Cannabis dependence
disease diseaseOn this page
Also known as cannabis abusemarijuana dependence
Summary
Cannabis dependence (MONDO:0005689) is a disease with 7 cohort genes (152 GWAS associations across 13 studies) and 96 clinical trials. Top therapeutic interventions include atomoxetine, dronabinol, and fluoxetine.
At a glance
- Cohort genes: 7
- GWAS associations: 152
- Clinical trials: 96
Clinical features
No curated clinical features (Orphanet) for this disease.
Identifiers
Disease identifiers
| Field | Value |
|---|---|
| Canonical name | cannabis dependence |
| Mondo ID | MONDO:0005689 |
| EFO | EFO:0007191 |
| MeSH | D002189 |
| DOID | DOID:1849, DOID:9505 |
| ICD-10-CM | F12.2 |
| ICD-11 | 1129015467 |
| NCIT | C34445 |
| SNOMED CT | 37344009, 85005007 |
| UMLS | C0006870 |
| MedGen | 14303 |
| Is cancer (heuristic) | no |
Also known as: cannabis abuse · marijuana dependence
Data availability: 152 GWAS associations (13 studies).
Disease family
Classification path: disease › human disease › disease by developmental or physiological process › psychiatric disorder › substance-related disorder › substance dependence › drug dependence › cannabis dependence
Related subtypes (9): barbiturate dependence, hallucinogen dependence, cocaine dependence, methamphetamine dependence, alcohol and nicotine codependence, opiate dependence, phencyclidine abuse, alcohol dependence, nicotine dependence
Genetics & variants
GWAS landscape
152 GWAS associations across 13 studies. Top hits map to 31 distinct genes (as reported by GWAS).
Top associations by p-value
| rsID | p-value | Gene | Risk allele | Odds ratio |
|---|---|---|---|---|
| rs4479020 | 1e-33 | NCAM1 | ? | 0.04 |
| rs11711407 | 2e-23 | SEMA3F | A | |
| rs62250713 | 4e-17 | CADM2 | ? | 0.03 |
| rs2310819 | 1e-16 | PDE4B | ? | 0.02 |
| rs11913634 | 1e-15 | TAFA5 | ? | |
| rs6756212 | 3e-15 | RPL6P5 - METAP2P1 | ? | 0.02 |
| rs7839435 | 2e-14 | EPHX2 - GULOP | ? | 0.03 |
| rs472140 | 2e-14 | CAMKMT - LINC01833 | ? | 0.02 |
| rs4593766 | 2e-14 | LINC01360 | ? | 0.02 |
| rs2132660 | 3e-14 | SEMA6D | ? | 0.03 |
| rs12497569 | 4e-14 | USP4 | A | 0.02 |
| rs56372821 | 7e-14 | GULOP | ? | |
| rs1526480 | 8e-14 | BARHL2 - LINC02609 | ? | 0.02 |
| rs8104317 | 1e-13 | CACNA1A | ? | |
| rs7519259 | 1e-13 | PDE4B | A | 0.02 |
| rs1823673 | 4e-13 | CRLF3P1 - CAPZBP1 | ? | 0.02 |
| rs13107325 | 5e-13 | SLC39A8 | T | 0.04 |
| rs11210887 | 1e-12 | PTPRF | ? | 0.02 |
| rs35984974 | 2e-12 | MCFD2P1 - ZNF184 | ? | 0.04 |
| rs3774800 | 2e-12 | USP4 | ? | |
| rs6589386 | 2e-12 | DRD2 - TMPRSS5 | T | 0.02 |
| rs35926495 | 2e-12 | SLC38A3 | T | |
| rs864882 | 3e-12 | RABEPK | T | 0.02 |
| rs7783012 | 4e-12 | FOXP2 | A | |
| rs2666550 | 6e-12 | SEMA6D | ? | 0.02 |
| rs6800583 | 6e-12 | PLCL2 | ? | 0.02 |
| rs4554002 | 7e-12 | USP4 | ? | 0.02 |
| rs6432708 | 1e-11 | DPP4 | ? | 0.02 |
| rs726610 | 2e-11 | CADM2 | T | 0.02 |
| rs9467773 | 2e-11 | BTN1A1P1 - BTN1A1 | A |
Top studies (by case count)
| Study | Lead author | Year | Cases | Controls | Title |
|---|---|---|---|---|---|
| GCST90320049 | Levey DF | 2023 | 42,281 | 843,744 | Multi-ancestry genome-wide association study of cannabis use disorder yields insight into disease biology and public health implications. |
| GCST90320050 | Levey DF | 2023 | 19,065 | 104,143 | Multi-ancestry genome-wide association study of cannabis use disorder yields insight into disease biology and public health implications. |
| GCST011179 | Johnson EC | 2020 | 17,068 | 357,219 | A large-scale genome-wide association study meta-analysis of cannabis use disorder. |
| GCST90455647 | Chen D | 2024 | 14,808 | 343,726 | Unraveling shared susceptibility loci and Mendelian genetic associations linking educational attainment with multiple neuropsychiatric disorders. |
| GCST90320051 | Levey DF | 2023 | 2,774 | 35,515 | Multi-ancestry genome-wide association study of cannabis use disorder yields insight into disease biology and public health implications. |
