Evidence map›Paper›PMID 25283697›Full record

Trial reportDrug and alcohol dependence2014

Do withdrawal-like symptoms mediate increased marijuana smoking in individuals treated with venlafaxine-XR?

Meredith A Kelly, Martina Pavlicova, Andrew Glass, John J Mariani, Adam Bisaga, Maria A Sullivan, Edward V Nunes, Frances R Levin

Abstract readRandomized Controlled Trial
PubMed Full text at PMC Publisher
In one paragraph

Trial report in Drug and alcohol dependence, 2014. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 8 papers, 2 of them syntheses that pooled it.

0numbers the graph read from it
0cells of the map it votes in
8citing papers in PubMed, 2 pooled it
–field-weighted citation impact
1 · What the graph read from it

What it found

Each row is one number read from the abstract, on the scale the paper reported it, with its interval. Left of the dashed line favours the treatment, right favours the comparator. Under each row is the sentence it came from. New to these charts? A ten-minute tutorial.

The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.

2 · The registry

The trial behind it

Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.

Neither the registry nor the abstract names a trial number. If this is a trial report, that itself is worth knowing.

3 · Its place in the literature

Who cites it

8 citing papers in PubMed, 2 syntheses or guidelines pooled it.

  1. Pharmacotherapies for cannabis use disorder.The Cochrane database of systematic reviews · 2025
    Pooled it
  2. Pharmacotherapies for cannabis dependence.The Cochrane database of systematic reviews · 2019
    Pooled it
  3. Guanfacine extended-release for cannabis use disorder: a pilot feasibility trial.The American journal of drug and alcohol abuse · 2020
    Trial
  4. Article
  5. Article
  6. The Current State of Pharmacological Treatments for Cannabis Use Disorder and Withdrawal.Neuropsychopharmacology : official publication of the American College of Neuropsychopharmacology · 2018
    Review
  7. The cannabis withdrawal syndrome: current insights.Substance abuse and rehabilitation · 2017
    Review
  8. Evidence-based Treatment Options in Cannabis Dependency.Deutsches Arzteblatt international · 2016
    Review
4 · The record

Corrections and comments

PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.

5 · Who and what money

Authors and funding

8 authors.

Meredith A KellyNew York State Psychiatric Institute, Division of Substance Abuse, 1051 Riverside Drive, New York, NY 10032, USA; Department of Psychiatry, College of Physicians and Surgeons of Columbia University, 630 West 168th Street, New York, NY 10032, USA. Electronic address: mak2102@columbia.edu.
Martina PavlicovaDepartment of Biostatistics, Columbia University, 722 West 168th Street, New York, NY 10032, USA.
Andrew GlassDivision of Biostatistics in the Department of Psychiatry, 722 West 168th Street, New York, NY 10032, USA.
John J MarianiNew York State Psychiatric Institute, Division of Substance Abuse, 1051 Riverside Drive, New York, NY 10032, USA; Department of Psychiatry, College of Physicians and Surgeons of Columbia University, 630 West 168th Street, New York, NY 10032, USA.
Adam BisagaNew York State Psychiatric Institute, Division of Substance Abuse, 1051 Riverside Drive, New York, NY 10032, USA; Department of Psychiatry, College of Physicians and Surgeons of Columbia University, 630 West 168th Street, New York, NY 10032, USA.
Maria A SullivanNew York State Psychiatric Institute, Division of Substance Abuse, 1051 Riverside Drive, New York, NY 10032, USA; Department of Psychiatry, College of Physicians and Surgeons of Columbia University, 630 West 168th Street, New York, NY 10032, USA.
Edward V NunesNew York State Psychiatric Institute, Division of Substance Abuse, 1051 Riverside Drive, New York, NY 10032, USA; Department of Psychiatry, College of Physicians and Surgeons of Columbia University, 630 West 168th Street, New York, NY 10032, USA.
Frances R LevinNew York State Psychiatric Institute, Division of Substance Abuse, 1051 Riverside Drive, New York, NY 10032, USA; Department of Psychiatry, College of Physicians and Surgeons of Columbia University, 630 West 168th Street, New York, NY 10032, USA.

