Cannabinoids for control of chemotherapy induced nausea and vomiting: quantitative systematic review BMJ Volume 323, pp 16-21
Cannabinoids (the active substances in cannabis) are more effective than conventional drugs at preventing nausea and vomiting in patients undergoing chemotherapy, and patients prefer them, finds a study in this week's BMJ. However, potentially serious side effects, even when taken short term, are likely to limit their widespread use, conclude the authors.
Thirty trials, involving over 1300 patients, were analysed to quantify the effectiveness and safety of cannabis in preventing sickness induced by chemotherapy. Three different cannabinoids were given either as tablets or by intramuscular injection.
Across all trials, cannabinoids were more effective than conventional anti-sickness drugs, although no difference was found for patients receiving very low or very high levels of chemotherapy. Most patients also preferred cannabinoids for future chemotherapy cycles. Patients reported more side effects with cannabinoids than with conventional drugs. Although some were potentially beneficial (euphoria, "high", sedation or drowsiness), others were harmful (dizziness, depression, hallucinations).
These results offer arguments both for and against the use of cannabinoids in chemotherapy patients, say the authors. They suggest that, in selected patients, cannabinoids may be useful as mood enhancing aids for controlling chemotherapy related sickness.
Martin Tramer, Staff Anaesthetist. Departement d'Anaesthesiologie, Hopitaux Universitaires, Geneve, Switzerland
Editorial: Cannabinoids for pain and nausea BMJ Volume 323, pp 2-3