Article

Dronabinol and Marijuana in HIV-Positive Marijuana Smokers: Caloric intake, Mood and Sleep

Department of Psychology, Columbia University, New York, New York, United States
JAIDS Journal of Acquired Immune Deficiency Syndromes (Impact Factor: 4.39). 09/2007; 45(5):545-54. DOI: 10.1097/QAI.0b013e31811ed205
Source: PubMed

ABSTRACT Individuals with HIV constitute the largest group using cannabinoids for medicinal reasons; yet, no studies have directly compared the tolerability and efficacy of smoked marijuana and oral dronabinol maintenance in HIV-positive marijuana smokers. This placebo-controlled within-subjects study evaluated marijuana and dronabinol across a range of behaviors: eating topography, mood, cognitive performance, physiologic measures, and sleep.
HIV-positive marijuana smokers (n = 10) completed 2 16-day inpatient phases. Each dronabinol (5 and 10 mg) and marijuana (2.0% and 3.9% Delta9-tetrahydrocannabinol [THC]) dose was administered 4 times daily for 4 days, but only 1 drug was active per day, thereby maintaining double-blind dosing. Four days of placebo washout separated each active cannabinoid condition.
As compared with placebo, marijuana and dronabinol dose dependently increased daily caloric intake and body weight in HIV-positive marijuana smokers. All cannabinoid conditions produced significant intoxication, except for low-dose dronabinol (5 mg); the intoxication was rated positively (eg, "good drug effect") with little evidence of discomfort and no impairment of cognitive performance. Effects of marijuana and dronabinol were comparable, except that only marijuana (3.9% THC) improved ratings of sleep.
These data suggest that for HIV-positive marijuana smokers, both dronabinol (at doses 8 times current recommendations) and marijuana were well tolerated and produced substantial and comparable increases in food intake.

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    • "Some reports have pointed out that synthetic Δ 9 -THC (marinol, dronabinol), which is used clinically to suppress chemotherapy-induced nausea and vomiting and to increase appetite in patients with AIDS, can modulate sleep. Haney et al. (2007) have shown that HIV-positive marijuana smokers displayed signs of improved sleep when they received dronabinol (5 and 10 mg) Fig. 29.2 Pharmacological effects of Δ 9 -tetrahydrocannabinol, cannabidiol and nabilone on the sleep-wake cycle. REMS, rapid eye movement sleep; SWS, slow-wave sleep. "
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    • "Marijuana has been reported to alleviate neuropathic pain, nausea, mood problems, and appetite loss from HIV/AIDS (Abrams et al., 2007; Corless et al., 2009; Ellis et al., 2009; Haney et al., 2007; Prentiss, Power, Balmas, Tzuang, & Israelski, 2004), and over a dozen U.S. states have decriminalized marijuana for medical use, with most of them identifying HIV/AIDS as a condition that may benefit from medical marijuana (NORML, 2010). Not surprisingly, there is a high prevalence of medical and recreational marijuana use among individuals with HIV (Fairfield, Eisenberg, Davis, Libman, & Phillips, 1998; Prentiss et al., 2004; Sidney, 2001). "
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