| GCST008414 | Demontis D | 2019 | 2,387 | 48,985 | Genome-wide association study implicates CHRNA2 in cannabis use disorder. |
| GCST008415 | Demontis D | 2019 | 2,387 | 0 | Genome-wide association study implicates CHRNA2 in cannabis use disorder. |
| GCST005133 | Agrawal A | 2017 | 2,080 | 6,435 | Genome-wide association study identifies a novel locus for cannabis dependence. |
| GCST000861 | Agrawal A | 2010 | 708 | 2,346 | A genome-wide association study of DSM-IV cannabis dependence. |
| GCST90320052 | Levey DF | 2023 | 194 | 6,649 | Multi-ancestry genome-wide association study of cannabis use disorder yields insight into disease biology and public health implications. |
Variant details and genetic-evidence tiers
Tier distribution (top 50 variants)
| Tier | Variants |
|---|---|
| Tier 1: coding | 1 |
| Tier 2: splice/UTR | 3 |
| Tier 3: regulatory | 1 |
| Tier 4: intronic/intergenic | 45 |
MAF distribution
| Bucket | Variants |
|---|---|
| common (>=0.05) | 50 |
| low_freq (0.01-0.05) | 0 |
| rare (<0.01) | 0 |
| unknown | 0 |
Functional consequences
| Consequence | Count |
|---|---|
| intron_variant | 37 |
| intergenic_variant | 8 |
| regulatory_region_variant | 1 |
| missense_variant | 1 |
| splice_region_variant | 1 |
| splice_polypyrimidine_tract_variant | 1 |
| 3_prime_UTR_variant | 1 |
Top variants
| rsID | Chr | Pos | Alleles | MAF | Consequence | Gene | p-value | Tier |
|---|---|---|---|---|---|---|---|---|
| rs4479020 | 11 | 112990721 | G>A | 0.05 | intron_variant | NCAM1 | 1e-33 | Tier 4: intronic/intergenic |
| rs11711407 | 3 | 50187596 | A>C,G,T | 0.05 | intron_variant | SEMA3F | 2e-23 | Tier 4: intronic/intergenic |
| rs62250713 | 3 | 85464643 | A>G,T | 0.05 | intron_variant | CADM2 | 4e-17 | Tier 4: intronic/intergenic |
| rs2310819 | 1 | 65974413 | C>A,T | 0.05 | intron_variant | PDE4B | 1e-16 | Tier 4: intronic/intergenic |
| rs11913634 | 22 | 48732047 | T>G | 0.05 | intron_variant | TAFA5 | 1e-15 | Tier 4: intronic/intergenic |
| rs6756212 | 2 | 145382564 | C>G,T | 0.05 | intergenic_variant | RPL6P5 - METAP2P1 | 3e-15 | Tier 4: intronic/intergenic |
| rs7839435 | 8 | 27555436 | G>A,T | 0.05 | intergenic_variant | EPHX2 - GULOP | 2e-14 | Tier 4: intronic/intergenic |
| rs472140 | 2 | 44912765 | C>T | 0.05 | regulatory_region_variant | CAMKMT - LINC01833 | 2e-14 | Tier 3: regulatory |
| rs4593766 | 1 | 73307360 | T>A,C | 0.05 | intron_variant | LINC01360 | 2e-14 | Tier 4: intronic/intergenic |
| rs2132660 | 15 | 47387610 | A>G | 0.05 | intron_variant | SEMA6D | 3e-14 | Tier 4: intronic/intergenic |
| rs12497569 | 3 | 49327397 | G>A | 0.44 | intron_variant | USP4 | 4e-14 | Tier 4: intronic/intergenic |
| rs56372821 | 8 | 27578983 | G>A | 0.05 | intron_variant | GULOP | 7e-14 | Tier 4: intronic/intergenic |
| rs1526480 | 1 | 90744429 | T>A,C | 0.05 | intron_variant | BARHL2 - LINC02609 | 8e-14 | Tier 4: intronic/intergenic |
| rs8104317 | 19 | 13563053 | C>T | 0.05 | intron_variant | CACNA1A | 1e-13 | Tier 4: intronic/intergenic |
| rs7519259 | 1 | 65969060 | G>A | 0.48 | intron_variant | PDE4B | 1e-13 | Tier 4: intronic/intergenic |
| rs1823673 | 2 | 103618170 | T>C | 0.05 | intergenic_variant | CRLF3P1 - CAPZBP1 | 4e-13 | Tier 4: intronic/intergenic |
| rs13107325 | 4 | 102267552 | C>A,T | 0.08 | missense_variant | SLC39A8 | 5e-13 | Tier 1: coding |
| rs11210887 | 1 | 43610348 | G>A | 0.05 | intron_variant | PTPRF | 1e-12 | Tier 4: intronic/intergenic |
| rs35984974 | 6 | 27442643 | G>A | 0.05 | intergenic_variant | MCFD2P1 - ZNF184 | 2e-12 | Tier 4: intronic/intergenic |
| rs3774800 | 3 | 49297335 | G>A,C,T | 0.05 | intron_variant | USP4 | 2e-12 | Tier 4: intronic/intergenic |
| rs6589386 | 11 | 113573031 | C>G,T | 0.43 | intergenic_variant | DRD2 - TMPRSS5 | 2e-12 | Tier 4: intronic/intergenic |
