Cannabinoids for the control of chemotherapy induced nausea and vomiting

A quantitative systematic review has investigated the use of cannabinoids for control of chemotherapy induced nausea and vomiting (1):

Data sources used in the systematic review were identified by searching Medline (from 1966), EMBASE/Excerpta Medica (from 1982), and the Cochrane Library (2000, Issue 3) with the terms cannabis, cannabinoids, marihuana, marijauna, nabilone, tetrahydrocanabinol (THC), THC, levonatradol, dronabinol, randomized, and human.

Studies included in the systematic review were randomised controlled trials (RCTs) comparing the antiemetic efficacy of cannabis with any other antiemetic group or placebo in patients receiving chemotherapy.

Results:

• there were 30 RCTs (involving 1366 patients) identified which met the selection criteria - mean number of patients per study was 46 (ranged from 8 to 139 patients)
• oral nabilone was examined in 16 studies; oral dronabinol was examined in 13 studies; 1 study examined intramuscular levonantradol
• active control groups were administered alizapride (1 study); thiethylperazine (1 study); chlorpromazine (2 studies); metoclopramide (4 studies); prochlorperazine (12 studies)
• cannabinoids were more effective than other active treatments for completely relieving vomiting and nausea in the first 24 hours of chemotherapy
• cannabinoids also led to an increase in potential beneficial (e.g. euphoria) and harmful side effects (e.g. dizziness, dysphoria or depression, hallucnination and hypotension).

The study authors concluded that cannabinoids control nausea and vomiting better than selected conventional antiemetics in patients receiving chemotherapy but are associated with increased side effects.

Reference:

1. BMJ 2001 Jul 7;323(7303):16-21