title: A randomized double-blind, placebo-controlled trial of venlafaxine-extended release for co-occurring cannabis dependence and depressive disorders.
abstract: OBJECTIVE
  To evaluate whether venlafaxine-extended release (VEN-XR) is an effective treatment for cannabis dependence with concurrent depressive disorders.
  
  
  METHODS
  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.
  
  
  METHODS
  The trial was conducted at two university research centers in the United States.
  
  
  METHODS
  One hundred and three cannabis-dependent adults participated in the trial.
  
  
  METHODS
  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 Hamilton Depression Rating Scale.
  
  
  RESULTS
  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%) (χ1 (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%) (χ1 (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 (F1,179  = 30.49, P < 0.01), but not the VEN-XR group (F1,186  = 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.
authors.affiliation: New York State Psychiatric Institute, Division of Substance Abuse, 1051 Riverside Drive, New York, NY 10032, USA. frl2@columbia.edu
authors.forename: Frances R
authors.initials: FR
authors.lastname: Levin
authors.forename: John
authors.initials: J
authors.lastname: Mariani
authors.forename: Daniel J
authors.initials: DJ
authors.lastname: Brooks
authors.forename: Martina
authors.initials: M
authors.lastname: Pavlicova
authors.forename: Edward V
authors.initials: EV
authors.lastname: Nunes
authors.forename: Vito
authors.initials: V
authors.lastname: Agosti
authors.forename: Adam
authors.initials: A
authors.lastname: Bisaga
authors.forename: Maria A
authors.initials: MA
authors.lastname: Sullivan
authors.forename: Kenneth M
authors.initials: KM
authors.lastname: Carpenter
mesh_terms: D000328:Adult; D018687:Antidepressive Agents, Second-Generation / Q000008:administration & dosage* / Q000009:adverse effects; D015928:Cognitive Behavioral Therapy / Q000379:methods; D003131:Combined Modality Therapy; D003511:Cyclohexanols / Q000008:administration & dosage* / Q000009:adverse effects; D003692:Delayed-Action Preparations; D003865:Major Depressive Disorder / Q000188:drug therapy* / Q000209:etiology; D004311:Double-Blind Method; D013759:Dronabinol / Q000652:urine; D005260:Female; D006801:Humans; D008297:Male; D002189:Marijuana Abuse / Q000188:drug therapy* / Q000523:psychology / Q000652:urine; D055118:Medication Adherence; D012008:Recurrence; D017367:Selective Serotonin Reuptake Inhibitors / Q000008:administration & dosage* / Q000009:adverse effects; D017211:Treatment Failure; D000069470:Venlafaxine Hydrochloride
chemical_list: D018687:Antidepressive Agents, Second-Generation; D003511:Cyclohexanols; D003692:Delayed-Action Preparations; D013759:Dronabinol; D017367:Selective Serotonin Reuptake Inhibitors; D000069470:Venlafaxine Hydrochloride