| rs35926495 | 3 | 50218231 | C>T | 0.05 | splice_region_variant | SLC38A3 | 2e-12 | Tier 2: splice/UTR |
| rs864882 | 9 | 125205830 | C>G,T | 0.3 | intron_variant | RABEPK | 3e-12 | Tier 4: intronic/intergenic |
| rs7783012 | 7 | 114476826 | G>A,T | 0.05 | intron_variant | FOXP2 | 4e-12 | Tier 4: intronic/intergenic |
| rs2666550 | 15 | 47625779 | T>C | 0.05 | intron_variant | SEMA6D | 6e-12 | Tier 4: intronic/intergenic |
| rs6800583 | 3 | 16810253 | A>G | 0.05 | intron_variant | PLCL2 | 6e-12 | Tier 4: intronic/intergenic |
| rs4554002 | 3 | 49299687 | C>G,T | 0.05 | intron_variant | USP4 | 7e-12 | Tier 4: intronic/intergenic |
| rs6432708 | 2 | 162035338 | C>T | 0.05 | splice_polypyrimidine_tract_variant | DPP4 | 1e-11 | Tier 2: splice/UTR |
| rs726610 | 3 | 85502253 | C>A,G,T | 0.36 | intron_variant | CADM2 | 2e-11 | Tier 4: intronic/intergenic |
| rs9467773 | 6 | 26498198 | A>G | 0.05 | intron_variant | BTN1A1P1 - BTN1A1 | 2e-11 | Tier 4: intronic/intergenic |
Genes & proteins
Mendelian disease overlap and somatic drivers
GenCC: 0 · Orphanet: 3 · OMIM-shared: 0 · Dual-evidence (GWAS+Mendelian): 0
Orphanet rare-disease linkage (cohort genes)
| Gene | Orphanet ID | Rare disease |
|---|---|---|
| FOXP2 | Orphanet:209908 | Isolated childhood apraxia of speech |
| FOXP2 | Orphanet:251061 | 7q31 microdeletion syndrome |
| CHRNA2 | Orphanet:98784 | Sleep-related hypermotor epilepsy |
Cohort genes → proteins
7 cohort genes, 7 distinct canonical proteins.
Evidence partition
| Subset | Genes |
|---|---|
| gwas_only | 7 |
Cohort genes (full)
| Symbol | HGNC | Ensembl | UniProt | Name | Evidence |
|---|---|---|---|---|---|
| FOXP2 | HGNC:13875 | ENSG00000128573 | O15409 | Forkhead box protein P2 | gwas |
| CHST11 | HGNC:17422 | ENSG00000171310 | Q9NPF2 | Carbohydrate sulfotransferase 11 | gwas |
| PIM3 | HGNC:19310 | ENSG00000198355 | Q86V86 | Serine/threonine-protein kinase pim-3 | gwas |
| CHRNA2 | HGNC:1956 | ENSG00000120903 | Q15822 | Neuronal acetylcholine receptor subunit alpha-2 | gwas |
| UCHL5 | HGNC:19678 | ENSG00000116750 | Q9Y5K5 | Ubiquitin carboxyl-terminal hydrolase isozyme L5 | gwas |
| ANKFN1 | HGNC:26766 | ENSG00000153930 | Q8N957 | Ankyrin repeat and fibronectin type-III domain-containing protein 1 | gwas |
| EPHX2 | HGNC:3402 | ENSG00000120915 | P34913 | Bifunctional epoxide hydrolase 2 | gwas |
Cohort function summary
Lead sentence per gene, UniProt-curated.
| Symbol | Protein name | Function (lead sentence) |
|---|---|---|
| FOXP2 | Forkhead box protein P2 | Transcriptional repressor that may play a role in the specification and differentiation of lung epithelium. |
| CHST11 | Carbohydrate sulfotransferase 11 | Catalyzes the transfer of sulfate to position 4 of the N-acetylgalactosamine (GalNAc) residue of chondroitin. |
| PIM3 | Serine/threonine-protein kinase pim-3 | Proto-oncogene with serine/threonine kinase activity that can prevent apoptosis, promote cell survival and protein translation. |
| CHRNA2 | Neuronal acetylcholine receptor subunit alpha-2 | Component of neuronal acetylcholine receptors (nAChRs) that function as pentameric, ligand-gated cation channels with high calcium permeability among other activities. nAChRs are excitatory neurotrasnmitter receptors formed by a collection… |
| UCHL5 | Ubiquitin carboxyl-terminal hydrolase isozyme L5 | Protease that specifically cleaves ‘Lys-48’-linked polyubiquitin chains. |
| ANKFN1 | Ankyrin repeat and fibronectin type-III domain-containing protein 1 | May play a role in neuronal function. |
| EPHX2 | Bifunctional epoxide hydrolase 2 | Bifunctional enzyme. |
Protein-family classification
Druggable: 5 · Difficult: 1 · Unknown: 1 · Druggable fraction: 0.71
Family distribution
Cohort families vs a genome-wide background (hypergeometric, BH-FDR; fold = observed/expected). Counts kept; sorted by enrichment, so the catch-all Other/Unknown bucket no longer leads.
