Know Your Medicine

 Cannabis, the Plant – Botany

 

Cannabis is a genus of flowering plants within the hemp family. A native of Asia, Cannabis has been naturalized and cultivated worldwide over thousands of years. Traditionally, three major classes have been recognized: Cannabis sativa, Cannabis indica and Cannabis ruderalis. But Cannabis is prolific and the case is made that these may simply be the most common of almost 700 variations of the genus. 

Sativas originated in the world’s equatorial zones, growing up to 15-20 feet tall in the heat and light of the tropics. Shorter, larger-leafed indicas have adapted to grow at higher altitudes. Ruderalis is short, fibrous and has a remarkable range of uses from rope to cloth and nutraceuticals.

 

The Cannabis leaf is iconic, with serrate-edged leaflets radiating from the base in a distinctly palmate pattern recognized around the world. Cannabis is dioecious, having both male and female plants, although monoecious plants are not unusual. Until flowering, the sexes are differentiated by size and shape. The female is shorter and with thicker foliage, the male taller and sparsely leafed.

 

The flowers of Cannabis develop as clusters or buds. The flowers of male plants are loose and hang from the plant. In females, flowers are dense, bristling with leaflets and upright in thick leaf clusters arrayed along the flowering limb. Cannabis produces psychotropic and therapeutic compounds in trichomes clustered on the flowers of the female plant. Male plants are staminate and produce pollen. Female plants are pistillate and produce seeds, which are fertilized by wind-driven pollen.

 

In the natural growth cycle, seeds germinate in the spring over the course of 3-7 days. A spindly embryonic stem topped by “seed leaves” emerges and grows to approximately 10 centimeters, or 4 inches. In the vegetative stage, the lengthening days of summer stimulate the plant to sprout leaves and limbs. As the season passes, the light signals of shorter days and longer lights cause the plant flower to begin the cycle again.

 

Cannabis Produces Psychotropic and Therapeutic Compounds in Trichome Clusters on the Flowers of the Female Plant.

 

 

 


Chemistry Cannabis – Chemistry

 

Cannabinoids

 

Cannabis produces a unique class of chemical compounds called cannabinoids, which are primarily, but not exclusively, responsible for the plant’s therapeutic and psychotropic properties. Cannabinoids are hydrocarbons that consist of bound atoms of hydrogen, carbon and oxygen. Cannabis has been shown to produce over 70 cannabinoids, with ongoing research uncovering new variations.

 

Due to its psychotropic effects on the human brain, THC (delta 9-THC) is the best-known cannabinoid. The amount of THC in Cannabis can vary greatly (< 0.3 - 25% dry weight) and the plant has been cultivated aggressively in the modern era to produce potent strains laden with THC. However, the therapeutic benefits of Cannabis are not limited to THC. For example, research has shown that cannabidiol (CBD) also plays a medically beneficial role as a powerful anti-inflammatory agent. The current scientific consensus is that cannabinoids other than THC and CBD have therapeutic applications.

 

Common Cannabinoids

 

THC delta (9)-Tetrahydrocannabinol

THC acts on the central nervous and immune systems of humans. It is the primary psychotropic ingredient in Cannabis, or the one that produces a high. While these psychotropic effects have therapeutic benefits, THC also acts as a painkiller, anti-inflammatory and anti-microbal (microorganisms e.g., bacteria) agent.

 

CBN cannabinol

Mildly psychoactive, CBN is the primary product of THC degradation. As a result, the CBN content of Cannabis goes up as THC is broken down during storage or when exposed to air and light. CBN interacts with the central nervous and immune systems, and may stimulate bone growth.

 

CBD cannabidiol 

CBD does not interact with the human body like other cannabinoids, but has significant therapeutic effects. It appears to relieve anxiety, convulsion, depression, inflammation and nausea. Mildly psychoactive, it is also believed to moderate psychotic side effects of THC, such as schizophrenia-like symptoms. While unproven, CBD may exhibit anti-cancer activity, especially in breast cancer.

 

CBG cannabigerol

CBG is called the “parent” cannabinoid because it is the chemical precursor of the acidic forms of THC, CBC and CBD. While its biological action is not completely understood, CBG is believed to be a painkiller, muscle relaxant and anti-erythemic (redness of skin, often a sign of inflammation or infection). It is also being investigated for potential anti-cancer activity.

 

CBC cannabichromene

CBC is an anti-inflammatory and an analgesic. It is found in higher concentrations early in the lifecycle of a Cannabis plant and has been shown in to reduce THC intoxication in mice.

 

THCV tetrahydrocannabivarin

Nearly identical to THC, THCV acts on the human nervous and immune systems. It has anti-obesity properties and aids in memory.

 

CBDV cannabidivarin 

Little is known about CBDV as it is uncommon in modern varieties ofCannabis. Cannabis chemotypes which express CBDV are relatively rare and should be monitored closely.

 

In raw plant form, Cannabis contains the acidic compound THCA – not delta 9-THC – and therefore could be ingested with no pharmacological or psychotropic effects. Only when heated does the acidic compound THCA convert to biologically active THC (delta-9 THC) in a process called decarboxylation (loss of carboxylic acid functional group). The rule applies to all cannabinoids: decarboxylation converts acidic CBDA to neutral CBD; CBGA to CBG; etc.

 

Terpenes

 

The essential oils of plants have been used for therapeutic purposes for nearly 6,000 years. These hydrophobic oils contain aroma compounds, which carry a distinctive scent, or essence, of the plant. The ancient Chinese, Egyptians, Greeks, Indians and Romans used essential oils in cosmetics, perfumes, medicines and rituals. Today they are used for their aroma, flavor and other properties in cosmetics, foods, household products, pharmaceuticals and in aromatherapy.

 

Essential oils contain terpenes, a large group of volatile unsaturated hydrocarbons. Terpenes are aroma and taste molecules. They produce the characteristic aromas of flowers, herbs and spices – almost all plant odors – that are used to attract pollinators, repel pests and discourage herbivores. For example, limonene, which lends citrus its characteristic odor, is also found in spices such as rosemary, juniper, peppermint and Cannabis. Terpenes are also biosynthetic building blocks for various phytochemicals including THCA, the precursor chemical to THC.

