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Trial record 11 of 18 for:    marijuana | Recruiting, Not yet recruiting, Active, not recruiting, Enrolling by invitation Studies | ( Map: Colorado, United States )

Anxiety, Inflammation, and Stress

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ClinicalTrials.gov Identifier: NCT03491384
Recruitment Status : Recruiting
First Posted : April 9, 2018
Last Update Posted : November 29, 2018
Sponsor:
Collaborator:
University of Colorado, Denver
Information provided by (Responsible Party):
L. Cinnamon Bidwell, University of Colorado, Boulder

Brief Summary:
This study investigates whether the anxiolytic effects and anti-inflammatory properties of cannabis vary as a function of the ratio of CBD to THC, with the goal that these effects may shed light on the mixed data linking cannabis use and anxiety. Individuals with mild to moderate anxiety who elect to use cannabis (smoked flower or edible) will complete four weeks of observation. Participants complete cognitive tasks, a substance use history, health questionnaires concerning sleep and physical activity, and a blood draw at four different time points (Baseline, after 2 weeks of cannabis use, and immediately before and after self-administration after 4 weeks of use) with the use of a mobile pharmacology laboratory, which goes to a convenient location for each participant to self-administer their cannabis. Participants are then followed for five months to self-report on cannabis use, anxiety, subjective cognitive functioning, sleep quality, and other mental health symptoms.

Condition or disease Intervention/treatment
Anxiety Anxiety Disorders Anxiety Generalized Anxiety Chronic Inflammation Inflammatory Response Drug: Cannabis (smoked flower, ingested edible)

Detailed Description:

Marijuana use is on the rise with the number of adults reporting medical and recreational use doubling in the past decade. Among adult medical marijuana users, 39% report using marijuana for the purposes of self-treating or coping with anxiety. Marijuana is approved for medical use in over half the states and is gaining traction for use as an "off-label" add-on therapy for treatment-resistant anxiety and stress-related disorders. Paradoxically, however, while data suggest that marijuana, in particular ∆9-tetrahydrocannabinol (THC), increases anxiety acutely, cross sectional and longitudinal data suggest associations between marijuana use and lower risk for anxiety disorders.

There is some evidence demonstrating that marijuana use is associated with increases in acute anxiety and anxiety disorders. However, other data suggests that marijuana use may be protective for adolescents at-risk for anxiety and decrease the chances of developing an anxiety disorder during college. This finding is consistent with a growing body of evidence from animal models suggesting that marijuana has anxiolytic and anti-inflammatory properties. Clarifying the anxiolytic effects of specific strains that differ in their cannabinoid composition may explain these discrepant findings. Thus, regardless of whether results support or refute the anxiolytic properties of marijuana, findings from this study fill a critical void and can inform public perception.

The study goal is to understand the anxiolytic effects of cannabinoids, in particular the effects of THC-based strains vs. CBD-based strains vs strains containing both THC and CBD in different ratios (1:0, 1:1, or 0:1) on inflammation, cognitive functioning, and anxiety/negative affect. This design will capitalize on the novel opportunity to examine the effects of real world marijuana strains on key outcomes.


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Study Type : Observational
Estimated Enrollment : 210 participants
Observational Model: Cohort
Time Perspective: Prospective
Official Title: Novel Approaches to Understanding the Role of Cannabinoids and Inflammation in Anxiety
Actual Study Start Date : April 1, 2018
Estimated Primary Completion Date : January 30, 2022
Estimated Study Completion Date : June 30, 2022

Resource links provided by the National Library of Medicine

MedlinePlus related topics: Anxiety Marijuana


Intervention Details:
  • Drug: Cannabis (smoked flower, ingested edible)
    Self-Directed Use (ad-libitum)


Primary Outcome Measures :
  1. Change in Anxiety/Negative Affect: Depression Anxiety Stress Scale (DASS21). [ Time Frame: Change over three time points over 4 weeks: Baseline (before 4 weeks of cannabis use), Pre-Administration (after 4 weeks of use, but before acute self-administration), and Post-Administration (after 4 weeks of use and after acute self-administration) ]
    The DASS21 is a 21-item scale that measures self-reported change in anxiety, depression, and stress symptoms. Subjects are asked to use 4-point severity/frequency scales (higher values indicate greater severity) to rate the extent to which they have experienced each state. Scores for Depression, Anxiety and Stress are calculated by summing the scores for the relevant items. Changes in DASS self-report will be tested in relation to THC and CBD blood levels.

  2. Change in Inflammation: Circulating Levels of cytokines (panel of inflammatory markers). [ Time Frame: Change over three time points over 4 weeks: Baseline (before 4 weeks of cannabis use), Pre-Administration (after 4 weeks of use, but before acute self-administration), and Post-Administration (after 4 weeks of use and after acute self-administration) ]
    Change in inflammation from before to after cannabis use will be tested in relation to THC and CBD blood levels.

  3. Patient Global Impression of Change: Global Impression of Change Scale (PGIC). [ Time Frame: Change over three time points over 4 weeks: Baseline (before 4 weeks of cannabis use), Pre-Administration (after 4 weeks of use, but before acute self-administration), and Post-Administration (after 4 weeks of use and after acute self-administration) ]
    Patient Global Impression of Change Scale (PGIC) measures self-reported change on a 1-7 scale (i.e. from 1 (very much worse) to 7 (very much improved)) in anxiety. Changes in this measure will be tested in relation to THC and CBD blood levels.