| Family | Genes | Fold | FDR |
|---|---|---|---|
| Protease | 1 | 5.2× | 0.340 |
| Antibody/Immunoglobulin | 1 | 4.2× | 0.340 |
| Kinase | 1 | 4.0× | 0.340 |
| Enzyme (other) | 2 | 3.4× | 0.340 |
| Transcription factor | 1 | 1.2× | 0.714 |
| Other/Unknown | 1 | 0.3× | 0.997 |
Per-gene assignment
| Symbol | Family | Druggable? | EC | InterPro (top 3) |
|---|---|---|---|---|
| FOXP2 | Transcription factor | no | Fork_head_dom, TF_fork_head_CS_2, FOXP-CC | |
| CHST11 | Enzyme (other) | yes | 2.8.2.5 | Sulfotransferase, Carb_sulfotrans_8-10 |
| PIM3 | Kinase | yes | Prot_kinase_dom, Ser/Thr_kinase_AS, Kinase-like_dom_sf | |
| CHRNA2 | Other/Unknown | no | Nicotinic_acetylcholine_rcpt, Neurotrans-gated_channel_TM, Neur_channel | |
| UCHL5 | Protease | yes | 3.4.19.12 | Peptidase_C12_UCH, Ubiquitinyl_hydrolase_UCH37, UCH37 |
| ANKFN1 | Antibody/Immunoglobulin | yes | Ankyrin_rpt, FN3_dom, Ig-like_fold | |
| EPHX2 | Enzyme (other) | yes | 3.1.3.106 | AB_hydrolase_1, Epox_hydrolase-like, HAD-SF_hydro_IA |
Expression context
Cohort genes with no expression data: 0.
6 cohort genes are a single-cell marker in ≥1 SCXA experiment.
Breadth distribution (Bgee present_calls)
| Bucket | Genes |
|---|---|
| narrow (1-5 tissues) | 0 |
| moderate (6-20) | 0 |
| broad (>20) | 7 |
| unknown | 0 |
Top tissues across cohort
| Tissue | Cohort genes |
|---|---|
| buccal mucosa cell | 2 |
| mucosa of paranasal sinus | 1 |
| tibialis anterior | 1 |
| blood | 1 |
| cartilage tissue | 1 |
| tibia | 1 |
| olfactory segment of nasal mucosa | 1 |
| skin of abdomen | 1 |
| skin of leg | 1 |
| cervix squamous epithelium | 1 |
| gingival epithelium | 1 |
| primordial germ cell in gonad | 1 |
| calcaneal tendon | 1 |
| cortical plate | 1 |
| islet of Langerhans | 1 |
| bronchial epithelial cell | 1 |
| male germ line stem cell (sensu Vertebrata) in testis | 1 |
| mucosa of transverse colon | 1 |
| right adrenal gland | 1 |
| right lobe of liver | 1 |
Per-gene tissue summary (top 30)
| Symbol | Bgee breadth | FANTOM5 breadth | SCXA | Top tissues |
|---|---|---|---|---|
| FOXP2 | 237 | broad | marker | buccal mucosa cell, tibialis anterior, mucosa of paranasal sinus |
| CHST11 | 243 | ubiquitous | marker | tibia, blood, cartilage tissue |
| PIM3 | 134 | ubiquitous | marker | olfactory segment of nasal mucosa, skin of abdomen, skin of leg |
| CHRNA2 | 143 | tissue_specific | yes | cervix squamous epithelium, primordial germ cell in gonad, gingival epithelium |
| UCHL5 | 276 | ubiquitous | marker | cortical plate, calcaneal tendon, islet of Langerhans |
| ANKFN1 | 148 | tissue_specific | marker | buccal mucosa cell, male germ line stem cell (sensu Vertebrata) in testis, bronchial epithelial cell |
| EPHX2 | 206 | ubiquitous | marker | right lobe of liver, mucosa of transverse colon, right adrenal gland |
Protein interactions among cohort
Intra-cohort edges: 0.
Hub genes (top 10 by interactor count)
| Symbol | Interactor count |
|---|---|
| EPHX2 | 4,455 |
| UCHL5 | 3,301 |
| FOXP2 | 2,557 |
| PIM3 | 1,603 |
| CHRNA2 | 982 |
| CHST11 | 932 |
| ANKFN1 | 601 |
Structural data
PDB: 4 · AlphaFold-only: 3 · No structure: 0
Cohort genes with PDB structures (top 30)
| Symbol | UniProt | PDB entries |
|---|---|---|
| EPHX2 | P34913 | 139 |
| UCHL5 | Q9Y5K5 | 11 |
| FOXP2 | O15409 | 2 |
| CHRNA2 | Q15822 | 1 |
AlphaFold-only cohort genes (top 30 by pLDDT)
| Symbol | UniProt | pLDDT |
|---|---|---|
| CHST11 | Q9NPF2 | 89.39 |
| PIM3 | Q86V86 | 85.64 |
| ANKFN1 | Q8N957 | 66.55 |
Function
Pathway analysis
Distinct Reactome pathways touched by cohort: 15. Enrichment computed across 7 evidence-associated genes (5 with Reactome annotation).
