CLINICAL RELEVANCE OF CANNABIS TOLERANCE AND DEPENDENCE
CLINICAL RELEVANCE OF CANNABIS TOLERANCE AND DEPENDENCE
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DOI：
10.1002/j.1552-4604.1981.tb02589.x
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发表时间：
1981-01-01
影响因子：
2.9
通讯作者：
HERNING, RI
中科院分区：
文献类型：
--
作者：
JONES, RT;BENOWITZ, NL;HERNING, RI
在耐受性和依赖性得到充分认识之前，精神活性药物常常被广泛使用。对大麻引起的心血管和自主神经变化、眼压降低、睡眠和睡眠脑电图、情绪和行为变化的耐受性是获得的，但在最佳条件下，很大程度上会迅速消失。机制似乎比新陈代谢更具功能性。获得率取决于剂量和剂量方案。依赖性，在 THC 给药短短 7 天后就会出现戒断症状，其特征是烦躁、烦躁、失眠、厌食、恶心、出汗、流涎、体温升高、睡眠和清醒脑电图改变、震颤和体重减轻。在所研究的 120 名受试者中，这种症状是轻微且短暂的，类似于镇静药物戒断症状。对药物副作用的耐受性可能是有用的。对治疗效果或目标症状的耐受性会带来问题。由于寻求药物行为有许多决定因素，因此很难评估依赖性的临床意义。在癫痫、青光眼或慢性疼痛等疾病中，只要预期长期服用药物，就应考虑大麻引起的超敏反应。大麻药理学提出了尽量减少耐受性和依赖性问题的方法。
Psychoactive drugs are often widely used before tolerance and dependence is fully appreciated. Tolerance to cannabis‐induced cardiovascular and autonomic changes, decreased intraocular pressure, sleep and sleep EEG, mood and behavioral changes is acquired and, to a great degree, lost rapidly with optimal conditions. Mechanisms appear more functional than metabolic. Acquisition rate depends on dose and dose schedule. Dependence, manifested by withdrawal symptoms after as little as 7 days of THC administration, is characterized by irritability, restlessness, insomnia, anorexia, nausea, sweating, salivation, increased body temperature, altered sleep and waking EEG, tremor, and weight loss. Mild and transient in the 120 subjects studied, the syndrome was similar to sedative drug withdrawal. Tolerance to drug side effects can be useful. Tolerance to therapeutic effects or target symptoms poses problems. Clinical significance of dependence is difficult to assess since drug‐seeking behavior has many determinants. Cannabis‐induced super sensitivity should be considered wherever chronic drug administration is anticipated in conditions like epilepsy, glaucoma or chronic pain. Cannabis pharmacology suggests ways of minimizing tolerance and dependence problems.