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Open Access Highly Accessed Review

Pharmacological interventions in the treatment of the acute effects of cannabis: a systematic review of literature

José AS Crippa1*, Guilherme N Derenusson1, Marcos HN Chagas1, Zerrin Atakan2, Rocio Martín-Santos3, Antonio W Zuardi1 and Jaime EC Hallak1

Author Affiliations

1 Department of Neurosciences and Behavior, Ribeirão Preto Medical School, University of São Paulo and INCT Translational Medicine (CNPq), Brazil

2 Section of Neuroimaging, Box PO67, Division of Psychological Medicine & Psychiatry, Institute of Psychiatry, King's College London, De Crespigny Park, London, SE5 8AF, UK

3 Department of Psychiatry, Institute of Neurosciences, Hospital Clínic, IDIBAPS, CIBERSAM, Barcelona, Spain and INCT Translational Medicine (CNPq), Brazil

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Harm Reduction Journal 2012, 9:7  doi:10.1186/1477-7517-9-7

Published: 25 January 2012

Abstract

Background

Cannabis intoxication is related to a number of physical and mental health risks with ensuing social costs. However, little attention has been given to the investigation of possible pharmacological interactions in this condition.

Objective

To review the available scientific literature concerning pharmacological interventions for the treatment of the acute effects of cannabis.

Methods

A search was performed on the Pubmed, Lilacs, and Scielo online databases by combining the terms cannabis, intoxication, psychosis, anxiety, and treatment. The articles selected from this search had their reference lists checked for additional publications related to the topic of the review.

Results

The reviewed articles consisted of case reports and controlled clinical trials and are presented according to interventions targeting the physiological, psychiatric, and cognitive symptoms provoked by cannabis. The pharmacological interventions reported in these studies include: beta-blockers, antiarrhythmic agents, antagonists of CB-1 and GABA-benzodiazepine receptors, antipsychotics, and cannabidiol.

Conclusion

Although scarce, the evidence on pharmacological interventions for the management of cannabis intoxication suggests that propanolol and rimonabant are the most effective compounds currently available to treat the physiological and subjective effects of the drug. Further studies are necessary to establish the real effectiveness of these two medications, as well as the effectiveness of other candidate compounds to counteract the effects of cannabis intoxication, such as cannabidiol and flumazenil.

Keywords:
cannabis; intoxication; acute effects; psychosis; anxiety; pharmacological treatment