• CAM-summaries
  • Alternative medical systems
  • Biologically-based practices
    • Boswellia
    • Cannabinoids
      • What are Cannabinoids?
      • How well do Cannabinoids work?
      • Are Cannabinoids safe?
      • Cannabinoids conclusions
    • Essiac
    • Galavit
    • Laetrile
    • Shark cartilage
    • Ukrain
    • Black cohosh
  • Diet & nutrition
  • Energy medicine
  • Manipulative & body-based practices
  • Mind-body medicine
• CAM systematic reviews
• CAM and the law
• Prevalence of CAM use

Cannabinoids conclusions

Medical cannabinoids (dronabinol, nabilone) have been investigated for three major problems of cancer patients: nausea and vomiting, anorexia-cachexia-syndrome, and pain. Evidence of a systematic review (LOE 1) supports the efficacy of cannabinoids against chemotherapy-induced nausea and vomiting, especially in medium emetogenic chemotherapy regimens. However, no randomised trial has compared cannabinoids with modern antiemetic medication, especially serotonin antagonists. Dose-limitating central nervous and cardiovascular adverse effects were frequent. Therefore, cannabinoids cannot be recommended for prevention of chemotherapy-induced nausea as solitary drugs, but may be beneficial as adjuvants for individual patients with insufficiently controlled chemotherapy-related sickness. Only anecdotal evidence is available to support the use of medical cannabinoids against radiotherapy-related nausea and nausea in palliative care patients.
Randomised trials did not support the claim that cannabinoids increase appetite and body weight in cancer-related anorexia-cachexia syndrome.

A qualitative systematic review including five rather small RCTs is available on cannabinoids in pain management. Findings suggested a similar efficacy against pain as the low potent opioid codeine, but dose-limitating adverse effects were a common problem with cannabinoids. Insufficient evidence is available to support the introduction of cannabinoids into widespread clinical use as analgesics.

The main limitation of cannabinoids is seen in the high frequency of serious adverse effects on the central nervous system and the cardiovascular system. Known absolute and relative contraindications and pharmacological interactions should be carefully considered. Medical cannabinoids are subject to country-specific prohibitory legislation.