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Randomized Controlled Trial
. 2015 Nov 1:156:29-37.
doi: 10.1016/j.drugalcdep.2015.08.013. Epub 2015 Aug 25.

Buspirone treatment of cannabis dependence: A randomized, placebo-controlled trial

Aimee L McRae-Clark  1 , Nathaniel L Baker  2 , Kevin M Gray  3 , Therese K Killeen  3 , Amanda M Wagner  3 , Kathleen T Brady  3 , C Lindsay DeVane  3 , Jessica Norton  3
Affiliations
Randomized Controlled Trial

Buspirone treatment of cannabis dependence: A randomized, placebo-controlled trial

Aimee L McRae-Clark et al. Drug Alcohol Depend. .

Abstract

Background: The purpose of this study was to evaluate the efficacy of buspirone, a partial 5-HT1A agonist, for treatment of cannabis dependence.

Methods: One hundred seventy-five cannabis-dependent adults were randomized to receive either up to 60mg/day of buspirone (n=88) or placebo (n=87) for 12 weeks combined with a brief motivational enhancement therapy intervention and contingency management to encourage study retention. Cannabis use outcomes were assessed via weekly urine cannabinoid tests.

Results: Participants in both groups reported reduced cannabis craving over the course of the study; however, buspirone provided no advantage over placebo in reducing cannabis use. Significant gender by treatment interactions were observed, with women randomized to buspirone having fewer negative urine cannabinoid tests than women randomized to placebo (p=0.007), and men randomized to buspirone having significantly lower creatinine adjusted cannabinoid levels as compared to those randomized to placebo (p=0.023). An evaluation of serotonin allelic variations did not find an association with buspirone treatment response.

Conclusions: Buspirone was not more efficacious than placebo in reducing cannabis use. Important gender differences were noted, with women having worse cannabis use outcomes with buspirone treatment. Considerations for future medication trials in this challenging population are discussed.

Keywords: Buspirone; Cannabis; Contingency management; Gender differences; Motivational enhancement therapy.

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Conflict of interest statement

Conflicts of Interest: Authors McRae-Clark and Brady have received previous grant support from Bristol-Myers Squibb (none in past seven years).

Figures

Figure 1
Figure 1. CONSORT Table
Figure 2
Figure 2
Proportion of randomized participants with negative weekly UCT by treatment assignment for A) all participants B) Male and C) Female participants. Results are shown from the intent to treat (ITT; n=175) data analysis sample (134 Males and 41 Females)
Figure 2
Figure 2
Proportion of randomized participants with negative weekly UCT by treatment assignment for A) all participants B) Male and C) Female participants. Results are shown from the intent to treat (ITT; n=175) data analysis sample (134 Males and 41 Females)
Figure 3
Figure 3
Creatinine adjusted cannabinoid levels by treatment assignment for A) all participants B) Male and C) Female participants. Results are model based means and are shown as the natural logarithm transformed ratio.
Figure 3
Figure 3
Creatinine adjusted cannabinoid levels by treatment assignment for A) all participants B) Male and C) Female participants. Results are model based means and are shown as the natural logarithm transformed ratio.
See this image and copyright information in PMC

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