Pathways by enrichment
Over-representation of cohort genes vs the genome-wide background (hypergeometric test, Benjamini-Hochberg FDR; fold = observed/expected over 5 annotated cohort genes). Counts and members are kept as ground-truth; sorted by enrichment.
| Pathway | Cohort genes | Fold | FDR | Sample cohort genes |
|---|---|---|---|---|
| Biosynthesis of maresins | 1 | 1142.0× | 0.011 | EPHX2 |
| Synthesis of epoxy (EET) and dihydroxyeicosatrienoic acids (DHET) | 1 | 285.5× | 0.011 | EPHX2 |
| Highly calcium permeable nicotinic acetylcholine receptors | 1 | 253.8× | 0.011 | CHRNA2 |
| Highly calcium permeable postsynaptic nicotinic acetylcholine receptors | 1 | 207.6× | 0.011 | CHRNA2 |
| Presynaptic nicotinic acetylcholine receptors | 1 | 190.3× | 0.011 | CHRNA2 |
| Positive Regulation of CDH1 Gene Transcription | 1 | 190.3× | 0.011 | FOXP2 |
| Acetylcholine binding and downstream events | 1 | 163.1× | 0.011 | CHRNA2 |
| Postsynaptic nicotinic acetylcholine receptors | 1 | 163.1× | 0.011 | CHRNA2 |
| CS-GAG biosynthesis | 1 | 108.8× | 0.015 | CHST11 |
| Downregulation of TGF-beta receptor signaling | 1 | 81.6× | 0.018 | UCHL5 |
| Peroxisomal protein import | 1 | 34.6× | 0.039 | EPHX2 |
| UCH proteinases | 1 | 24.8× | 0.050 | UCHL5 |
| Neurotransmitter receptors and postsynaptic signal transmission | 1 | 20.0× | 0.056 | CHRNA2 |
| Transmission across Chemical Synapses | 1 | 15.2× | 0.069 | CHRNA2 |
| Neuronal System | 1 | 8.8× | 0.108 | CHRNA2 |
GO biological processes by enrichment
Over-representation of cohort genes vs the genome-wide background (hypergeometric test, Benjamini-Hochberg FDR; fold = observed/expected over 7 annotated cohort genes). Counts and members are kept as ground-truth; sorted by enrichment.
| GO term | Cohort genes | Fold | FDR | Sample cohort genes |
|---|---|---|---|---|
| caudate nucleus development | 1 | 2407.4× | 0.006 | FOXP2 |
| putamen development | 1 | 2407.4× | 0.006 | FOXP2 |
| polysaccharide localization | 1 | 2407.4× | 0.006 | CHST11 |
| stilbene catabolic process | 1 | 2407.4× | 0.006 | EPHX2 |
| regulation of establishment of bipolar cell polarity | 1 | 2407.4× | 0.006 | ANKFN1 |
| modulation of inhibitory postsynaptic potential | 1 | 2407.4× | 0.006 | CHRNA2 |
| post-embryonic development | 2 | 58.7× | 0.006 | FOXP2, CHST11 |
| epoxide metabolic process | 1 | 802.5× | 0.013 | EPHX2 |
| epithelial cell proliferation involved in lung morphogenesis | 1 | 481.5× | 0.020 | FOXP2 |
| equilibrioception | 1 | 343.9× | 0.021 | ANKFN1 |
| positive regulation of epithelial cell proliferation involved in lung morphogenesis | 1 | 343.9× | 0.021 | FOXP2 |
| vocal learning | 1 | 300.9× | 0.021 | FOXP2 |
| cellular response to nicotine | 1 | 300.9× | 0.021 | CHRNA2 |
| righting reflex | 1 | 267.5× | 0.021 | FOXP2 |
| embryonic viscerocranium morphogenesis | 1 | 240.7× | 0.021 | CHST11 |
| negative regulation of insulin secretion involved in cellular response to glucose stimulus | 1 | 240.7× | 0.021 | PIM3 |
| carbohydrate biosynthetic process | 1 | 218.9× | 0.021 | CHST11 |
| forebrain morphogenesis | 1 | 200.6× | 0.021 | UCHL5 |
| lateral ventricle development | 1 | 185.2× | 0.021 | UCHL5 |
| regulation of cholesterol metabolic process | 1 | 160.5× | 0.021 | EPHX2 |
| cellular response to forskolin | 1 | 160.5× | 0.021 | PIM3 |
| positive regulation of telomere maintenance in response to DNA damage | 1 | 160.5× | 0.021 | UCHL5 |
| cerebellar Purkinje cell differentiation | 1 | 150.5× | 0.021 | FOXP2 |
| locomotor rhythm | 1 | 150.5× | 0.021 | ANKFN1 |
| phospholipid dephosphorylation | 1 | 150.5× | 0.021 | EPHX2 |
| smooth muscle tissue development | 1 | 150.5× | 0.021 | FOXP2 |
| regulation of DNA strand elongation | 1 | 150.5× | 0.021 | UCHL5 |
| chondrocyte development | 1 | 133.8× | 0.022 | CHST11 |
| regulation of chromosome organization | 1 | 133.8× | 0.022 | UCHL5 |
| vocalization behavior | 1 | 126.7× | 0.022 | FOXP2 |
Therapeutics
Drugs indicated or in trials for this disease
No drug has an approved disease-direct ChEMBL indication for this disease.