 

Derived from isoprene (C5H8), terpenes are classified by size based on the number of isoprene units in the molecule. Most relevant to Cannabis are monoterpenes with two isoprene units (C10H16) such as pinene, myrcene and limonene as well as sesquiterpenes (C15H24) with three isoprene units, such as humulene and beta-caryophyllene. Terpenes are major components of Cannabis resin and extracts produced from these resins. Up to 30% of the resin in Cannabis smoke is composed of terpenes. Plant essential oils, each with a distinct combination of terpenes, are used in aromatherapy because the terpenes affect our mood and brain function. Scientists now think that unique combinations of terpenes account for the medical benefits and mood alterations of various strains of Cannabis.

 

For example, one of the most significant phytochemical differences between Cannabis sativa strains and Cannabis indica strains is in their unique expressions of terpenes. The general rule that patients prefer sativas for daytime use and indicas for nighttime use suggests that the sedative effects of Cannabis may be influenced by terpene content. In one study, a strain of Cannabis that produced strong sedative effects among most patients was found to have a relatively conventional phytochemical profile except for unusually high levels of a single terpene.

 

 The ratios of terpenes – their relative proportions in a plant – are chemotype-specific i.e., associated with the plant’s unique chemical composition instead of its appearance. The absolute levels of terpenes seem to vary with environmental factors such as water content, soil type, nutrient, light, temperature, etc. Modern cultivation methods enable production of strains with consistent ratios of terpenes to cannabinoids.

 

Cannabis also contains over 20 flavonoids, a large group of water-soluble organic compounds found in the pigments of fruits and flowers. Flavonoids found uniquely in Cannabis, called cann-flavins, are thought to have anti-inflammatory and anti-oxidant properties. In addition, they may help protect against cancer and other diseases.

 

Just as rose varieties have different odors, Cannabis varieties have unique odors ranging from sweet to acrid, from floral to skunky. Each of these odors indicates combinations of terpenes. Some of them, such as the various analogs of limonene, are familiar. Limonene carries a citrus odor such as orange, tangerine, lemon and grapefruit. Limonene is thought to enhance alertness and focus attention, and also has fungicidal properties.

 

Common Terpenes

 

Beta-Caryophyllene   

A major component of clove oils and black pepper, beta-caryophyllene is a bicyclic terpene that smells and tastes peppery, with hints of clove and camphor. Research has shown that beta-caryophyllene binds to CB-2 receptors in the brain, immune system, gastrointestinal system and peripheral nervous system. It can therefore be regarded as a non-psychoactive cannabinoid analog. Beta-caryophyllene has demonstrated anti-inflammatory effects in mice and also appears to moderate pain and protect neurons in humans.

 

cis-Ocimene   

Found in a variety of fruits and plants, cis-Ocimene is used as a scent in perfumes. While often found in Cannabis, its medical effects are undefined.

 

Limonene   

Limonene is named after the lemon, which like other citrus fruits contains this fragrant compound in its rind. Limonene is used as a scent in cosmetics and perfumes, as a flavoring in food manufacturing, as a flavor to mask the bitter taste of alkaloids in some medicines, as a skin-penetrating agent in pharmaceuticals, as a botanical insecticide and cleaning solvent.

 

Limonene is used as an anti-anxiety and antidepressant remedy as well as to treat acid reflux and bronchitis. Laboratory research suggests that limonene may block certain cancer-forming chemicals and even kill cancerous cells – although further scientific study is required to determine its effects in humans.

 

Linalool 

A naturally occurring terpene alcohol, linalool is found in over 200 species of plants. Linalool’s scent is reminiscent of spring flowers such as Lily of the Valley, but with spicy overtones, and it is used in many perfumed hygiene and cleaning products such as soaps, lotions, shampoos and detergents.

 

Linalool is a powerful sedative when inhaled. As a result, patients with insomnia or pain seek out floral, fruity or sweet-scented strains of Cannabis for their sedative properties. For daytime use and alertness, patients avoid strains with a high level of linalool or in which linalool’s floral undertones are masked by limonene-citrus odors. Linalool is being tested for use in treating some cancers.

 

Myrcene 

The most common monoterpene found in Cannabis, myrcene is a potent analgesic, anti-inflammatory and antibiotic. The aroma of myrcene has been described as citrus, clove, earthy, fruity, mango and green vegetative. Variations in the odor result from slight differences in the chemotype, or the distinct chemical make-up of the molecule.

 

Myrcene may act in synergy with THC, with their combined molecules creating a stronger effect than THC alone. This may be due to myrcene’s influence on the permeability of the cell membrane, which allows more THC to reach the brain. Myrcene blocks the effects of pro-mutagens implicated as carcinogens, such as aflotoxin B, and small amounts are found in essential oils associated with anti-depressive and mood-enhancing effects.

 

Pinene 

Pinene is found in pine trees as well as in rosemary, sage and eucalyptus. It has a piney odor and is a major component of turpentine. The skunky odors of some Cannabis varieties are created largely by analogs of pinene.

 

Pinene is thought to help memory by crossing the blood brain barrier and inhibiting a chemical that destroys an information transfer molecule in the brain. The information transfer molecule works longer before becoming inactive, improving memory. Aroma therapists also report that pinene increases focus and self-satisfaction.

 

Terpenol 

Terpenol has a floral smell that has been described as hyacinthine with hints of lilac and orange blossom. In Cannabis, it is often found with pinene, whose stronger scent masks terpenol’s flowery aroma.

 

Terpenol causes drowsiness, and a desire to rest. It is often found in Cannabis in conjunction with pinene, which masks its odor. This is what causes some Afghan varieties to have such a sedative affect. It is useful as a sleep aid and general sedative.

 

Terpinolene 

A monocyclic terpene, terpinolene is commonly found in Cannabis, but its medical effects are unknown. It is used as a solvent and as a chemical intermediate for resins and essential oils.

 

Cannabis Has Been Shown to Produce Over 70 Cannabinoids

Cannabis Varieties Have Unique Odors Ranging From Sweet to Acrid, Floral to Skunky

 

 

 


 

How Cannabis Works – Biochemistry

      

      Respiratory System               Digestive System                       Skin – Topical

 

Cannabinoids are delivered to the bloodstream through the lungs (when inhaled), the digestive system (when consumed) or the skin (when applied topically). Once in the bloodstream, they are available to the brain and central nervous system.

 

Inhalation is the fastest method, with peak blood levels achieved within 5-20 minutes. Oral ingestion is slower because the cannabinoids go through the gastrointestinal tract before entering the bloodstream. The bioavailability of cannabinoids in the body is an important area of ongoing research with implications for the medicinal use of Cannabis.

