Cannabinoids for nausea and vomiting in adults with cancer receiving chemotherapy (Review)
Background: As many as three-quarters of people who receive chemotherapy experience nausea (feeling sick) and vomiting (being sick), which many find distressing. While conventional anti-sickness medicines are effective, they do not work for everyone, all of the time. Therapeutic drugs based on the active ingredient of cannabis, known as THC (delta-9-tetrahydrocannabinol), have been approved for use as antisickness medicines in some countries.
Review question: This review evaluated how well cannabis-based medicines work for treating nausea and vomiting due to chemotherapy treatment in people with cancer, and what the side effects were.
Main findings: This review of 23 randomised controlled trials (clinical studies where people are randomly put into one of two or more treatment groups) found that fewer people who received cannabis-based medicines experienced nausea and vomiting than people who received placebo (a pretend medicine). The proportion of people who experienced nausea and vomiting who received cannabis-based medicines was similar to conventional anti-nausea medicines. However, more people experienced side effects such as ’feeling high’, dizziness, sedation (feeling relaxed or sleepy) and dysphoria (feeling uneasy or dissatisfied) and left the study due to the side effects with cannabis-based medicines, compared with either placebo or other anti-nausea medicines. In trials where people received cannabis-based medicines and conventional medicines in turn, overall people preferred the cannabis-based medicines.
Quality of the evidence: The trials were of generally of low to moderate quality and reflected chemotherapy treatments and anti-sickness medicines that were around in the 1980s and 1990s. Also, the results from combining studies on the whole were of low quality. This means that we are not very confident in our ability to say how well the anti-sickness medicines worked, and further research reflecting modern treatment approaches is likely to have an important impact on the results.
Cannabis-based medicines may be useful for treating chemotherapy-induced nausea and vomiting that responds poorly to commonly used anti-sickness medicines.
Publication titleCochrane Database of Systematic Reviews
Department/SchoolTasmanian School of Medicine
PublisherJohn Wiley & Sons Ltd.
Place of publicationUnited Kingdom
Rights statementCopyright 2015 The Cochrane Collaboration This review is published as a Cochrane Review in the Cochrane Database of Systematic Reviews 2015, Issue 11. Cochrane Reviews are regularly updated as new evidence emerges and in response to comments and criticisms, and the Cochrane Database of Systematic Reviews should be consulted for the most recent version of the Review