28 drugs in clinical trials for this disease (phase 2–3, investigational): efficacy not established — a trial record, not an indication.
| Drug | Highest phase |
|---|---|
| Acetylcysteine | Phase 3 |
| Cannabinol | Phase 3 |
| Nicotine | Phase 3 |
| Aprepitant | Phase 2 |
| Atomoxetine | Phase 2 |
| Baclofen | Phase 2 |
| Bupropion | Phase 2 |
| Buspirone | Phase 2 |
| Cannabidiol | Phase 2 |
| Citicoline | Phase 2 |
| Clonazepam | Phase 2 |
| Clonidine | Phase 2 |
| Dronabinol | Phase 2 |
| Fluoxetine | Phase 2 |
| Gabapentin | Phase 2 |
| Guanfacine | Phase 2 |
| Lofexidine | Phase 2 |
| Nabilone | Phase 2 |
| Nabiximols | Phase 2 |
| Naltrexone | Phase 2 |
| Nefazodone | Phase 2 |
| Pregnenolone Succinate | Phase 2 |
| Progesterone | Phase 2 |
| Psilocybin | Phase 2 |
| Quetiapine | Phase 2 |
| Topiramate | Phase 2 |
| Varenicline | Phase 2 |
| Vilazodone | Phase 2 |
Drug target analysis
Approved (phase 4): 3 · Phase ≥3: 3 · Phased (≥1): 4 · Undrugged: 3
Druggability breadth: 4 of 7 evidence-associated genes (57%) have a ChEMBL target (buckets above are over the deeply-mined display cohort).
Genes with an approved drug
The molecule shown is one approved compound that hits the gene — not necessarily a drug of choice or one indicated for this disease.
| Symbol | Example approved molecule |
|---|---|
| PIM3 | RUCAPARIB |
| CHRNA2 | VARENICLINE |
| EPHX2 | OXAPROZIN |
Top cohort targets by molecule count
| Symbol | Molecules | Max phase |
|---|---|---|
| PIM3 | 24 | 4 |
| EPHX2 | 19 | 4 |
| CHRNA2 | 4 | 4 |
| UCHL5 | 1 | 2 |
| FOXP2 | 0 | 0 |
| CHST11 | 0 | 0 |
| ANKFN1 | 0 | 0 |
Drugs targeting cohort genes (top 30)
| Molecule | Max phase | Targets in cohort |
|---|---|---|
| RUCAPARIB | 4 | PIM3 |
| SUNITINIB | 4 | PIM3 |
| MIDOSTAURIN | 4 | PIM3 |
| GEFITINIB | 4 | PIM3 |
| LEFLUNOMIDE | 4 | PIM3 |
| VARENICLINE | 4 | CHRNA2 |
| MECAMYLAMINE | 4 | CHRNA2 |
| NICOTINE | 4 | CHRNA2 |
| OXAPROZIN | 4 | EPHX2 |
| SORAFENIB | 4 | EPHX2 |
| FULVESTRANT | 4 | EPHX2 |
| REGORAFENIB | 4 | EPHX2 |
| ZAFIRLUKAST | 4 | EPHX2 |
| ZILEUTON | 4 | EPHX2 |
| MASITINIB | 3 | PIM3 |
| ENZASTAURIN | 3 | PIM3 |
| ALVOCIDIB | 3 | PIM3 |
| ALISERTIB | 3 | PIM3 |
| LESTAURTINIB | 3 | PIM3 |
| RUBOXISTAURIN | 3 | PIM3 |
| RUTIN | 3 | EPHX2 |
| SODIUM LAURYL SULFATE | 3 | EPHX2 |
| QUERCETIN | 3 | EPHX2 |
| EBSELEN | 3 | EPHX2 |
| SU-014813 | 2 | PIM3 |
| CENISERTIB | 2 | PIM3 |
| LY-2090314 | 2 | PIM3 |
| NUVISERTIB | 2 | PIM3 |
| DAPOLSERTIB | 2 | PIM3 |
| R-406 | 2 | PIM3 |
Bioactivity and enzyme data
Enzyme cohort genes (≥1 EC): 3.
Cohort genes with ChEMBL bioactivity (full, sorted by assay count)
| Symbol | Assays | Type breakdown |
|---|---|---|
| PIM3 | 450 | Binding:419, Functional:30, Toxicity:1 |
| EPHX2 | 314 | Binding:311, ADMET:3 |
| CHRNA2 | 40 | Binding:37, Functional:2, ADMET:1 |
| UCHL5 | 31 | Binding:31 |
Cohort enzymes (BRENDA EC)
| Symbol | EC numbers | Names |
|---|---|---|
| CHST11 | 2.8.2.5 | chondroitin 4-sulfotransferase |
| UCHL5 | 3.4.19.12 | ubiquitinyl hydrolase 1 |
| EPHX2 | 3.1.3.106, 3.3.2.10 | 2-lysophosphatidate phosphatase, soluble epoxide hydrolase |
Cohort genes with high screening signal
≥100 ChEMBL assays — a studied-ness signal; see Therapeutics for approved-drug status.
| Symbol | ChEMBL assays |
|---|---|
| PIM3 | 450 |
| EPHX2 | 314 |
Pharmacogenomics
Cohort genes with a PharmGKB record: 7; with CPIC/DPWG dosing guidelines: 0.
No cohort gene has a CPIC/DPWG genotype-guided dosing guideline (PharmGKB).