 

In 1988, a major breakthrough in our understanding of Cannabis took place when American scientist Dr. Allyn Howlett discovered cannabinoid receptors in the human brain. Basically, these receptors are protein molecules embedded in cellular surfaces that receive chemical signals from other cells. These signals result in a range of effects from pain to nausea and euphoria to depression. They can stimulate or suppress appetite or growth, while also impacting mood and perception. Cannabinoid receptors have also been discovered in mammals, birds, fish and reptiles.

 

There are two types of cannabinoid receptors in our bodies, CB1 and CB2. The CB1 receptors are found in the central nervous system, on brain cells and in the peripheral nervous system. The CB2 receptors are generally found on immune cells. Humans have many thousands of receptors that we still have not identified or fully understood. A common characteristic is that receptors bind with naturally occurring substances such as hormones (e.g., estrogen, testosterone) and growth factors (e.g., insulin) as well as with exogenous substances introduced into the body to mimic the effect of endogenous substances.

 

Substances that activate receptors after binding with them are called agonists. Those that suppress the ability of the receptor to activate are called antagonists. Generally, agonists have the effect of turning receptors "on" while antagonists turn them "off." As a result, the signal running along the neural pathway where the receptor is located is either enhanced or suppressed. Cannabinoids have been shown to stimulate the CB1 and CB2 receptors in a number of ways, serving as agonists, antagonists or as both.

 

Having discovered cannabinoid receptors, scientists began to search for the naturally occurring ligand that binds with the receptors to achieve a biologic purpose. Their research uncovered two endocannabinoids in the human body: anandaminde (AEA) and 2-AG2-arachidonogylglycerol. Both are agonists that influence pain, appetite, motor learning and synaptic plasticity.

 

 In the bloodstream, exogenous cannabinoids act like endocannabinoids, binding with receptors to mitigate pain, suppress nausea, decrease pressure and enhance appetite. Thus, as far as we know, Cannabis does not cure anything. Instead, the plant’s active ingredients can deliver important palliative effects. Note: the stimulation of the CB receptors by exogenous cannabinoids is complex, as not all cannabinoids interact with the receptors in the same way. Because of this, scientists are still trying to unravel the details of the system and its implications for medicine.

 

Currently, medical Cannabis is used to treat the symptoms – and the side effects of treatments for – cancer, Crohn’s Disease, epilepsy and other seizure disorders, multiple sclerosis, neuropathic pain, rheumatoid arthritis and cachexia. Medical studies are exploring the use of Cannabis to suppress muscle spasms and spasticity, relieve chronic pain, manage glaucoma and bronchial asthma. There is also ongoing research into whether Cannabis prevents or even cures certain diseases and conditions.

 

 

 


 

      Safety and Addiction

 

Scientific literature indicates that, in practice, it is difficult and quite rare to overdose on Cannabis since its administration requires ongoing deliberate and complex actions such as smoking. Acute adverse reactions due to overdose include anxiety, panic attacks, increased heart rate and changes in blood pressure. There is ongoing debate about possible long-term adverse effects on psyche and cognition, immune system, fertility and pregnancy.

 

Regular use of Cannabis can lead to dependency and a mild withdrawal syndrome. A federal government study showed an increase in dependency rates, including among young people, over the last 20 years. Some authorities have considered illegal marijuana as a gateway drug that leads to the use of more dangerous and addictive substances.

 

The most common form of administering Cannabis, smoking, is harmful to health and safety. Smoking produces carcinogenic, toxic or irritating byproducts that are dangerous for patients and any user.

 

Cannabis provided to patients and for other users should be tested for potencies of all biologically relevant ingredients and to ensure that it is free from dangerous levels of contaminants and pathogenic species such as heavy metals, pesticides, herbicides, growth enhancers, microbes and fungi.

 

 

 

 


 

      Medical Use<>

 

Cannabis has been used as a medicine for centuries, with the earliest record found in the Chinese Pharmacopeia of the 1st Century AD. The science of Cannabis was advanced during the 19th and 20th Centuries as more than 100 articles on the subject were published in medical journals. Cannabis was listed in the United States Pharmacopeia from 1850 until 1942 and used as a prescription for various conditions including labor pains, nausea and rheumatism.

 

Modern research conducted under FDA-approved protocols, including studies sponsored by federal and state governments, has documented the effectiveness of Cannabis as an antiemetic for nausea and an anti-convulsant for epilepsy. When the federal government ended Cannabis research in 1992, it had nearly completed the requirements for new drug approval. Federal restrictions have limited subsequent Cannabis research in the United States.

 

Growing abuse of marijuana and an aggressive anti-marijuana campaign by the Federal Bureau of Narcotics led to federal prohibition of possession and transfer (but not medical and industrial use) in 1932. The Controlled Substances Act of 1970 ranked Cannabis, alongside heroin and LSD, as a Schedule 1 drug with the highest potential for abuse and no accepted medical uses. In 1996, California became the first state to legalize the use of medical Cannabis.

 

Today, 25 states and the District of Columbia allow medical use. However, the possession and use of Cannabis in any form remains illegal under federal law. Recent federal drug enforcement policy has been not to interfere with qualified patients who use medical Cannabis in compliance with the laws of states that have legalized medical use.

 

There is considerable misinformation about medical Cannabis. Further research is required and is being conducted in the United States and around the world. What we do know, however, is that Cannabis is recognized by science for its well-established palliative effects and is used to treat the symptoms of cancer, Crohn’s disease, epilepsy and other seizure disorders, multiple sclerosis, rheumatoid arthritis and cachexia.

 

The drug provides doctors with an alternative to pharmaceuticals with debilitating and often devastating side effects. As such, medical Cannabis is being used today in some parts of the country to provide critical palliative relief to patients suffering from a host of diseases and conditions. Ultimately, it has the potential to help millions of patients in the United States and worldwide.

