Distinct effects of cocaine and cocaine plus cannabis on neurocognitive functioning and abstinence: A six-month follow-up study

Autor(es)

de Oliveira Junior, Hercilio Pereira ^{[1, 2]} ; di Goncalves, Priscila ^{[1, 2, 3]} ; Ometto, Mariella ^[2] ; dos Santos, Bernardo ^[4] ; Malbergier, Andre ^[1] ; Amaral, Ricardo ^[1] ; Nicastri, Sergio ^{[1, 2]} ; de Andrade, Arthur Guerra ^[1] ; Cunha, Paulo Jannuzzi ^{[1, 2]}

Afiliação do(s) autor(es)

^[1] Univ Sao Paulo, Fac Med, Grp Interdisciplinar Estudos Alcool & Drogas GREA, Dept & Inst Psiquiatria, Hosp Clin HCFMUSP, 785 Rua Dr Ovidio Pires de Campos, Sao Paulo, SP - Brazil

^[2] Univ Sao Paulo, Fac Med, Lab Psychiat Neuroimaging LIM 21, Dept & Inst Psiquiatria, Hosp Clin HCFMUSP, 785 Rua Dr Ovidio Pires de Campos, Sao Paulo, SP - Brazil

^[3] Univ Sao Paulo, Fac Med, Hosp Clin HCFMUSP, Serv Psicol & Neuropsicol, Inst Psiquiatria, 785 Rua Dr Ovidio Pires de Campos, Sao Paulo, SP - Brazil

^[4] Univ Sao Paulo, Escola Enfermagem, 419 Ave Dr Eneas Carvalho Aguiar Cerqueira Cesar, Sao Paulo, SP - Brazil

• Tipo de documento: Artigo Científico
• Fonte: DRUG AND ALCOHOL DEPENDENCE; v. 205, DEC 1 2019.
• Citações Web of Science: 0

Resumo

Background and Aims: Cannabis use is frequent among individuals with cocaine use disorder. Despite recent non-controlled studies advocating a therapeutic role of smoked cannabis, there is a paucity of evidence-based data on potential therapeutic and cognitive side-effects of this association. Methods: We examined 63 cocaine-addicted subjects who used cannabis more than 50 times in lifetime (COC + CAN), 24 cocaine-addicted patients who use cannabis less than 50 times (COC), and 36 controls (CON). Participants were evaluated with an extensive battery of neurocognitive tests after two weeks of supervised detoxification in an inpatient treatment program. Patients were followed up in one, three, and six months after discharge. Results: Both groups of patients performed worse than CON on working memory, processing speed, inhibitory control, mental flexibility, and decision making. COC + CAN performed worse than COC on speed processing, inhibitory control and sustained attention, while COC performed worse than COC + CAN on mental flexibility. Concomitant cannabis use did not decrease relapses to cocaine use after one, three and six months. Among COC + CAN, earlier cocaine and cannabis use, and impaired executive functioning were predictive of relapse on cocaine after six months. Conclusion: Our results did not support the recommendation of smoked cannabis as a safe therapeutic approach for cocaine-addicted patients due to significant negative cognitive side-effects and absence of efficacy. Further studies investigating frontal brain morphology, neuromaturation, and prescription of the non-psychoactive constituent of cannabis sativa cannabidiol among cocaine-addicted patients who use cannabis are warranted. (AU)

• Processo FAPESP: 11/19179-5 - Compatibilidade estímulo-resposta e valência emocional: uma investigação das bases neurológicas envolvidas no processamento da informação espacial e emocional
• Beneficiário: Geraldo Busatto Filho
• Linha de fomento: Auxílio à Pesquisa - Regular
• Processo FAPESP: 00/12081-5 - Alterações neuropsicológicas em dependentes de cocaína
• Beneficiário: Sergio Nicastri
• Linha de fomento: Auxílio à Pesquisa - Regular
• Processo FAPESP: 10/01272-6 - Pesquisa sobre o impacto da reabilitação neuropsicológica em dependentes de cocaína/crack
• Beneficiário: Priscila Dib Goncalves
• Linha de fomento: Bolsas no Brasil - Mestrado
• Processo FAPESP: 10/15604-0 - Integridade de substância branca em corpo caloso e desempenho neuropsicológico em crianças e adolescentes vítimas de violência e maus tratos: estudo morfométrico cerebral e de imagem por tensores de difusão
• Beneficiário: Paulo Jannuzzi Cunha
• Linha de fomento: Bolsas no Brasil - Pós-Doutorado