Proof of concept trial of dronabinol in obstructive sleep apnea.

Abstract:

STUDY OBJECTIVE:Animal data suggest that Δ(9)-TetraHydroCannabinol (Δ(9)THC) stabilizes autonomic output during sleep, reduces spontaneous sleep-disordered breathing, and blocks serotonin-induced exacerbation of sleep apnea. On this basis, we examined the safety, tolerability, and efficacy of dronabinol (Δ(9)THC), an exogenous Cannabinoid type 1 and type 2 (CB1 and CB2) receptor agonist in patients with Obstructive Sleep Apnea (OSA). DESIGN AND SETTING:Proof of concept; single-center dose-escalation study of dronabinol. PARTICIPANTS:Seventeen adults with a baseline Apnea Hypopnea Index (AHI) ≥15/h. Baseline polysomnography (PSG) was performed after a 7-day washout of Continuous Positive Airway Pressure treatment. INTERVENTION:Dronabinol was administered after baseline PSG, starting at 2.5 mg once daily. The dose was increased weekly, as tolerated, to 5 mg and finally to 10 mg once daily. MEASUREMENTS AND RESULTS:Repeat PSG assessments were performed on nights 7, 14, and 21 of dronabinol treatment. Change in AHI (ΔAHI, mean ± SD) was significant from baseline to night 21 (-14.1 ± 17.5; p = 0.007). No degradation of sleep architecture or serious adverse events was noted. CONCLUSION:Dronabinol treatment is safe and well-tolerated in OSA patients at doses of 2.5-10 mg daily and significantly reduces AHI in the short-term. These findings should be confirmed in a larger study in order to identify sub-populations with OSA that may benefit from cannabimimetic pharmacologic therapy.

journal_name

Front Psychiatry

journal_title

Frontiers in psychiatry

authors

Prasad B,Radulovacki MG,Carley DW

doi

10.3389/fpsyt.2013.00001

subject

Has Abstract

pub_date

2013-01-22 00:00:00

pages

1

issn

1664-0640

journal_volume

4

pub_type

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