Use of a Synthetic Cannabinoid in a Correctional Population for Posttraumatic Stress Disorder-Related Insomnia and Nightmares, Chronic Pain, Harm Reduction, and Other Indications A Retrospective Evaluation
Use of a Synthetic Cannabinoid in a Correctional Population for Posttraumatic Stress Disorder-Related Insomnia and Nightmares, Chronic Pain, Harm Reduction, and Other Indications A Retrospective Evaluation
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DOI：
10.1097/jcp.0000000000000180
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发表时间：
2014-10-01
影响因子：
2.9
通讯作者：
Robinson, Jeffrey
中科院分区：
文献类型：
--
作者：
Cameron, Colin;Watson, Diane;Robinson, Jeffrey
纳比龙是一种合成大麻素，有望用于治疗创伤后应激障碍（PTSD）相关的失眠和噩梦，以及治疗慢性疼痛的疗效。它也被提议用于减少大麻依赖的危害。它对严重精神疾病矫正人群并发疾病管理的有效性尚未得到评估。本研究对104名患有严重精神疾病的男性囚犯进行回顾性研究，分析其适应症、疗效和使用安全性。随着纳比龙的开始而停止的药物也进行了回顾。结果显示，纳比龙平均针对每位患者3.5个适应症，从而可能降低多药风险。平均最终剂量为4.0 mg。结果显示创伤后应激障碍相关的失眠、噩梦、创伤后应激障碍症状、整体功能评估和慢性疼痛的主观改善有显著改善。与纳比龙相比，不良反应或滥用风险更大的药物往往能够随着纳比龙的开始而停止使用，最常见的是抗精神病药和镇静/催眠药。没有证据表明在这一高危人群中滥用纳比龙，也没有证据表明纳比龙以粉剂形式加水而不是胶囊形式给予疗效降低。这项研究支持纳比龙作为一种安全、有效的治疗严重精神疾病矫正人群并发疾病的方法。需要前瞻性、随机对照试验来证实我们的初步结果。将需要在社区开展后续行动，以确认在减少危害方面的有效性。
Nabilone is a synthetic cannabinoid that has shown promise for the treatment of posttraumatic stress disorder (PTSD)-related insomnia and nightmares as well as efficacy in the management of chronic pain. It has also been proposed for harm reduction in cannabis dependence. Its effectiveness for management of concurrent disorders in seriously mentally ill correctional populations has not been evaluated. This retrospective study of 104 male inmates with serious mental illness prescribed nabilone analyzes the indications, efficacy, and safety of its use. Medications discontinued with the initiation of nabilone were also reviewed. The results showed nabilone targeting a mean of 3.5 indications per patient, thus likely reducing polypharmacy risk. The mean final dosage was 4.0 mg. Results indicated significant improvement in PTSD-associated insomnia, nightmares, PTSD symptoms, and Global Assessment of Functioning and subjective improvement in chronic pain. Medications associated with greater risk for adverse effects or abuse than nabilone were often able to be discontinued with the initiation of nabilone, most often antipsychotics and sedative/hypnotics. There was no evidence of abuse within this high-risk population or reduction of efficacy when nabilone was given in powder form with water rather than as a capsule. This study supports the promise of nabilone as a safe, effective treatment for concurrent disorders in seriously mentally ill correctional populations. Prospective, randomized controlled trials are required to confirm our preliminary results. Follow-up in the community will be required to confirm effectiveness in harm reduction.