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Original Articles

Guanfacine extended-release for cannabis use disorder: a pilot feasibility trial

, , , , , & show all
Pages 44-48 | Received 06 Aug 2017, Accepted 13 May 2019, Published online: 24 Jul 2019
 

ABSTRACT

Background: Currently, there are no established pharmacotherapies for cannabis use disorders (CUDs). As a long-acting alpha-2-adrenergic receptor agonist, guanfacine extended-release (G-XR) could be useful in the treatment of CUDs by mitigating withdrawal and improving behavioral control.

Objectives: To evaluate the feasibility and tolerability of G-XR as a treatment for CUDs.

Methods: In an eight-week open-label outpatient pilot trial, we evaluated the safety and tolerability of G-XR in 22 cannabis dependent individuals. Using 2 different titration schedules, G-XR was gradually titrated to a dose of 4 mg or the highest dose tolerated. All participants received standard medication management.

Results: Retention at week eight was 41%. Average daily amount of cannabis use (in grams: F1,86 = 8.74, p = .004; in dollars: F1,86 = 16.67, p < .0001) and cannabis using days (F1,86 = 7.67, p = .007) significantly reduced over the course of study participation. There were no significant differences between the titration schedules on emergence of side effects (Fisher exact test, p = .378) or retention (Log-Rank Test X21 = 0.021, p = .886). A total of 3 participants achieved 3 weeks or greater of total abstinence.

Conclusions: G-XR is a feasible treatment for CUDs, and should be evaluated further in an efficacy trial.

Disclosures

The authors have no conflicts of interest to report.

Additional information

Funding

This trial was funded the NIDA [grant DA029647].

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