title: The dose effects of short-term dronabinol (oral THC) maintenance in daily cannabis users.
abstract: BACKGROUND
  Prior studies have separately examined the effects of dronabinol (oral THC) on cannabis withdrawal, cognitive performance, and the acute effects of smoked cannabis. A single study examining these clinically relevant domains would benefit the continued evaluation of dronabinol as a potential medication for the treatment of cannabis use disorders.
  
  
  METHODS
  Thirteen daily cannabis smokers completed a within-subject crossover study and received 0, 30, 60 and 120mg dronabinol per day for 5 consecutive days. Vital signs and subjective ratings of cannabis withdrawal, craving and sleep were obtained daily; outcomes under active dose conditions were compared to those obtained under placebo dosing. On the 5th day of medication maintenance, participants completed a comprehensive cognitive performance battery and then smoked five puffs of cannabis for subjective effects evaluation. Each dronabinol maintenance period occurred in a counterbalanced order and was separated by 9 days of ad libitum cannabis use.
  
  
  RESULTS
  Dronabinol dose-dependently attenuated cannabis withdrawal and resulted in few adverse side effects or decrements in cognitive performance. Surprisingly, dronabinol did not alter the subjective effects of smoked cannabis, but cannabis-induced increases in heart rate were attenuated by the 60 and 120mg doses.
  
  
  CONCLUSIONS
  Dronabinol's ability to dose-dependently suppress cannabis withdrawal may be therapeutically beneficial to individuals trying to stop cannabis use. The absence of gross cognitive impairment or side effects in this study supports safety of doses up to 120mg/day. Continued evaluation of dronabinol in targeted clinical studies of cannabis treatment, using an expanded range of doses, is warranted.
authors.affiliation: Johns Hopkins University School of Medicine, Baltimore, MD 21224, USA. rvandrey@jhmi.edu
authors.forename: Ryan
authors.initials: R
authors.lastname: Vandrey
authors.forename: Maxine L
authors.initials: ML
authors.lastname: Stitzer
authors.forename: Miriam Z
authors.initials: MZ
authors.lastname: Mintzer
authors.forename: Marilyn A
authors.initials: MA
authors.lastname: Huestis
authors.forename: Jeannie A
authors.initials: JA
authors.lastname: Murray
authors.forename: Dayong
authors.initials: D
authors.lastname: Lee
mesh_terms: D000293:Adolescent; D000328:Adult; D002188:Cannabis / Q000009:adverse effects*; D018592:Cross-Over Studies; D004305:Dose-Response Relationship, Drug; D013759:Dronabinol / Q000008:administration & dosage / Q000627:therapeutic use*; D004334:Drug Administration Schedule; D004435:Eating / Q000187:drug effects; D005260:Female; D006339:Heart Rate / Q000187:drug effects; D006801:Humans; D008297:Male; D002189:Marijuana Abuse / Q000188:drug therapy*; D008875:Middle Aged; D012890:Sleep / Q000187:drug effects; D013375:Substance Withdrawal Syndrome / Q000188:drug therapy*
chemical_list: D013759:Dronabinol