What do we know about the pharmacotheraputic management of insomnia in cannabis withdrawal: A systematic review.
Level 1 - systematic review of randomized trials
Systematic review of human pharmacological intervention studies
PubMed 30113101 · doi:10.1111/ajad.12783
What was done
Researchers conducted a systematic review across five electronic databases (PubMed, Psycinfo, MEDLINE, Cochrane review, and Embase) examining pharmacological treatments for sleep disturbance associated with cannabis withdrawal in humans. Review articles, case-series, open trials, posters, and editorials were excluded.
What was found
Seventeen publications covering 562 participants and 12 pharmacological agents met inclusion criteria. No meta-analysis was performed and the abstract reports no pooled quantitative effect estimates due to data limitations and heterogeneity. Evidence was deemed insufficient for any treatment option, though Gabapentin, Lofexidine, Mirtazapine, Quetiapine, and Zolpidem showed preliminary benefits for sleep difficulties.
Why it matters
Sleep disturbance is a hallmark of cannabis withdrawal that can impede abstinence, but current pharmacotherapeutic strategies lack sufficient evidence to guide clinical practice.
Limits
The included studies were limited by small sample sizes, high dropout rates, participant heterogeneity, and significant methodological limitations. Most studies were judged to be at high risk of bias.
Cited by
- supports Sleeplessness is a clinical symptom of cannabis withdrawal.