 

 

 



STUDIES AND CASE REPORTS

Source: International Association of Cannabis Medicine

www.cannabis-med.org

+ Improvement of symptoms or positive evaluation by authors

± No relevant change of symptoms or negative evaluation by authors

– Deterioration of symptoms

Major Categories

 

Nausea and Vomiting

Cancer Chemotherapy

Radiotherapy

Metastases

Surgery

HIV/AIDS

Therapy of Hepatitis C

Pregnancy

Motion Sickness

Other Subjects

Healthy Subjects

 

Appetite Loss

HIV/AIDS

Cancer

Alzheimer's Disease

Geriatrics

Anorexia nervosa

COPD

Healthy Subjects 

 

Spasticity

Multiple Sclerosis

Spinal Cord Injury

Different Causes

 

Pain

Chronic, Neuropathic/Multiple Sclerosis

Chronic, Cancer

Rheumatic

Fibromyalgia

Chronic

Acute, Surgery

Acute, Healthy Subjects

  

Specialized Studies  

Alcohol Dependency

Alzheimer's Disease

Amyotrophic Lateral Sclerosis

Anxiety

Asthma

Attention-Deficit/Hyperactivity Disorder

Bipolar Disorder

Bladder Dysfunction

Blood Pressure/Hypertension

Bronchodilation - Healthy Subjects

Cancer

Cannabis Dependency

Cocaine/Crack Dependency

COPD (Chronic Obstructive Pulmonary Disease)

Crohn's Disease

Depression

Different Diseases

Dystonia

Epilepsy

Gastro-Oesophageal Reflux

Headache/Migraine

Hiccups (Singultus)

Huntington's Disease

Hyperkinetic Movement Disorder 

Intraocular Pressure - Glaucoma

Intraocular Pressure - Healthy Subjects

Irritable Bowel Syndrome, Diarrhoea

Isaacs' Syndrome

L-Dopa-induced Dyskinesia (Tardive Dyskinesia)

Neuroprotection

Night Sweats

Night Vision

Obsessive Compulsive Disorder

Obstetrics and Gynecology

Opioid Dependency

Parkinson's Disease

Posttraumatic Stress Disorder

Pruritus

Schizophrenic Psychosis

Sleep

Tinnitus

Tourette's Syndrome, Tics

Traumatic Brain Injury

Tremor

Trichotillomania

Ulcerative Colitis

 

Nausea and Vomiting – Cancer Chemotherapy

Controlled Studies

 

Dronabinol

 

+ Artim R, DiBella N. Tetrahydrocannabinol (THC) plus prochlorperazine (PCZ) for refractory nausea and vomiting (N/V). Proceedings of the American Society for Clinical Oncology 1983;2:84.

+ Chang AE, Shiling DJ, Stillman RC, Goldberg NH, Seipp CA, Barofsky I. Delta-9-tetrahydrocannabinol as an antiemetics in cancer patients receiving high-dose methotrexate. Annals of Internal Medicine 1979;91:819-824.

± Chang AE, Shiling DJ, Stillman RC, Goldberg NH, Seipp CA, Barofsky I, Rosenberg SA.. A prospective evaluation of delta-9-tetrahydrocannabinol as an antiemetic in patients receiving adriamycin and cytoxan chemotherapy. Cancer 1981; 47: 1746-1751.

+ Colls BM, Ferry DG, Gray AJ, Harvey VJ, McQueen EG. The antiemetic activity of tetrahydrocanabinol versus metoclopramide and thiethylperazine in patients undergoing cancer chemotherapy. New Zealand Medical Journal 1980;91:449-451.

 

+ Ekert H, Waters KD, Jurk KH, Mobilia J, Loughnan P. Ameriloration of cancer chemotherapy-induced nausea and vomiting by delta-9-tetrahydrocannabinol. Medical Journal of Australia 1979;2:657-659.

+ Frytak S, Moertel CG, O'Fallon JR, Rubin J, Creagan ET, O'Connnell MJ. Delta-9-tetrahydrocannabinol as an antiemetics for patients receiving cancer chemotherapy. A comparison with prochlorperazine and a placebo. Annals of Internal Medicine 1979;91:825-830.

+ Gralla RJ, Tyson LB, Bordin LA, Clark RA, Kelsen DP, Kris MG. Antiemetic therapy: a review of recent studies and a report of a random assignment trial comparing metoclopramide with delta-9-tetrahydrocannabinol. Cancer Treatment Report 1984;68:163-172.

+ Kluin-Nelemans JC, Nelemans FA, Meuwissen OJATh, Maes RAA. D9-tetrahydrocannabinol (THC) as an antiemetic in patients treated with cancer chemotherapy; a double-blind cross-over trial against placebo. Veterinary and Human Toxicology 1979;21:338-340.

+ Lane M, Vogel CL, Ferguson J, Krasnow S, Saiers JL, Hamm J. Dronabinol and prochlorperazine in combination for treatment of cancer chemotherapy-induced nausea and vomiting. Journal of Pain and Symptom Management 1991;6:352-359.

+ Levitt M, Faiman C, Hawks R, Wilson A. Randomized double blind comparison of delta-9-tetrahydroicannabinol (THC) and marijuana as chemotherapy antiemetics. Proceedings of the American Society for Clinical Oncology 1984;3:91.

+ Levitt M, Wilson A, Bowman D, Faiman C, Kemel S, Krepart G. Dose vs response of tetrahydroannabinol (THC) vs prochlorperazine as chemotherapy antiemetics. Proceedings of the American Society for Clinical Oncology 1981;22:422.

+ McCabe M, Smith FP, Goldberg D, Macdonald J, Woolley PV, Warren R. Efficacy of tetrahydrocannabinol in patients refractory to standard anti-emetic therapy. Investigational New Drugs 1988;6:243-246.

+ Neidhart JA, Gagen MM, Wilson HE, Young DC. Comparative trial of the antiemetic effects of THC and haloperidol. International Journal of Clinical Pharmacology Research 1981; 21: 38-42S.

+ Orr LE, McKernan JF, Bloome B. Antiemetic effect of tetrahydrocannabinol. Compared with placebo and prochlorperazine in chemotherapy-associated nausea and emesis. Archives of Internal Medicine 1980;140:1431-433.

+ Sallan SE, Cronin C, Zelen M, Zinberg NE. Antiemetics in patients receiving chemotherapy for cancer. A randomized comparison of delta-9-tetrahydrocannabinol and prochlorperazine. New England Journal of Medicine 1980;302:135-138.

+ Sallan SE, Zinberg NE, Frei E. Antiemetic effect of delta-9-tetrahydrocannabinol in patients receiving cancer chemotherapy. New England Journal of Medicine 1975;293:795-797.

+ Ungerleider JT, Andrysiak T, Fairbanks L, Goodnight J, Sarna G, Jamison K. Cannabis and cancer chemotherapy. A comparison of oral delta-9-THC and prochlorperazine. Cancer 1982;50:636-645.

+ Ungerleider JT, Sarna G, Fairbanks LA, Goodnight J, Andrysiak T, Jamison K. THC or compazine for the cancer chemotherapy patientthe UCLA study. Part II: patient drug preference. American Journal of Clinical Oncology 1985; 8: 142-147.

