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LETTERS TO EDITOR  
Year : 2020  |  Volume : 62  |  Issue : 2  |  Page : 224
Comments on “Relative efficacy of N-Acetylcystiene and Baclofen in cannabis dependence - A retrospective study with telephonic follow-up”


Department of Psychiatry, Government Medical College, Kozhikode, Kerala, India

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Date of Submission13-Aug-2019
Date of Acceptance18-Nov-2019
Date of Web Publication17-Mar-2020
 

How to cite this article:
Sudevan SS, Aparna G, Tharayil HM. Comments on “Relative efficacy of N-Acetylcystiene and Baclofen in cannabis dependence - A retrospective study with telephonic follow-up”. Indian J Psychiatry 2020;62:224

How to cite this URL:
Sudevan SS, Aparna G, Tharayil HM. Comments on “Relative efficacy of N-Acetylcystiene and Baclofen in cannabis dependence - A retrospective study with telephonic follow-up”. Indian J Psychiatry [serial online] 2020 [cited 2020 Apr 4];62:224. Available from: http://www.indianjpsychiatry.org/text.asp?2020/62/2/224/280868




We read the article by Narasimha et al.[1] with interest. The authors have presented the data on the use of two drugs (N-acetylcysteine and baclofen) in a condition with very little pharmacotherapy options, cannabis use disorders (CUDs), with the caveat that it can only provide preliminary evidence as this was not a randomized controlled trial. These drugs are already in use for different indications.

The study gives data on 72 patients treated for the primary diagnosis of CUDs. But, 47 (65.2%) of their sample had a comorbid psychiatric illness and would have received some psychotropic medications. But curiously, they have not considered that this could also be a contributing factor to the benefits they attribute to the study drugs (N-acetylcysteine and baclofen) and/or psychosocial intervention. If they had considered this as a covariate in their analysis, the findings would have been different. There is evidence that combined treatment with psychotropics and other drugs is more effective in cases of substance use disorders with comorbidity.[2]

Further, they have not separately mentioned the outcomes for the 25 (34.8%) patients who did not have other psychiatric comorbidities and hence did not receive any other psychotropics, except the study drugs. Although a small number, this would be noteworthy. They have mentioned all other limitations. We agree with them that this study provides only very preliminary evidence that has to be evaluated by further studies.

Financial support and sponsorship

Nil.

Conflicts of interest

There are no conflicts of interest.



 
   References Top

1.
Narasimha VL, Shukla L, S Shyam RP, Kandasamy A, Benegal V. Relative effectiveness of N-acetylcysteine and baclofen as anticraving agents in cannabis dependence – A retrospective study with telephonic follow-up. Indian J Psychiatry 2019;61:228-31.  Back to cited text no. 1
[PUBMED]  [Full text]  
2.
Kelly TM, Daley DC, Douaihy AB. Treatment of substance abusing patients with comorbid psychiatric disorders. Addict Behav 2012;37:11-24.  Back to cited text no. 2
    

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Correspondence Address:
Swathy Sheela Sudevan
Department of Psychiatry, Government Medical College, Kozhikode, Kerala
India
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Source of Support: None, Conflict of Interest: None


DOI: 10.4103/psychiatry.IndianJPsychiatry_479_19

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