Selective serotonin reuptake inhibitors in the treatement of cannabis dependence

Treatment of cannabis dependence should aim cannabis abstinence and psychosocial support as in general dependency treatment approach.

The cannabis detoxification of the patient might be achieved by treatment interventions in hospital setting or following up the patient closely in outpatient setting. In outpatient setting, the regular urinalyses and close monitoring of the patient must be carried out. The metabolites of the cannabinoids could be detected in urinalysis from 3 days up to 4 weeks following the last use.

Individual, family, and group psychotherapies might be beneficial while supporting the patient. Education is the most important element for both "abstinence" and "support programs," as the motivation to quit and not to restart is primarily due to education on the effects and harmful consequences of cannabis abuse. Tranquilizer drugs might be efficient in short term withdrawal symptoms that might be seen in cannabis abusers or addicts.

Selective serotonin reuptake inhibitors (SSRIs) as other antidepressant agents may be used in the treatment of depressive patients, who use cannabis as a self treatment for depression, and in co-morbid depression of cannabis use disorders or in depressive symptoms caused by cannabis abuse. In addition, SSRIs might also be used in the treatment of cannabis-induced anxiety disorders.

There is growing interest in the use of antidepressants in cannabis abuse because of highly reported depression rates during the treatment of cannabis abuse or after the cessation. Nevertheless, there is a dearth of knowledge about the treatment of cannabis abuse with SSRIs. In a double blind placebo controlled study, şuoxetine has been reported to decrease the frequency of cannabis use in alcoholic patients with depression.

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