+ Meiri E, Jhangiani H, Vredenburgh JJ, Barbato LM, Carter FJ, Yang HM, Baranowski V. Efficacy of dronabinol alone and in combination with ondansetron versus ondansetron alone for delayed chemotherapy-induced nausea and vomiting. Curr Med Res Opin 2007;23(3):533-43.

 

Cannabis (smoked)

 

+ Levitt M, Faiman C, Hawks R, Wilson A. Randomized double blind comparison of delta-9-tetrahydroicannabinol (THC) and marijuana as chemotherapy antiemetics. Proceedings of the American Society for Clinical Oncology 1984;3:91.

 

Cannabis (oral, sublingual)

 

+ Duran M, Pérez E, Abanades S, Vidal X, Saura C, Majem M, Arriola E, Rabanal M, Pastor A, Farré M, Rams N, Laporte JR, Capellà D. Preliminary efficacy and safety of an oromucosal standardized cannabis extract in chemotherapy-induced nausea and vomiting. Br J Clin Pharmacol 2010;70(5):656-63.

 

Nabilone

 

+ Ahmedzai S, Carlyle DL, Clader IT, Moran F. Anti-emetic efficacy and toxicity of nabilone, a synthetic cannabinoid, in lung cancer chemotherapy. British Journal of Cancer 1983;48:657-663.

+ Chan HS, Correia JA, MacLeod SM. Nabilone versus prochlorperazine for control of cancer chemotherapy-induced emesis in children: a double-blind, crossover trial. Pediatrics 1987; 79: 946-952

+ Crawford SM, Buckman R. Nabilone and metoclopramide in the treatment of nausea and vomiting due to cisplatinum: a double blind study. Medical Oncology and Tumor Pharmacotherapy 1986; 3: 39-42.

+ Cunningham D, Bradley CJ, Forrest GJ, Hutcheon AW, Adams L, Sneddon M, et al. A randomized trial of oral nabilone and prochlorperazine compared to intravenous metoclopramide and dexamethasone in the treatment of nausea and vomiting induced by chemotherapy regimens containing cisplatin or cisplatin analogues. European Journal of Cancer and Clinical Oncology 1988; 24: 685-689.

+ Dalzell AM, Bartlett H, Lilleyman JS. Nabilone: An alternative antiemetic for cancer chemotherapy. Archives of Disease in Childhood 1986;61:502-505.

+ Einhorn LH, Nagy C, Furnas B, Williams SD. Nabilone: an effective antiemetic in patients receiving cancer chemotherapy. Journal of Clinical Pharmacology. 1981 Aug-Sep;21(8-9 Suppl):64S-69S.

+ George M, Pejovic MH, Thuaire M, Kramar A, Wolff JP. Randomized comparative trial of a new anti-emetic: nabilone, in cancer patients treated with cisplatin. Biomedicine and Pharmacotherapy 1983; 37: 24-27.

+ Herman TS, Einhorn LH, Jones SE, Nagy C, Chester AB, Dean JC, et al. Superiority of nabilone over prochlorperazine as an antiemetic in patients receiving cancer chemotherapy. New England Journal of Medicine 1979; 300: 1295-1297.

+ Johansson R, Kilkku P, Groenroos M. A double-blind, controlled trial of nabilone vs prochlorperazine for refractory emesis induced by cancer chemotherapy. Cancer Treatment Reviews 1982; 9: 25-33.

+ Jones SE, Durant JR, Greco FA, Robertone A. A multi-institutional phase III study of nabilone vs placebo in chemotherapy-induced nausea and vomiting. Cancer Treatment Reviews 1982; 9: 45-48

+ Levitt M. Nabilone vs placebo in the treatment of chemotherapy-induced nausea and vomiting in cancer patients. Cancer Treatment Reviews 1982; 9(suppl B): 49-53.

+ Nagy CM, Furnas BE, Einhorn LH, Bond WH. Nabilone: antiemetic crossover study in cancer chemotherapy patients. Proceedings of the American Society for Cancer Research 1978;19:30.

 

+ Niederle N, Schutte J, Schmidt CG. Crossover comparison of the antiemetic efficacy of nabilone and alizapride in patients with nonseminomatous testicular cancer receiving cisplatin therapy. Klinische Wochenschrift 1986; 64: 362-365.

+ Niiranen Aila, Mattson K. A cross-over comparison of nabilone and prochlorperazine for emesis induced by cancer chemotherapy. American Journal of Clinical Oncology 1985;8:336-340.

+ Pomeroy M, Fennelly JJ, Towers M. Prospective randomized double-blind trial of nabilone versus domperidone in the treatment of cytotoxic-induced emesis. Cancer Chemotherapy and Pharmacology 1986;17:285-288.

+ Priestman SG, Priestman TJ, Canney PA. A double-blind randomised cross-over comparison of nabilone and metoclopramide in the control of radiation-induced nausea. Clinical Radiology 1987; 38: 543-544.

+ Steele N, Gralla RJ, Braun Jr DW, Young CW. Double-blind comparison of the antiemetic effects of nabilone and prochlorperazine on chemotherapy-induced emesis. Cancer Treatment Report 1980; 64: 219-224.

+ Wada JK, Bogdon DL, Gunnell JC, Hum GJ, Gota CH, Rieth TE. Double-blind, randomized, crossover trial of nabilone vs. placebo in cancer chemotherapy. Cancer Treatment Reviews 1982; 9(Suppl B): 39-44

 

Levonantradol

 

+ Citron ML, Herman TS, Vreeland F, Krasnow SH, Fossieck BE, Jr. Antiemetic efficacy of levonantradol compared to delta-9-tetrahydrocannabinol for chemotherapy-induced nausea and vomiting. Cancer Treatment Reports 1985;69:109-112.

+ Higi M, Niederle N, Bremer K, Schmitt G, Schmidt CG, Seeber S. Levonantradol bei der Behandlung von zytostatika-bedingter Nausea and Vomiting. Deutsche Medizinische Wochenschrift 1982; 107: 1232-1234.

+ Hutcheon AW, Palmer JB, Soukop M, Cunningham D, McArdle C, Welsh J, et al. A randomised multicentre single blind comparison of a cannabinoid anti-emetic (levonantradol) with ychlorpromazine in patients receiving their first cytotoxic chemotherapy. European Journal for Cancer and Clinical Oncology 1983; 19: 1087-1090

+ Stambaugh Jr JE, McAdams J, Vreeland F. Dose ranging evaluation of the antiemetic efficacy and toxicity of intramuscular levonantradol in cancer subjects with chemotherapy-induced emesis. International Journal of Clinical Pharmacology Research1984; 24: 480-485

 

Uncontrolled Studies

Delta-8-THC

 

+ Abrahamov A, Abrahamov A, Mechoulam R. An efficient new cannabinoid antiemetic in pediatric oncology. Life Sciences 1995;56:2097-2102.

