It caused almost half of the study volunteers to drop out.
Marijuana advocates will insist that it’s impossible to get addicted to the psychedelic plant, but that’s not exactly the case. Yes, the withdrawal is extremely mild compared to other drug addictions, but chronic marijuana users can still become dependent on weed.
According to the National Institute on Drug Abuse, “Over time, overstimulation of the endocannabinoid system by marijuana use can cause changes in the brain that lead to addiction, a condition in which a person cannot stop using a drug even though it interferes with many aspects of his or her life.”
In order to help people who are dependent on marijuana or simply want to cut back on smoking, scientists are trying to find a medication to treat cannabis dependence. A new study found that combining psychological counseling with the drug topiramate, an epilepsy drug marketed as Topamax, combats marijuana dependence among young smokers significantly more than counseling on its own.
The 66 study volunteers, all aged 15–24 and interested in receiving psychological and drug treatment to reduce their marijuana use, reported that they smoked at least twice a week. Heavy marijuana use is linked to impaired memory and cognitive function, and difficulty sustaining attention and filtering out irrelevant information. According to the researchers, more than half of the participants met the clinical criteria for marijuana dependence or abuse during the initial screening.
All of the participants received 50-minute counseling sessions during the six-week study (at weeks one, three, and five), which involved professionally guided motivational discussion about quitting or reducing marijuana use. 40 of the 66 study participants received topiramate on top of the counseling, while the rest were given a placebo.
For those who were given topiramate, the doses slowly scaled up from 25 milligrams during the first week to 200 milligrams by the fifth week. The doses were weaned off a few days after the study ended.
Throughout the study, volunteers self-reported how often they smoked pot and how much, and urine tests also showed whether they were using marijuana and either the medicine or the placebo. Both groups reduced the number of days they smoked, but those who took the medication also used about 0.2 fewer grams of cannabis each time, on average.
Sounds promising, right?
However, there was one big problem. Over half of the study participants who were given the medication experienced nasty side effects including depression, anxiety, trouble with coordination and balance, weight loss, and unusual sensations. By the end of the study, 21 of the 50 participants taking the drug had dropped out, while only six taking the placebo decided to discontinue participating. Two-thirds of the volunteers who dropped out cited the awful side effects of topiramate as their reason for leaving.
Robert Miranda Jr., associate professor (research) of psychiatry and human behavior at Brown University, says the results were “promising in the sense that it suggests that medications can help, but it asks questions about for whom it might be most effective because many people can’t tolerate the medication.”
Next, the researchers plan to conduct a larger and possibly longer trial in hopes to determine whether genetic markers or other factors would be able to help predict which individuals would be least affected by the side effects of topiramate.
Unfortunately, there is no FDA-approved medication for treating cannabis dependence and misuse, and the benefits of psychological counseling aren’t enough to help many patients, the researchers say. Hopefully future research will lead to effective ways to curb marijuana dependence without all of the nasty side effects.