No medication is currently recognized in the management of cannabis withdrawal and given the anxiolytic MI-773 cell line effects of this drug we decided to propose treatment with baclofen, a drug that we also commonly use, off label, in our addiction department for the treatment of alcohol dependence. Before
starting treatment and after informing the patient and obtaining his consent, we carried out a somatic and biological assessment which showed no abnormality and a urine screen attested to the consumption of cannabis. The Cannabis Withdrawal Scale (CWS) [Allsop et al. 2011] score was 79/190 and the Cannabis Abuse Screening Test (CAST) [Legleye et al. 2012] score was 6/6. We then Inhibitors,research,lifescience,medical initiated treatment with baclofen at a dose
of 15 mg/day divided into three doses of 5 mg (given in the morning, afternoon and evening). The dose was then increased by 15 mg each week to reach a maximum dose of 60 mg per day after 4 weeks of monitoring (20 mg in the morning, 20 mg at noon and 20 mg in the evening). During the first 2 weeks of treatment Inhibitors,research,lifescience,medical with baclofen, the consumption of cannabis did not change, and the patient felt no adverse effects of the treatment. CWS score was 50/190. In the third week he described a decreased desire Inhibitors,research,lifescience,medical to consume cannabis, and a decrease in his usual evening impulsiveness, being manifested by an increase in activity with his children and a slight improvement in relations with his wife. After 4 weeks of treatment, he had decreased his consumption of cannabis by more than half during the week, but he still persisted with notable consumption for the weekend and especially for sleep disorder. A biological assessment was taken after 1 month of treatment and no disorder was observed compared Inhibitors,research,lifescience,medical with the baseline taken before starting treatment with baclofen. The CWS score
was then 37/190. The dose of baclofen was increased to 70 mg for the weekend (20 mg in the morning, 20 mg Inhibitors,research,lifescience,medical at noon and 30 mg in the evening) and this dose was maintained during the week. After six weeks of treatment with baclofen the patient consumed no cannabis at all, said he felt more relaxed and no longer complained of sleep disorder. The consumption of alcohol was not noted during the monitored period. We continued treatment with baclofen at the same dose and continued monitoring Rebamipide and consultation. At 16 weeks after the start of treatment the patient felt calmer, less anxious and was still not consuming cannabis. Conclusion This case report provides preliminary support for the use of baclofen in the management of cannabis dependence, especially for heavy cannabis users, with long-term and significant consumption. Nevertheless, further investigations are needed and randomized controlled trials are necessary to confirm that baclofen could be recommended as an efficient treatment for cannabis dependence.