Chemical tractability of cohort targets
28 approved/phased compounds have measured bioactivity against a cohort gene (and aren’t yet in disease-level trials). This is a research / tractability signal, NOT a therapeutic recommendation — a bioactivity row often reflects off-target or screening binding (e.g. promiscuous kinase inhibitors against a cohort kinase), implying no disease mechanism.
| Compound | Max phase | Cohort target (bioactivity) |
|---|---|---|
| RUCAPARIB | 4 | PIM3 |
| SUNITINIB | 4 | PIM3 |
| MIDOSTAURIN | 4 | PIM3 |
| GEFITINIB | 4 | PIM3 |
| LEFLUNOMIDE | 4 | PIM3 |
| MECAMYLAMINE | 4 | CHRNA2 |
| OXAPROZIN | 4 | EPHX2 |
| SORAFENIB | 4 | EPHX2 |
| FULVESTRANT | 4 | EPHX2 |
| REGORAFENIB | 4 | EPHX2 |
| ZAFIRLUKAST | 4 | EPHX2 |
| ZILEUTON | 4 | EPHX2 |
| MASITINIB | 3 | PIM3 |
| ENZASTAURIN | 3 | PIM3 |
| ALVOCIDIB | 3 | PIM3 |
| ALISERTIB | 3 | PIM3 |
| LESTAURTINIB | 3 | PIM3 |
| RUBOXISTAURIN | 3 | PIM3 |
| RUTIN | 3 | EPHX2 |
| SODIUM LAURYL SULFATE | 3 | EPHX2 |
| QUERCETIN | 3 | EPHX2 |
| EBSELEN | 3 | EPHX2 |
| SU-014813 | 2 | PIM3 |
| CENISERTIB | 2 | PIM3 |
| LY-2090314 | 2 | PIM3 |
| NUVISERTIB | 2 | PIM3 |
| DAPOLSERTIB | 2 | PIM3 |
| R-406 | 2 | PIM3 |
Druggability pyramid
Cohort genes binned by druggability tier (high → low):
| Tier | Definition | Genes | Symbols |
|---|---|---|---|
| A | Approved (phase 4 drug) | 3 | PIM3, CHRNA2, EPHX2 |
| B | Phased (≥1) drug, not yet approved | 1 | UCHL5 |
| C | Druggable family + PDB, no drug | 0 | |
| D | Druggable family + AlphaFold only, no drug | 2 | CHST11, ANKFN1 |
| E | Difficult family or no structure, no drug | 1 | FOXP2 |
Undrugged target profiles
3 cohort genes are undrugged. Ranked by ‘starting-point quality’ (assay depth + drugged-partner adjacency).
| Symbol | ChEMBL assays | Drugged partners (top 3) |
|---|---|---|
| FOXP2 | 0 | — |
| CHST11 | 0 | — |
| ANKFN1 | 0 | — |
Clinical trials & evidence
Clinical trials
Clinical trials: 96.
Phase distribution (across all retrieved trials)
| Phase | Trials |
|---|---|
| Not specified | 42 |
| PHASE2 | 26 |
| PHASE1 | 10 |
| PHASE4 | 9 |
| PHASE2/PHASE3 | 4 |
| PHASE3 | 2 |
| PHASE1/PHASE2 | 2 |
| EARLY_PHASE1 | 1 |
Top trials by phase / activity
| NCT | Phase | Status | Title |
|---|---|---|---|
| NCT00498550 | PHASE4 | COMPLETED | Treatment of Schizophrenia and Comorbid Cannabis Use Disorder: Comparing Clozapine to Treatment-as-Usual |
| NCT00687609 | PHASE4 | TERMINATED | Pilot Evaluation of Atomoxetine on Attention Deficit Hyperactivity Disorder (ADHD) Symptoms in Adolescents With Cannabis abusE |
| NCT00875836 | PHASE4 | COMPLETED | Buspirone Treatment for Marijuana Dependence |
| NCT01153490 | PHASE4 | COMPLETED | Improving Substance Use and Clinical Outcomes in Heavy Cannabis Users With Quetiapine |
| NCT01400243 | PHASE4 | COMPLETED | Nicotine Patch for Marijuana Withdrawal |
| NCT01639872 | PHASE4 | COMPLETED | Clozapine for Cannabis Use in Schizophrenia |
| NCT03221231 | PHASE4 | UNKNOWN | N-acetylcysteine for the Treatment of Cannabis Dependence: Working Mechanisms |
| NCT04595318 | PHASE4 | COMPLETED | Varenicline for Co-occurring Cannabis and Tobacco Use |
| NCT04721353 | PHASE4 | COMPLETED | Reducing Cannabis Overuse With Prazosin |
| NCT00484367 | PHASE2/PHASE3 | UNKNOWN | A Comparison of Adolescent Group Therapy and Transitional Family Therapy for Adolescent Alcohol and Drug Abusers |
| NCT01020019 | PHASE2/PHASE3 | COMPLETED | Combined Pharmacotherapy for Cannabis Dependency |
| NCT01347762 | PHASE2/PHASE3 | COMPLETED | Nabilone for Cannabis Dependence: A Pilot Study |
| NCT01598896 | PHASE2/PHASE3 | TERMINATED | Combination of Dronabinol and Clonidine for Cannabis Dependence in Patients With Schizophrenia |
| NCT01675661 | PHASE3 | COMPLETED | Achieving Cannabis Cessation-Evaluating N-Acetylcysteine Treatment |
