativa plant, has shown anxiolytic effects both in humans and in animals. This preliminary study aimed to compare the effects of a simulation public speaking test (SPST) on healthy control (HC) patients and treatment-naïve SAD patients who received a single dose of CBD or placebo. A total of 24 never-treated patients with SAD were allocated to receive either CBD (600 mg; n=12) or placebo (placebo; n=12) in a double-blind randomized design 1 h and a half before the test. The same number of HC (n=12) performed the SPST without receiving any medication. Each volunteer participated in only one experimental session in a double-blind procedure. Subjective ratings on the Visual Analogue Mood Scale (VAMS) and Negative Self-Statement scale (SSPS-N) and physiological measures (blood pressure, heart rate, and skin conductance) were measured at six different time points during the SPST. The results were submitted to a repeated-measures analysis of variance. Pretreatment with CBD significantly reduced anxiety, cognitive impairment and discomfort in their speech performance, and significantly decreased alert in their anticipatory speech. The placebo group presented higher anxiety, cognitive impairment, discomfort, and alert levels when compared with the control group as assessed with the VAMS. The SSPS-N scores evidenced significant increases during the testing of placebo group that was almost abolished in the CBD group. No significant differences were observed between CBD and HC in SSPS-N scores or in the cognitive impairment, discomfort, and alert factors of VAMS. The increase in anxiety induced by the SPST on subjects with SAD was reduced with the use of CBD, resulting in a similar response as the HC

Psychometric properties of the Fagerström Test for Nicotine Dependence As propriedades psicométricas do Teste de Fagerström para Dependência de Nicotina

OBJECTIVE: The Fagerström Test for Nicotine Dependence (FTND) is a screening instrument for physical nicotine dependence and is extensively used in various countries. The objective of the present report was to review articles related to the psychometric properties of the FTND. METHODS: A systematic search for articles published up through December of 2007 was carried out in various electronic databases. The following search terms were used: "Fagerström Test for Nicotine Dependence"; "FTND"; "psychometric"; "validity"; "reliability"; "feasibility"; and "factors". We included articles published in English, Spanish or Portuguese and in which the psychometric properties of the FTND were evaluated. RESULTS: Twenty-six studies related to the psychometric properties of the FTND were identified in the indexed literature. Analysis of the studies confirmed the reliability of the FTND for the assessment of nicotine dependence in different settings and populations. CONCLUSIONS: Further validation studies using previously validated instruments as a comparative measure are needed before the extensive use of the FTND can be justified on the basis of its psychometric qualities.<br>OBJETIVO: O Fagerström Test for Nicotine Dependence (FTND, Teste de Fagerström para Dependência de Nicotina) é um instrumento de rastreamento para dependência física de tabaco, amplamente utilizado em diversos países. Objetivou-se realizar uma revisão de artigos relacionados às propriedades psicométricas do FTND. MÉTODOS: Uma busca sistemática foi realizada usando-se vários indexadores eletrônicos até dezembro de 2007, com os seguintes descritores: "Fagerström Test for Nicotine Dependence"; "FTND"; "psychometric"; "validity"; "reliability"; "feasibility"; e "factors". Foram incluídos os artigos relacionados à avaliação das propriedades psicométricas do FTND publicados em inglês, espanhol e português. RESULTADOS: Vinte e seis estudos relativos às propriedades psicométricas do FTND foram identificados na literatura indexada. A análise dos estudos confirmou a confiabilidade do FTND na avaliação da dependência de tabaco em diferentes contextos e populações. CONCLUSÕES: Futuros estudos de validação, utilizando como medida comparativa instrumentos aferidos, de modo a referendar o seu extenso uso pelas suas qualidades psicométricas ainda são necessários