Dronabinol and Marijuana in HIV-Positive Marijuana Smokers

Caloric Intake, Mood, and Sleep. Individuals with HIV constitute the largest group using cannabinoids for medicinal reasons; yet, no studies have directly compared the tolerability and
efficacy of smoked marijuana and oral dronabinol maintenance in HIV-positive marijuana smokers. This placebocontrolled within-subjects study evaluated marijuana and dronabinol across a range of behaviors: eating topography, mood, cognitive performance, physiologic
measures, and sleep. Methods: HIVpositive marijuana smokers (n = 10) completed 2 16-day inpatient phases. Each dronabinol (5 and 10 mg) and marijuana (2.0% and 3.9% Δ9-
tetrahydrocannabinol [THC]) dose was administered 4 times daily for 4 days, but only 1 drug was active per day, thereby maintaining double-blind dosing. Four days of placebo washout separated each active cannabinoid condition. Results: As compared with placebo,
marijuana and dronabinol dose dependently increased daily caloric intake and body weight in HIV-positive marijuana smokers. All cannabinoid conditions produced significant
intoxication, e xcept f or lo w-dose dronabinol (5 mg); t he int oxication was rated positively (eg, “good drug effect”) with little evidence of discomfort and no impairment of cognitive performance. Effects of marijuana and dronabinol were comparable, except that only marijuana (3.9% THC) improved ratings of sleep. Conclusions: These data suggest that for HIV-positive marijuana smokers, both dronabinol (at doses 8 times current
recommendations) and marijuana were well tolerated and produced substantial
and comparable increases in food intake.