| NCT02955329 | PHASE3 | COMPLETED | Vaping THC From Electronic Cigarettes |
| NCT07523633 | PHASE2 | RECRUITING | Effect of Semaglutide on Cannabis Use in Adults With Cannabis Use Disorder |
| NCT00114439 | PHASE2 | COMPLETED | Lithium Cannabis Withdrawal Study |
| NCT00149643 | PHASE2 | COMPLETED | Effectiveness of Fluoxetine in Young People for the Treatment of Major Depression and Marijuana Dependence |
| NCT00167297 | PHASE2 | COMPLETED | Atomoxetine for the Treatment of Cannabis Dependence |
| NCT00350285 | PHASE2 | COMPLETED | The Teen Marijuana Check-Up |
| NCT00350649 | PHASE2 | COMPLETED | Maximizing the Efficacy of Cognitive Behavior Therapy and Contingency Management |
| NCT00373295 | PHASE2 | COMPLETED | Effect of Baclofen on Marijuana Withdrawal and Relapse |
| NCT00373503 | PHASE2 | COMPLETED | Effect of Lofexidine and Oral THC on Marijuana Withdrawal and Relapse |
| NCT00374127 | PHASE2 | COMPLETED | Comparison Between Marijuana Smoked in Cigarette Paper Versus Cigar Paper |
| NCT00395044 | PHASE2 | COMPLETED | Gabapentin Treatment of Cannabis Dependence |
| NCT00480441 | PHASE2 | COMPLETED | Effectiveness Study of Dronabinol and BRENDA for the Treatment of Cannabis Withdrawal |
| NCT00542750 | PHASE1/PHASE2 | COMPLETED | An Open-Label Trial of N-Acetylcysteine in Cannabis Dependent Adolescents |
| NCT00656487 | PHASE2 | COMPLETED | Clinical and Neurobiological Effects of Cannabis Dependence in Young Adults |
| NCT00954681 | PHASE2 | COMPLETED | Study of Quetiapine Treatment for Cannabis Dependence |
| NCT00974376 | PHASE2 | COMPLETED | Gabapentin Treatment of Cannabis Dependence |
| NCT01005810 | PHASE2 | COMPLETED | A Trial of N-Acetylcysteine (an Over-the-Counter Medicine) in Adolescents Who Smoke Marijuana |
| NCT01110434 | PHASE2 | COMPLETED | Biobehavioral Effects of Topiramate on Cannabis-Related Outcomes in Adolescents |
| NCT01292642 | PHASE2 | COMPLETED | Cognitive Behavioral Therapy and the Nicotine Transdermal Patch for Cannabis Dependence and Nicotine Dependence |
| NCT01439828 | PHASE2 | TERMINATED | Clinical Trial of N-acetylcysteine Versus Placebo Efficacy in the Cannabis Withdrawal |
| NCT01574183 | PHASE2 | COMPLETED | Vilazodone Treatment for Marijuana Dependence |
| NCT01611948 | PHASE2 | COMPLETED | Treatment for Cannabis Withdrawal and Dependence |
| NCT01618656 | PHASE2 | COMPLETED | Safety and Efficacy of a FAAH-Inhibitor to Treat Cannabis Withdrawal |
| NCT01697709 | PHASE2 | COMPLETED | Quetiapine Pharmacotherapy for Cannabis Dependence |
| NCT01747850 | PHASE2 | COMPLETED | Sativex and Behavioral-relapse Prevention Strategy in Cannabis Dependence |
| NCT02011516 | PHASE2 | COMPLETED | Baclofen Effects on Marijuana Dependence |
Drugs tested across these trials (top 30)
| Molecule | Max phase | Trials referencing |
|---|---|---|
| ATOMOXETINE | 4 | 6 |
| DRONABINOL | 4 | 6 |
| FLUOXETINE | 4 | 3 |
| GUANFACINE | 4 | 3 |
| VILAZODONE | 4 | 3 |
| ACETYLCYSTEINE | 4 | 2 |
| APREPITANT | 4 | 2 |
| BACLOFEN | 4 | 2 |
| CLONIDINE | 4 | 2 |
| CLOZAPINE | 4 | 2 |
| LOFEXIDINE | 4 | 2 |
| VARENICLINE | 4 | 2 |
| BUSPIRONE | 4 | 1 |
| ESZOPICLONE | 4 | 1 |
| LITHIUM CARBONATE | 4 | 1 |
| NABILONE | 4 | 1 |
| NICOTINE | 4 | 1 |
| PRAZOSIN HYDROCHLORIDE | 4 | 1 |
| RAMELTEON | 4 | 1 |
| RIMONABANT | 4 | 1 |
| RISPERIDONE | 4 | 1 |
| ZOLPIDEM | 4 | 1 |
| ZOPICLONE | 4 | 1 |
| NABIXIMOLS | 3 | 2 |
| PREGNENOLONE SUCCINATE | 3 | 1 |
| REDAFAMDASTAT | 2 | 1 |
| PREGNENOLONE | 1 | 1 |
| CHEMBL5435500 | 0 | 3 |
Related Atlas pages
- Cohort genes: FOXP2, CHST11, PIM3, CHRNA2, UCHL5, ANKFN1, EPHX2
- Drugs: Atomoxetine, Dronabinol, Fluoxetine, Guanfacine, Vilazodone, Acetylcysteine, Aprepitant, Baclofen, Clonidine, Clozapine, Lofexidine, Varenicline, Buspirone, Eszopiclone, Lithium Carbonate, Nabilone, Nicotine, Prazosin, Ramelteon, Rimonabant, Risperidone, Zolpidem, Zopiclone, Nabiximols, Pregnenolone