 

Cannabis (smoked)

 

+ Vinciguerra V, Moore T, Brennan E. Inhalation marijuana as an antiemetic for cancer chemotherapy. New York State Journal of Medicine 1988;88:525-527.

+ Musty RE, Rossi R. Effects of smoked cannabis and oral delta-9-tetrahydrocannabinol on nausea and emesis after cancer chemotherapy: A review of state clinical trials. J Cannabis Ther 2001;1(1):29-42.

 

Case Reports, Surveys

 

+ Doblin RE, Kleiman MA. Marijuana as antiemetic medicine: a survey of oncologists' experiences and attitudes. American Journal of Clinical Oncology 1991; 9: 1314-1319.

± Schwartz RH, Voth EA, Sheridan MJ. Marijuana to prevent nausea and vomiting in cancer patients: a survey of clinical oncologists. South Medical Journal 1997;90(2):167-72.

 

Nausea and Vomiting – Radiotherapy

Controlled Studies

Dronabinol

 

+ Ungerleider JT, Andrysiak TA, Fairbanks LA, Tesler AS, Parker RG. Tetrahydrocannabinol vs. prochlorperazine. The effects of two antiemetics on patients undergoing radiotherapy. Radiology 1984;150(2):598-9.

 

Levonantrado

 

+ Lucraft HH, Palmer MK. Randomised clinical trial of levonantradol and chlorpromazine in the prevention of radiotherapy-induced vomiting. Clinical Radiology 1982; 33: 621-622.

 

Nausea and Vomiting – Metastases

Uncontrolled Studies

Dronabinol

 

+ Zutt M, Hanssle H, Emmert S, Neumann C, Kretschmer L. [Dronabinol for supportive therapy in patients with malignant melanoma and liver metastases] [Article in German]. Hautarzt 2006;57(5):423-7.

 

Case Reports, Surveys

Dronabinol

 

+ Gonzalez-Rosales F, Walsh D. Intractable nausea and vomiting due to gastrointestinal mucosal metastases relieved by tetrahydrocannabinol (dronabinol). Journal of Pain and Symptom Management 1997;14(5):311-314.

 

Nausea and Vomiting – Surgery

Controlled Studies

Dronabinol

 

+ Layeeque R, Siegel E, Kass R, Henry-Tillman RS, Colvert M, Mancino A, Klimberg VS. Prevention of nausea and vomiting following breast surgery. Am J Surg 2006;191(6):767-72.

 

Nabilone

 

+ Lewis IH, Campbell DN, Barrowcliffe MP. Effect of nabilone on nausea and vomiting after total abdominal hysterectomy. British Journal of Anaesthesia 1994; 73: 244-246.

 

Nausea and Vomiting – HIV/AIDS

Uncontrolled Studies

Cannabis (smoked)

 

+ de Jong BC, Prentiss D, McFarland W, Machekano R, Israelski DM. Marijuana use and its association with adherence to antiretroviral therapy among HIV-infected persons with moderate to severe nausea. J Acquir Immune Defic Syndr 2005;38(1):43-6.

 

Case Reports, Surveys

Cannabis (smoked)

 

+ Woolridge E, Barton S, Samuel J, Osorio J, Dougherty A, Holdcroft A. Cannabis use in HIV for pain and other medical symptoms. J Pain Symptom Manage 2005;29(4):358-67.

+ Sidney S. Marijuana use in HIV-positive and AIDS patients: Results of a an anonymous mail survey. J Cannabis Ther 2001;1(3-4):35-43.

+ Corless IB, Lindgren T, Holzemer W, Robinson L, Moezzi S, Kirksey K, Coleman C, Tsai YF, Sanzero Eller L, Hamilton MJ, Sefcik EF, Canaval GE, Rivero Mendez M, Kemppainen JK, Bunch EH, Nicholas PK, Nokes KM, Dole P, Reynolds N. Marijuana Effectiveness as an HIV Self-Care Strategy. Clin Nurs Res 2009;18(2):172-93.

 

Nausea and Vomiting – Therapy of Hepatitis C

Uncontrolled Studies

Dronabinol, Nabilone

 

+ Costiniuk CT, Mills E, Cooper CL. Evaluation of oral cannabinoid-containing medications for the management of interferon and ribavirin-induced anorexia, nausea and weight loss in patients treated for chronic hepatitis C virus. Can J Gastroenterol 2008;22(4):376-80.

 

Cannabis (smoked)

 

+ Sylvestre DL, Clements BJ, Malibu Y. Cannabis use improves retention and virological outcomes in patients treated for hepatitis C. Eur J Gastroenterol Hepatol 2006;18(10):1057-63.

 

Nausea and Vomiting – Pregnancy

Case Reports, Surveys

Cannabis (smoked)

 

+ Curry W-NL. Hyperemesis gravidarum and clinical cannabis: To eat or not to eat? J Cannabis Ther 2002;2(3-4):63-83.

+ Westfall RE, Janssen PA, Lucas P, Capler R. Survey of medicinal cannabis use among childbearing women: patterns of its use in pregnancy and retroactive self-assessment of its efficacy against 'morning sickness'. Complement Ther Clin Pract 2006;12(1):27-33.

 

Nausea and Vomiting – Motion Sickness

Uncontrolled Studies

Parabolic Flight (no substance)

 

+ Choukèr A, Kaufmann I, Kreth S, Hauer D, Feuerecker M, Thieme D, Vogeser M, Thiel M, Schelling G. Motion sickness, stress and the endocannabinoid system. PLoS One 2010;5(5):e10752.

 

Nausea and Vomiting – Other Case Reports, Surveys

Dronabinol

 

+ Merriman AR, Oliak DA. Use of medical marijuana for treatment of severe intractable nausea after laparoscopic Roux-en-Y gastric bypass surgery: case report. Surg Obes Relat Dis 2008;4(4):550-1.

 

Nausea and Vomiting – Healthy Subjects

Controlled Studies

Cannabis (smoked)

 

+ Soderpalm AH, Schuster A, de Wit H. Antiemetic efficacy of smoked marijuana: subjective and behavioral effects on nausea induced by syrup of ipecac. Pharmacology, Biochemistry and Behavior 2001;69(3-4):343-50.

