title: Buspirone treatment of cannabis dependence: A randomized, placebo-controlled trial.
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.
authors.affiliation: Department of Psychiatry, Medical University of South Carolina, Charleston, SC 29425, USA. Electronic address: mcraeal@musc.edu.
authors.forename: Aimee L
authors.initials: AL
authors.lastname: McRae-Clark
authors.affiliation: Department of Public Health Sciences, Medical University of South Carolina, Charleston, SC 29425, USA.
authors.forename: Nathaniel L
authors.initials: NL
authors.lastname: Baker
authors.affiliation: Department of Psychiatry, Medical University of South Carolina, Charleston, SC 29425, USA.
authors.forename: Kevin M
authors.initials: KM
authors.lastname: Gray
authors.affiliation: Department of Psychiatry, Medical University of South Carolina, Charleston, SC 29425, USA.
authors.forename: Therese K
authors.initials: TK
authors.lastname: Killeen
authors.affiliation: Department of Psychiatry, Medical University of South Carolina, Charleston, SC 29425, USA.
authors.forename: Amanda M
authors.initials: AM
authors.lastname: Wagner
authors.affiliation: Department of Psychiatry, Medical University of South Carolina, Charleston, SC 29425, USA.
authors.forename: Kathleen T
authors.initials: KT
authors.lastname: Brady
authors.affiliation: Department of Psychiatry, Medical University of South Carolina, Charleston, SC 29425, USA.
authors.forename: C Lindsay
authors.initials: CL
authors.lastname: DeVane
authors.affiliation: Department of Psychiatry, Medical University of South Carolina, Charleston, SC 29425, USA.
authors.forename: Jessica
authors.initials: J
authors.lastname: Norton
mesh_terms: D000328:Adult; D000483:Alleles; D002065:Buspirone / Q000008:administration & dosage / Q000009:adverse effects / Q000627:therapeutic use*; D002186:Cannabinoids / Q000097:blood; D003131:Combined Modality Therapy; D004311:Double-Blind Method; D005260:Female; D006801:Humans; D008297:Male; D002189:Marijuana Abuse / Q000188:drug therapy* / Q000523:psychology; D009042:Motivation; D010349:Patient Compliance; D011613:Psychotherapy; D044282:Receptor, Serotonin, 5-HT1A / Q000235:genetics; D017366:Serotonin Receptor Agonists / Q000008:administration & dosage / Q000009:adverse effects / Q000627:therapeutic use*; D012727:Sex Characteristics; D016896:Treatment Outcome; D055815:Young Adult
chemical_list: D002186:Cannabinoids; D017366:Serotonin Receptor Agonists; D044282:Receptor, Serotonin, 5-HT1A; D002065:Buspirone
keywords: Buspirone; Cannabis; Contingency management; Gender differences; Motivational enhancement therapy