Pharmacotherapies Targeting GABA and Glutamate for Cannabis Use Disorder

Introduction

• This article is based on the ASAM Review of Potential Pharmacological Treatments for Cannabis Abuse published on August 9,2021.

• GABA and Glutamate transmission is altered through the actions of the CB1 receptor.

• Human studies have tested how restoring the activity of GABA and Glutamate can be used as a treatment for cannabis use disorder

Baclofen

• Derivative of GABA

• Human laboratory studies:

  • Showed no improvement in withdrawal or relapse

  • Showed reduction in cravings.

Gabapentin

• Similar structure to GABA however binds poorly to GABA receptors

• Clinical Trial (1200 mg/day) for CUD:

  • High Drop out rate makes findings less reliable

  • Attenuates severity of withdrawal.

  • Reduced cannabis use compared to placebo

N-Acetylcysteine (NAC)

• Restores normal glutamate activity that is disrupted by chronic drug use by up-regulatine cysteine-glutamate exchange.

• Clinical trial (1200 mg, bid) in combinateion with contingency mangagement

  • Patients receiving NAC were more likely to reduce their cannabis consumption compared to CM alone

References

1. American Society of Addiction Medicine. (2021, August 9). A review of potential pharmacological treatments for cannabis abuse. https://www.asam.org/blog-details/article/2021/08/09/a-review-of-potential-pharmacological-treatments-for-cannabis-abuse