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 .
Efficacy, safety and tolerability of an orally administered cannabis extract in the treatment of spasticity in patients with multiple sclerosis: a randomized, double-blind, placebo-controlled, crossover study
Objective : Cannabis may alleviate some symptoms associated with multiple sclerosis ( MS ) . This study investigated the effect of an orally administered st and ardized Cannabis sativa plant extract in MS patients with poorly controlled spasticity . Methods : During their inpatient rehabilitation programme , 57 patients were enrolled in a prospect i ve , r and omized , double-blind , placebo-controlled crossover study of cannabis-extract capsules st and ardized to 2.5 mg tetrahydrocannabinol ( THC ) and 0.9 mg cannabidiol ( CBD ) each . Patients in group A started with a drug escalation phase from 15 to maximally 30 mg THC by 5 mg per day if well tolerated , being on active medication for 14 days before starting placebo . Patients in group B started with placebo for seven days , crossed to the active period ( 14 days ) and closed with a three-day placebo period ( active drug dose escalation and placebo sham escalation as in group A ) . Measures used included daily self-report of spasm frequency and symptoms , Ashworth Scale , Rivermead Mobility Index , 10-m timed walk , nine-hole peg test , paced auditory serial addition test ( PASAT ) , and the digit span test . Results : In the 50 patients included into the intention-to-treat analysis set , there were no statistically significant differences associated with active treatment compared to placebo , but trends in favour of active treatment were seen for spasm frequency , mobility and getting to sleep . In the 37 patients ( per- protocol set ) who received at least 90 % of their prescribed dose , improvements in spasm frequency ( P- 0.013 ) and mobility after excluding a patient who fell and stopped walking were seen ( P- 0.01 ) . Minor adverse events were slightly more frequent and severe during active treatment , and toxicity symptoms , which were generally mild , were more pronounced in the active phase . Conclusion : A st and ardized Cannabis sativa plant extract might lower spasm frequency and increase mobility with tolerable side effects in MS patients with persistent spasticity not responding to other drugs
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 .