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Compared with placebo or supportive care, how effective are pharmacotherapies for reducing symptoms of cannabis withdrawal and promoting cessation or reduction of cannabis use?
There was incomplete evidence for all of the pharmacotherapies investigated. Antidepressants, bupropion, buspirone and atomoxetine were of little value in the treatment of cannabis dependence. Preparations containing tetrahydrocannabinol (THC) were of potential value in the treatment of cannabis dependence, but limitations in the evidence were such that this application of THC preparations should be considered still experimental. The evidence base for gabapentin and N-acetylcysteine was weak, and it was not possible to quantitatively estimate their effectiveness.
Quantitative analysis was not possible for most of the outcomes, and was limited for most of the pharmacotherapies investigated. The quality of evidence for many of the outcomes was downgraded due to small sample size, inconsistency and risk of attrition bias.
Cannabis is the most prevalent illicit drug in the world. Demand for treatment of cannabis use disorders is increasing. There are currently no pharmacotherapies approved for treatment of cannabis use disorders.
Marshall K et al. Pharmacotherapies for cannabis dependence. Cochrane Reviews, 2014, Issue 12. Art. No.: CD008940.DOI: 10.1002/14651858. CD008940.pub2. This review contains 14 studies involving 958 participants.
Cochrane Systematic Reviews for primary care practitioners
Developed by the Cochrane Primary Care Field, New Zealand Branch of the Australasian Cochrane Centre at the Department of General Practice and Primary Health Care, University of Auckland and funded by the Ministry of Health and New Zealand Doctor. PEARLS are meant for educational use and not to guide clinical care. New Zealanders can access the Cochrane Library free via www.cochrane.org.nz
Prostate cancer consultations are common in primary care and there is no one approach to testing and treatment that fits all patients. Urologist Simon van Rij discusses the key considerations and options for personalised care, appropriate investigation and treatment
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