Most trials showed improvement in symptoms associated with cannabinoids but these associations did not reach statistical significance in all trials .
There was an increased risk of short-term AEs with cannabinoids , including serious AEs .
Common AEs included dizziness , dry mouth , nausea , fatigue , somnolence , euphoria , vomiting , disorientation , drowsiness , confusion , loss of balance , and hallucination .
CONCLUSIONS AND RELEVANCE There was moderate- quality evidence to support the use of cannabinoids for the treatment of chronic pain and spasticity .
There was low- quality evidence suggesting that cannabinoids were associated with improvements in nausea and vomiting due to chemotherapy , weight gain in HIV infection , sleep disorders , and Tourette syndrome .
Cannabinoids were associated with an increased risk of short-term AEs
IMPORTANCE Cannabis and cannabinoid drugs are widely used to treat disease or alleviate symptoms , but their efficacy for specific indications is not clear .
OBJECTIVE To conduct a systematic review of the benefits and adverse events ( AEs ) of cannabinoids .
A randomised multicentre single blind comparison of a cannabinoid anti-emetic (levonantradol) with chlorpromazine in patients receiving their first cytotoxic chemotherapy.
One hundred and eight patients selected to receive combinations of highly emetic cytotoxic chemotherapy for malignant disease were included in a study of anti-emetic therapy . The patients were r and omly allocated to receive levonantradol ( 0.5 , 0.75 or 1 mg ) or chlorpromazine ( 25 mg ) prior to receiving their first course of cytotoxic therapy . The appropriate anti-emetic was administered 2 hr prior to the start of chemotherapy , 2 hr after chemotherapy and subsequently at 4-hourly intervals for a further 8 hr . The extent of anorexia , nausea and vomiting along with other side-effects were assessed at regular intervals by physicians and nursing staff during the 24 hr following chemotherapy . In addition , a self- assessment question naire was completed by the patients . Levonantradol ( 0.5 mg ) was superior to chlorpromazine ( 25 mg ) as an anti-emetic . Both were reasonably well tolerated , although at this dose of levonantradol 22 % of patients experienced dysphoric reactions . At higher doses of levonantradol the proportion of patients experiencing these reactions rose to 50 % , but without a concomitant increase in antiemetic activity . Neither drug achieved satisfactory control of vomiting in patients receiving combinations containing cis-platinum . We conclude that levonantradol ( 0.5 mg ) is a more effective anti-emetic than chlorpromazine ( 25 mg ) in patients receiving cytotoxic chemotherapy . However , its use can not be recommended due to its high incidence of unacceptable central nervous system side-effects
Most trials showed improvement in symptoms associated with cannabinoids but these associations did not reach statistical significance in all trials .
There was an increased risk of short-term AEs with cannabinoids , including serious AEs .
Common AEs included dizziness , dry mouth , nausea , fatigue , somnolence , euphoria , vomiting , disorientation , drowsiness , confusion , loss of balance , and hallucination .
CONCLUSIONS AND RELEVANCE There was moderate- quality evidence to support the use of cannabinoids for the treatment of chronic pain and spasticity .
There was low- quality evidence suggesting that cannabinoids were associated with improvements in nausea and vomiting due to chemotherapy , weight gain in HIV infection , sleep disorders , and Tourette syndrome .
Cannabinoids were associated with an increased risk of short-term AEs
IMPORTANCE Cannabis and cannabinoid drugs are widely used to treat disease or alleviate symptoms , but their efficacy for specific indications is not clear .
OBJECTIVE To conduct a systematic review of the benefits and adverse events ( AEs ) of cannabinoids .