Secondary Outcome Measures :
  1. Cognitive Impairment: NIH Toolbox Cognitive Battery, Flanker Inhibitory Control Attention Task (FICA), International Shopping List Test (ISLT), and Functional Assessment of Cancer Therapy Cognitive Scale (FACT-Cog). [ Time Frame: Change over three time points over 4 weeks: Baseline (before 4 weeks of cannabis use), Pre-Administration (after 4 weeks of use, but before acute self-administration), and Post-Administration (after 4 weeks of use and after acute self-administration) ]
    Co-outcomes testing multiple domains of thinking, memory, and perception (NIH Toolbox), cognitive impairment in the domains of immediate and delayed recall (ISLT), attention and inhibitory control (FICA), and a subjective report of cognitive complaint (FACT-Cog). Cognitive outcomes are measured in standard scores (e.g. Range of >70 to >140 (Mean of 100 and SD of 15) with higher scores indicating better performance) and can be averaged to reflect a Standard score of overall cognitive function.

  2. Stress reactivity induction [ Time Frame: Change over three time points over 4 weeks: Baseline (before 4 weeks of cannabis use), Pre-Administration (after 4 weeks of use, but before acute self-administration), and Post-Administration (after 4 weeks of use and after acute self-administration). ]
    Measure affective and stress reactivity responses through lab paradigm assessing attention to affective/stress inducing cues.

  3. Depression and Mood [ Time Frame: Change over three time points over 4 weeks: Baseline (before 4 weeks of cannabis use), Pre-Administration (after 4 weeks of use, but before acute self-administration), and Post-Administration (after 4 weeks of use and after acute self-administration) ]
    Self-report of depression and mood states will be assessed at baseline and the four-week appointment. Given the observational nature of the study, co-outcomes are appropriate to comprehensively assess change in depression/negative affect over the course of the study.

  4. Health and Wellbeing [ Time Frame: Change over three time points over 4 weeks: Baseline (before 4 weeks of cannabis use), Pre-Administration (after 4 weeks of use, but before acute self-administration), and Post-Administration (after 4 weeks of use and after acute self-administration) ]
    Self-report measure across primary domains of health-related well-being, diet, and assessment of sleep quality.

  5. Motor Battery: Balance and Motor Function [ Time Frame: Change over three time points over 4 weeks. ]
    Motor control assessed via dynamic sway, proprioception, and finger tapping rate. Motor outcomes can be aggregated via Z-score to reflect a Z-score of overall motor function.

  6. Objective physical activity/exercise [ Time Frame: Change over 2 weeks. ]
    Physical activity via objective daily data on wearable watch.

  7. Physical activity/exercise [ Time Frame: Change over 4 weeks. ]
    Physical activity via subjective self-report data.


Other Outcome Measures:
  1. Exploratory: Daily Follow-Up Messages [ Time Frame: One survey per day for 30 days (at the start of the 4 week study) ]
    Brief self-report from participants on anxiety, cannabis use, and sleep in the past 24 hours.

  2. Exploratory: Monthly Follow-Up Surveys [ Time Frame: One survey per month for 5 months (at the end of the 4 week study) ]
    Self-report from participants on anxiety, drug use, sleep, subjective cognitive functioning, and mental health.


Biospecimen Retention:   Samples With DNA
Blood samples (including DNA analysis) gut microbiome samples (including microbial DNA analysis)


Information from the National Library of Medicine

Choosing to participate in a study is an important personal decision. Talk with your doctor and family members or friends about deciding to join a study. To learn more about this study, you or your doctor may contact the study research staff using the contacts provided below. For general information, Learn About Clinical Studies.


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Ages Eligible for Study:   21 Years to 70 Years   (Adult, Older Adult)
Sexes Eligible for Study:   All
Accepts Healthy Volunteers:   No
Sampling Method:   Non-Probability Sample
Study Population
Community Sample
Criteria

Inclusion Criteria:

  • Non-users of cannabis must have been a non-user of cannabis for at least six months
  • If a user of cannabis, at least one episode of lifetime cannabis use and a desire to use cannabis to cope with anxiety.
  • Reports at least mild to moderate anxiety (≥5 on GAD-7)

Exclusion Criteria:

  • Seeking treatment for a substance use disorder
  • Current use of other drugs (e.g., cocaine, methamphetamine)
  • Current use psychotropic or steroid-based medications
  • Has an immune-relevant disease (e.g. HIV)
  • Daily tobacco user
  • Currently pregnant or trying to become pregnant
  • In treatment for psychotic disorder, bipolar disorder or major depression disorder with suicidal ideation; or a history with these disorders.

Information from the National Library of Medicine

To learn more about this study, you or your doctor may contact the study research staff using the contact information provided by the sponsor.

Please refer to this study by its ClinicalTrials.gov identifier (NCT number): NCT03491384


Contacts
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Contact: Leah Hitchcock, PhD 303-492-0288 OASIS.CUstudy@gmail.com

Locations
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United States, Colorado
Center for Innovation and Creativity Recruiting
Boulder, Colorado, United States, 80304
Contact: Leah Hitchcock, PhD         
Sponsors and Collaborators
University of Colorado, Boulder
University of Colorado, Denver
Investigators
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Principal Investigator: Cinnamon Bidwell, PhD University of Colorado, Boulder

Additional Information:
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Responsible Party: L. Cinnamon Bidwell, Assistant Research Professor, University of Colorado, Boulder
ClinicalTrials.gov Identifier: NCT03491384     History of Changes
Other Study ID Numbers: R01DA04413
First Posted: April 9, 2018    Key Record Dates
Last Update Posted: November 29, 2018
Last Verified: November 2018
Individual Participant Data (IPD) Sharing Statement:
Plan to Share IPD: No

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Studies a U.S. FDA-regulated Drug Product: No
Studies a U.S. FDA-regulated Device Product: No
Keywords provided by L. Cinnamon Bidwell, University of Colorado, Boulder:
anxiety
inflammation
cannabis
marijuana
stress
Additional relevant MeSH terms:
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Inflammation
Anxiety Disorders
Mental Disorders
Pathologic Processes