A randomized double-blind, placebo-controlled trial of venlafaxine-extended release for co-occurring cannabis dependence and depressive disorders.
Open accessAbstract
Aim: To evaluate whether venlafaxine‐extended release (VEN‐XR) is an effective treatment for cannabis dependence with concurrent depressive disorders. Design: This was a randomized, 12‐week, double‐blind, placebo‐controlled trial of out‐patients (n = 103) with DSM‐IV cannabis dependence and major depressive disorder or dysthymia. Participants received up to 375 mg VEN‐XR on a fixed‐flexible schedule or placebo. All patients received weekly individual cognitive–behavioral psychotherapy that primarily targeted marijuana use. Settings: The trial was conducted at two university research centers in the U nited S tates. Participants: One hundred and three cannabis‐dependent adults participated in the trial. Measurements: The primary outcome measures were (i) abstinence from marijuana defined as at least two consecutive urine‐confirmed abstinent weeks and (ii) improvement in depressive symptoms based on the H amilton D epression R ating S cale. Findings: The proportion of patients achieving a clinically significant mood improvement (50% decrease in Hamilton Depression score from baseline) was high and did not differ between groups receiving VEN‐XR (63%) and placebo (69%) (χ 12 = 0.48, P = 0.49). The proportion of patients achieving abstinence was low overall, but was significantly worse on VEN‐XR (11.8%) compared to placebo (36.5%) (χ 12 = 7.46, P < 0.01; odds ratio = 4.51, 95% confidence interval: 1.53, 13.3). Mood improvement was associated with reduction in marijuana use in the placebo group (F1,179 = 30.49, P < 0.01), but not the VEN‐XR group (F1,186 = 0.02, P = 0.89). Conclusions: For depressed, cannabis‐dependent patients, venlafaxine‐extended release does not appear to be effective at reducing depression and may lead to an increase in cannabis use.
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“Interestingly, venlafaxine has been shown to be ineffective in treating depressive symptoms comorbid with cannabis use, and may in fact be associated with greater cannabis use (Levin et al., 2013).”
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- Authors
- Levin, F. R., Mariani, J., Brooks, D. J., Pavlicova, M., Nunes, E. V., Agosti, V., Bisaga, A., Sullivan, M. A., & Carpenter, K. M.
- Affiliations
- New York State Psychiatric Institute (US)
- Department of Biostatistics Columbia University New York NY USA
- Columbia University (US)
- Corresponding author
- Levin, Frances R.
- ORCID
- Venue
- Addiction
- Publisher
- Wiley
- Published
- 2013-03-21
- Volume
- 108
- Issue
- 6
- Pages
- 1084-1094
- ISSN
- 0965-2140 (ISSN-L)
- 1360-0443
- PMC
- PMC3636166
- OpenAlex
- W1571318933
- Cited by
- 89
- References
- 54
- Citations by year
- 2026: 5 · 2025: 4 · 2024: 8 · 2023: 5 · 2022: 3 · 2021: 8 · 2020: 5 · 2019: 5 · 2018: 12 · 2017: 6 · 2016: 9 · 2015: 8 · 2014: 10 · 2013: 1
- FWCI
- 6.87
- Type
- journal article
- Language
- en
- Open access
- green
- europepmc.org
- Locations
- Addiction (publishedVersion)
- PubMed (publishedVersion)
- Europe PMC (PubMed Central) (acceptedVersion)
- PubMed Central (acceptedVersion)
- Funders
- New York State Psychiatric Institute
- U.S. Public Health Service (KO2 000465)
- National Institute on Drug Abuse (K24DA022412, K02DA000465, R01DA15451, R01DA015451, K24DA029647)
- Topics
- Health Sciences › Medicine › Pharmacology › Cannabis and Cannabinoid Research
- Health Sciences › Medicine › Pharmacology › Treatment of Major Depression
- Health Sciences › Medicine › Epidemiology › Substance Abuse Treatment and Outcomes
- Keywords
- venlafaxine extended release, cannabis use disorder, major depressive disorder, dysthymia, co-occurring disorders, cognitive behavioral therapy, antidepressant efficacy
- MeSH terms
- Venlafaxine Hydrochloride, Adult, Marijuana Abuse, Combined Modality Therapy, Cyclohexanols, Delayed-Action Preparations, Depressive Disorder, Major, Major Depressive Disorder, Double-Blind Method, Female, Humans, Male, Recurrence, Dronabinol, Cognitive Behavioral Therapy, Treatment Failure, Selective Serotonin Reuptake Inhibitors, Antidepressive Agents, Second-Generation, Medication Adherence
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