Funding

Translational Clinical Research Fellowship on Substance Use DisordersT32DA007294 · NIDA · COLUMBIA UNIV NEW YORK MORNINGSIDE · PI Frances Rudnick Levin, Diana M Martinez · 1993 to 2026
$9.3M
Marijuana Dependence &Depression: Venlafaxine TreatmentR01DA015451 · NIDA · NEW YORK STATE PSYCHIATRIC INSTITUTE DBA RESEARCH FOUNDATION FOR MENTAL HYGIENE, INC · PI LEVIN, FRANCES RUDNICK · 2003 to 2006
$1.8M
Substance Abuse Treatment Development and Clinical Research MentoringK24DA029647 · NIDA · COLUMBIA UNIVERSITY HEALTH SCIENCES · PI LEVIN, FRANCES RUDNICK · 2010 to 2019
$1.8M
Drug Abuse Treatment Development and Research MentoringK24DA022412 · NIDA · COLUMBIA UNIVERSITY HEALTH SCIENCES · PI NUNES, EDWARD V. · 2007 to 2016
$1.7M
TREATMENT OF SUBSTANCE ABUSE AND PSYCHIATRIC COMORBIDITYK02DA000465 · NIDA · COLUMBIA UNIVERSITY HEALTH SCIENCES · PI LEVIN, FRANCES RUDNICK · 2000 to 2009
$1.2M
NIDA NIH HHS K02 DA000465NIDA NIH HHS K24 DA022412NIDA NIH HHS K24DA022412NIDA NIH HHS K24 DA029647NIDA NIH HHS R01 DA015451NIDA NIH HHS R01DA15451NIDA NIH HHS T32 DA007294PHS HHS K02 000465
6 · The paper itself

Abstract

BACKGROUND AND

aimsCannabis-dependent participants with depressive disorder are less likely to achieve abstinence with venlafaxine-XR (VEN-XR) treatment. Individuals on VEN-XR reported more severe withdrawal, despite not reducing their smoking behavior. We hypothesized that withdrawal-like symptoms, likely medication side effects, led to continued marijuana smoking in this group.

methodsWe conducted a secondary analysis using Marijuana Withdrawal Checklist (MWC) scores and urine THC to test whether severity of withdrawal-like symptoms mediates the relationship between VEN-XR treatment and continued marijuana smoking. We included 103 participants (VEN-XR=51, Placebo=52). Marijuana use was dichotomized into smoking (THC>100 ng/ml) and non-smoking (THC ≤ 100 ng/ml) weeks. MWC scores were obtained weekly. We used three models in a regression based mediation analysis.

resultsThe estimated risk of smoking marijuana was greater for individuals on VEN-XR in weeks 7-9, even when controlling for MWC scores (week 7 Risk Difference (RD)=0.11, p=0.034; week 8 RD=0.20, p=0.014), and higher scores mediated this effect. In weeks 10 and 11, the estimated effect was stronger (week 10 RD=0.03, p=0.380; week 11 RD=0.07, p=0.504), and worse withdrawal-like symptoms more fully accounted for continued marijuana smoking in the VEN-XR group, according to the models.

conclusionsIndividuals treated with VEN-XR had more severe withdrawal-like symptoms, which mediated their continued marijuana smoking. Noradrenergic agents, such as VEN-XR, may negatively impact treatment outcomes in cannabis-dependent patients attempting to reduce or stop their use.

Indexed as

AdolescentAdultAntidepressive Agents, Second-GenerationCyclohexanolsDepressive DisorderDouble-Blind MethodFemaleHumansMaleMarijuana SmokingMiddle AgedSubstance Withdrawal SyndromeTreatment OutcomeVenlafaxine HydrochlorideAntidepressive Agents, Second-GenerationCyclohexanolsVenlafaxine HydrochlorideCannabisCannabis WithdrawalMarijuanaMarijuana WithdrawalTreatmentVenlafaxine

Identifiers

PMID25283697
PMCPMC4252763

What OpenQuestion holds

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Registered trials

None linked

Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the OpenQuestion graph.