Cannabis is the most widely used illicit drug in Australia. General practice on the Mid-North coast of NSW is experiencing increased presentations of patients exhibiting dependence/harmful use. Little research has been done on evaluating effective and safe medications for cannabis withdrawal an alternative to benzodiazepines and as an adjunct to psychological interventions. Abstinence syndrome following abrupt cessation of heavy use includes irritability, anxiety, craving and insomnia. Pericyazine is a typical antipsychotic that has been used mainly for anxiety. There are anecdotal reports of its safe and effective role in the improvement of cannabis withdrawal.
A small case-control study is being conducted to assess the safety and efficacy of pericyazine in the treatment of cannabis withdrawal. Thirty participants are being recruited from: Aboriginal Medical Service and a Drug & Alcohol Service on the Mid-North coast of NSW. Patients are given the option to receive a 4 week course of pericyazine (up to 8 x 2.5 mg tablets daily) and weekly review or to receive weekly review only. Side-effects, ECG, blood tests monitored. Brief intervention is also offered to all patients. Measures of dependence severity, depression, anxiety, insomnia and levels of cannabis use are taken at baseline and 4-week follow-up utilizing validated psychometric tools.
Preliminary results have yielded 15 completed subjects that at baseline were smoking, on average, 204 cones of cannabis per week. On average:31 years of age, 73% male, 60% single, 60% unemployed and 20% aboriginal. 2 subjects have reported sedative side-effects and no subjects reported phenothiazine related side-effects. Subjects opting for pharmacotherapy have displayed marked reduction in cannabis use.
Follow-up data on the remaining subjects will be collated and the final efficacy and safety results will be reported. Preliminary results suggest that pericyazine is a useful, safe, simple short-term treatment to minimize the acute withdrawal symptoms from cannabis dependence.