A double-blind randomized controlled trial of N-acetylcysteine in cannabis-dependent adolescents.
A double-blind randomized controlled trial of N-acetylcysteine in cannabis-dependent adolescents.
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DOI：
10.1176/appi.ajp.2012.12010055
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发表时间：
2012-08
期刊：
影响因子：
--
通讯作者：
Brady KT
中科院分区：
文献类型：
--
作者：
Gray KM;Carpenter MJ;Baker NL;DeSantis SM;Kryway E;Hartwell KJ;McRae-Clark AL;Brady KT
临床前的研究结果表明，通过伏隔核中谷氨酸的调节，非处方药补充N-乙酰半胱氨酸有望成为一种针对物质依赖的药物治疗。我们试图研究N-乙酰半胱氨酸作为一种新的大麻戒断疗法在青少年中的应用，这是一个现有治疗方法对其疗效有限的脆弱群体。在这项为期8周的双盲随机安慰剂对照试验中，寻求治疗的大麻依赖青少年(15-21岁，N=116)每天接受两次N-乙酰半胱氨酸(1200 Mg)或安慰剂治疗，每次都增加了应急管理干预和每周简短的戒烟咨询(≤10分钟)。通过意向治疗分析，主要的疗效衡量标准是接受N-乙酰半胱氨酸治疗的参与者与服用安慰剂的参与者在治疗期间每周尿大麻素试验阴性的几率。主要的耐受性测量是不良事件的频率，与治疗组相比较。N-乙酰半胱氨酸耐受性良好，不良反应最小。与安慰剂参与者相比，N-乙酰半胱氨酸参与者在治疗期间提交尿大麻素阴性测试的几率是安慰剂组的两倍多(优势比=2.4，[95%可信区间：1.1-5.2]，p=0.029)。探索性二次禁欲的结果在数值上有利于N-乙酰半胱氨酸，但没有统计学意义。这是第一次在任何年龄段的大麻依赖药物治疗的随机试验，通过意向治疗分析产生了积极的初步戒烟结果。研究结果支持N-乙酰半胱氨酸作为一种药物疗法来补充青少年大麻依赖的心理社会治疗。需要进一步的研究来重复这些发现，并探索N-乙酰半胱氨酸在各种治疗环境和结果中的疗效。ClinicalTrials.gov标识：nct 01005810
Preclinical findings suggest that the over-the-counter supplement N-acetylcysteine, via glutamate modulation in the nucleus accumbens, holds promise as a pharmacotherapy targeting substance dependence. We sought to investigate N-acetylcysteine as a novel cannabis cessation treatment in adolescents, a vulnerable group for whom existing treatments have limited efficacy. In this 8-week double-blind randomized placebo-controlled trial, treatment-seeking cannabis-dependent adolescents (age 15-21, N = 116) received N-acetylcysteine (1200 mg) or placebo twice daily, each added to a contingency management intervention and brief (≤10 minute) weekly cessation counseling. The primary efficacy measure was the odds of negative weekly urine cannabinoid tests during treatment among participants receiving N-acetylcysteine versus placebo, via intent-to-treat analysis. The primary tolerability measure was frequency of adverse events, compared by treatment group. N-acetylcysteine was well tolerated with minimal adverse events. N-acetylcysteine participants had more than twice the odds, compared to placebo participants, of submitting negative urine cannabinoid tests during treatment (odds ratio = 2.4, [95% CI: 1.1-5.2], p = 0.029). Exploratory secondary abstinence outcomes numerically favored N-acetylcysteine, but were not statistically significant. This is the first randomized trial of pharmacotherapy for cannabis dependence in any age group yielding a positive primary cessation outcome via intent-to-treat analysis. Findings support N-acetylcysteine as a pharmacotherapy to complement psychosocial treatment for cannabis dependence in adolescents. Further research is needed to replicate these findings and explore the efficacy of N-acetylcysteine across a variety of treatment contexts and outcomes. clinicaltrials.gov identifier: NCT 01005810
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影响因子：
25
作者：
Moussawi, Khaled;Pacchioni, Alejandra;Moran, Megan;Olive, M. Foster;Gass, Justin T.;Lavin, Antonieta;Kalivas, Peter W.
通讯作者：
Kalivas, Peter W.
DOI：
10.1016/j.pbb.2011.04.015
发表时间：
2012-02
期刊：
Pharmacology, biochemistry, and behavior
影响因子：
--
作者：
Olive MF;Cleva RM;Kalivas PW;Malcolm RJ
通讯作者：
Malcolm RJ
影响因子：
3.4
作者：
Murray, Jennifer E.;Everitt, Barry J.;Belin, David
通讯作者：
Belin, David
DOI：
10.1073/pnas.1011265108
发表时间：
2011-01-04
影响因子：
11.1
作者：
Moussawi, Khaled;Zhou, Wenhua;Kalivas, Peter W.
通讯作者：
Kalivas, Peter W.
戒烟试验的安慰剂应答率是否会导致成瘾的力量？
DOI：
10.3390/ijerph9010192
发表时间：
2012-01
影响因子：
--
作者：
Moore RA;Aubin HJ
通讯作者：
Aubin HJ