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 .
Treatment of Tourette's syndrome with Delta 9-tetrahydrocannabinol (THC): a randomized crossover trial.
Anecdotal reports in Tourette 's syndrome ( TS ) have suggested that marijuana ( cannabis sativa ) and delta-9-tetrahydrocannabinol ( Delta(9)-THC ) , the major psychoactive ingredient of marijuana , reduce tics and associated behavioral disorders . We performed a r and omized double-blind placebo-controlled crossover single-dose trial of Delta(9)-THC ( 5.0 , 7.5 or 10.0 mg ) in 12 adult TS patients . Tic severity was assessed using a self-rating scale ( Tourette 's syndrome Symptom List , TSSL ) and examiner ratings ( Shapiro Tourette 's syndrome Severity Scale , Yale Global Tic Severity Scale , Tourette 's syndrome Global Scale ) . Using the TSSL , patients also rated the severity of associated behavioral disorders . Clinical changes were correlated to maximum plasma levels of THC and its metabolites 11-hydroxy-Delta(9)-tetrahydrocannabinol ( 11-OH-THC ) and 11-nor-Delta(9)-tetrahydrocannabinol-9-carboxylic acid ( THC-COOH ) . Using the TSSL , there was a significant improvement of tics ( p=0.015 ) and obsessive-compulsive behavior ( OCB ) ( p = 0.041 ) after treatment with Delta(9)-THC compared to placebo . Examiner ratings demonstrated a significant difference for the subscore " complex motor tics " ( p = 0.015 ) and a trend towards a significant improvement for the subscores " motor tics " ( p = 0.065 ) , " simple motor tics " ( p = 0.093 ) , and " vocal tics " ( p = 0.093 ) . No serious adverse reactions occurred . Five patients experienced mild , transient side effects . There was a significant correlation between tic improvement and maximum 11-OH-THC plasma concentration . Results obtained from this pilot study suggest that a single-dose treatment with Delta(9)-THC is effective and safe in treating tics and OCB in TS . It can be speculated that clinical effects may be caused by 11-OH-THC . A more long-term study is required to confirm these results
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 .