 

Appetite Loss – HIV/AIDS

Controlled Studies

Dronabinol

 

+ Beal JE, Olson R, Laubenstein L, Morales JP, Bellman P, Yangco B, Lefkowitz L, Plasse TF, Shepard KV. Dronabinol as a treatment for anorexia associated with weight loss in patients with AIDS. Journal of Pain and Symptom Management 1995;10(2):89-97.

+ Timpone JG, Wright DJ, Li N, Egorin MJ, Enama ME, Mayers J, Galetto G, and the DATRI 004 Study Group. The safety and pharmacokinetics of single-agent and combination therapy with megestrol acetate and dronabinol for the treatment of HIV wasting syndrome. AIDS Research and Human Retroviruses 1997;13:305-315.

+ Abrams DI, Hilton JF, Leiser RJ, Shade SB, Elbeik TA, Aweeka FT, Benowitz NL, Bredt BM, Kosel B, Aberg JA, Deeks SG, Mitchell TF, Mulligan K, Bacchetti P, McCune JM, Schambelan M. Short-term effects of cannabinoids in patients with HIV-1 infection: a randomized, placebo-controlled clinical trial. Ann Intern Med 2003;139(4):258-66.

+ Haney M, Rabkin J, Gunderson E, Foltin RW. Dronabinol and marijuana in HIV(+) marijuana smokers: acute effects on caloric intake and mood. Psychopharmacology (Berl) 2005;181(1):170-8.

+ Haney M, Gunderson EW, Rabkin J, Hart CL, Vosburg SK, Comer SD, Foltin RW. Dronabinol and marijuana in HIV-positive marijuana smokers. Caloric intake, mood, and sleep. J Acquir Immune Defic Syndr 2007;45(5):545-54.

+ Bedi G, Foltin RW, Gunderson EW, Rabkin J, Hart CL, Comer SD, Vosburg SK, Haney M. Efficacy and tolerability of high-dose dronabinol maintenance in HIV-positive marijuana smokers: a controlled laboratory study. Psychopharmacology (Berl) 2010;212(4):675-86.

 

Cannabis (smoked)

 

+ Haney M, Rabkin J, Gunderson E, Foltin RW. Dronabinol and marijuana in HIV(+) marijuana smokers: acute effects on caloric intake and mood. Psychopharmacology (Berl) 2005;181(1):170-8.

+ Haney M, Gunderson EW, Rabkin J, Hart CL, Vosburg SK, Comer SD, Foltin RW. Dronabinol and marijuana in HIV-positive marijuana smokers. Caloric intake, mood, and sleep. J Acquir Immune Defic Syndr 2007;45(5):545-54.

 

Uncontrolled Studies

Dronabinol

 

+ Gorter R, Seefried M, Volberding P. Dronabinol effects on weight in patients with HIV infection. AIDS 1992;6:127.· Plasse TF, Gorter RW, Krasnow SH, Lane M, Shepard KV, Wadleigh RG. Recent clinical experience with dronabinol. Pharmacology, Biochemistry and Behavior 1991;40:695-700.

+ Plasse T, Conant M, Gorter R, Shepard KV. Dronabinol stimulates appetite and causes weight gain in HIV patients. International Conference on AIDS 1992;8(3):122 (abstract no. PuB 7442).

+ Struwe M, Kaempfer SH, Geiger CJ, Pavia AT, Plasse TF, Shepard KV, Ries K, Evans TG. Effect of dronabinol on nutritional status in HIV infection. Annals of Pharmacotherapy 1993;27:827-831.

+ Beal JE, Olson R, Lefkowitz L, Laubenstein L, Bellman P, Yangco B, Morales JO, Murphy R, Powderly W, Plasse TF, Mosdell KW, Shepard KV. Long-term efficacy and safety of dronabinol for acquired immunodeficiency syndrome-associated anorexia. Journal of Pain and Symptom Management 1997;14(1):7-14.

+ Dejesus E, Rodwick BM, Bowers D, Cohen CJ, Pearce D. Use of dronabinol improves appetite and reverses weight loss in HIV/AIDS-infected patients. J Int Assoc Physicians AIDS Care 2007;6(2):95-100.

 

Case Reports, Surveys

Cannabis (smoked)

 

+ Prentiss D, Power R, Balmas G, Tzuang G, Israelski DM. Patterns of marijuana use among patients with HIV/AIDS followed in a public health care setting. J Acquir Immune Defic Syndr 2004;35(1):38-45.

+ Woolridge E, Barton S, Samuel J, Osorio J, Dougherty A, Holdcroft A. Cannabis use in HIV for pain and other medical symptoms. J Pain Symptom Manage 2005;29(4):358-67.

+ Sidney S. Marijuana use in HIV-positive and AIDS patients: Results of a an anonymous mail survey. J Cannabis Ther 2001;1(3-4):35-43.

+ Corless IB, Lindgren T, Holzemer W, Robinson L, Moezzi S, Kirksey K, Coleman C, Tsai YF, Sanzero Eller L, Hamilton MJ, Sefcik EF, Canaval GE, Rivero Mendez M, Kemppainen JK, Bunch EH, Nicholas PK, Nokes KM, Dole P, Reynolds N. Marijuana Effectiveness as an HIV Self-Care Strategy. Clin Nurs Res 2009;18(2):172-93.

 

Appetite Loss – Cancer

Controlled Studies

Dronabinol

 

+ Jatoi A, Windschitl HE, Loprinzi CL, Sloan JA, Dakhil SR, Mailliard JA, Pundaleeka S, Kardinal CG, Fitch TR, Krook JE, Novotny PJ, Christensen B. Dronabinol versus megestrol acetate versus combination therapy for cancer-associated anorexia: a North Central Cancer Treatment Group study. Journal of Clinical Oncology 2002;20(2):567-573.

+ Regelson W, Butler JR, Schulz J, Kirk T, Peek L, Green ML, Zalis MO. Delta-9-tetrahydrocannabinol as an effective antidepressant and appetite-stimulating agent in advanced cancer patients. In: Braude MC, Szara S, editors. Pharmacology of marihuana. Vol 2. New York: Raven Press, 1976. p. 763-776.

+ Wadleigh R, Spaulding GM, Lumbersky B, Zimmer M, Shepard K, Plasse T. Dronabinol enhancement of appetite in cancer patients. Proc Am Soc Oncology 1990; 9: 331.

± Strasser F, Luftner D, Possinger K, Ernst G, Ruhstaller T, Meissner W, Ko YD, Schnelle M, Reif M, Cerny T. Comparison of orally administered cannabis extract and delta-9-tetrahydrocannabinol in treating patients with cancer-related anorexia-cachexia syndrome: a multicenter, phase III, randomized, double-blind, placebo-controlled clinical trial from the Cannabis-in-Cachexia-Study-Group. J Clin Oncol 2006;24(21):3394-400.

+ Brisbois TD, de Kock IH, Watanabe SM, Mirhosseini M, Lamoureux DC, Chasen M, Macdonald N, Baracos VE, Wismer WV. Delta-9-tetrahydrocannabinol may palliate altered chemosensory perception in cancer patients: results of a randomized, double-blind, placebo-controlled pilot trial. Ann Oncol. 2011 Feb 22. [Epub ahead of print]

 

Cannabis (oral, sublingual)

 

± Strasser F, Luftner D, Possinger K, Ernst G, Ruhstaller T, Meissner W, Ko YD, Schnelle M, Reif M, Cerny T. Comparison of orally administered cannabis extract and delta-9-tetrahydrocannabinol in treating patients with cancer-related anorexia-cachexia syndrome: a multicenter, phase III, randomized, double-blind, placebo-controlled clinical trial from the Cannabis-in-Cachexia-Study-Group. J Clin Oncol 2006;24(21):3394-400.

 

Uncontrolled Studies

Dronabinol

 

+ Plasse TF, Gorter RW, Krasnow SH, Lane M, Shepard KV, Wadleigh RG. Recent clinical experience with dronabinol. Pharmacology, Biochemistry and Behavior 1991;40:695-700.

+ Nelson K, Walsh D, Deeter P, Sheehan F. A phase II study of delta-9-tetrahydrocannabinol for appetite stimulation in cancer-associated anorexia. Journal of Palliative Care 1994;10:14-18.

+ Gottschling S. [Cannabinoids in children] [Article in German] Cannabinoide bei Kindern. Angewandte Schmerztherapie und Palliativmedizin 2011;(1):55-57.

 

Appetite Loss – Alzheimer's Disease

Controlled Studies

Dronabinol

 

+ Volicer L, Stelly M, Morris J, McLaughlin J, Volicer BJ. Effects of dronabinol on anorexia and disturbed behavior in patients with Alzheimer's disease. International Journal of Geriatric Psychiatry 1997;12:913-919.

 

Uncontrolled Studies

Dronabinol

 

+ Patel S, Shua-Haim JR, Pass M. Safety and efficacy of dronabinol in the treatment of agitation in patients with Alzheimer’s disease with anorexia: A retrospective chart review. Abstract, 11th International Conference of the IPA, 17-22 August 2003, Chicago.

 

Appetite Loss – Geriatrics

Uncontrolled Studies

Dronabinol

 

+ Wilson MM, Philpot C, Morley JE. Anorexia of aging in long term care: is dronabinol an effective appetite stimulant? - a pilot study. J Nutr Health Aging 2007;11(2):195-8.

 

Appetite Loss - Anorexia nervosa

Controlled Studies

Dronabinol

 

± Gross H, Ebert MH, Faden VB, Goldberg SC, Kaye WH, Caine ED, Hawks R, Zinberg N. A double-blind trial of delta 9-tetrahydrocannabinol in primary anorexia nervosa. Journal of Clinical Psychopharmacology 1983;3(3):165-171.

 

Appetite Loss – COPD

Uncontrolled Studies

Dronabinol

 

+ Bergmann K-C. [Dronabinol, a possible new therapeutic option in patients with COPD and pulmonal cachexia] [Article in German]. Abstract, 2005 Conference of the German Society for Pneumology, 17 March 2005, Berlin.

 

Appetite Loss – Healthy Subjects

Uncontrolled Studies

Cannabis (smoked)

 

+ Morgan CJ, Freeman TP, Schafer GL, Curran HV. Cannabidiol attenuates the appetitive effects of Delta 9-tetrahydrocannabinol in humans smoking their chosen cannabis. Neuropsychopharmacology. 2010;35(9):1879-85.

 

Controlled Studies

Cannabis (smoked)

 

+ Foltin RW, Fishman MW, Brady JV. Behavioral analysis of marijuana effects on food intake in humans. Pharmacology, Biochemistry and Behavior 1986;25:577-582.· Foltin RW, Fischman MW, Byrne MF. Effects of smoked marijuana on food intake and body weight of humans living in a residential laboratory. Appetite 1988;11(1):1-14.

 

Spasticity – Multiple Sclerosis

Controlled Studies

Dronabinol

 

± Killestein J, Hoogervorst EL, Reif M, Kalkers NF, Van Loenen AC, Staats PG, Gorter RW, Uitdehaag BM, Polman CH. Safety, tolerability, and efficacy of orally administered cannabinoids in MS. Neurology 2002;58(9):1404-7.

+ Petro DJ, Ellenberger C. Treatment of human spasticity with D9-tetrahydrocannabinol. Journal of Clinical Pharmacology 1981;(Suppl 21):413S-416S.

+ Ungerleider JT, Andyrsiak T, Fairbanks L, Ellison GW, Myers LW. D9-THC in the treatment of spasticity associated with multiple sclerosis. Advances in Alcohol and Substance Abuse 1987;7:39-50.

+ Zajicek J, Fox P, Sanders H, Wright D, Vickery J, Nunn A, Thompson A, on behalf of the UK MS Research Group. Cannabinoids for treatment of spasticity and other symptoms related to multiple sclerosis (CAMS study): multicentre randomised placebo-controlled trial. Lancet 2003; 362(9385): 1517-1526.

 

+ Zajicek JP, Sanders HP, Wright DE, Vickery PJ, Ingram WM, Reilly SM, Nunn AJ, Teare LJ, Fox PJ, Thompson AJ. Cannabinoids in multiple sclerosis (CAMS) study: safety and efficacy data for 12 months follow up. J Neurol Neurosurg Psychiatry 2005;76(12):1664-9.

 

Nabilone

 

+ Martyn CN, Illis LS, Thom J. Nabilone in the treatment of multiple sclerosis. Lancet 1995;345:579.

 

Cannabis (oral, sublingual)

 

+ Vaney C, Heinzel-Gutenbrunner M, Jobin P, Tschopp F, Gattlen B, Hagen U, Schnelle M, Reif M. Efficacy of tetrahydrocannabinol in patients refractory to standard antiemetic therapy.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. Multiple Sclerosis 2004;10(4):417-24.

+ Wade DT, Makela P, Robson P, House H, Bateman C. Do cannabis-based medicinal extracts have general or specific effects on symptoms in multiple sclerosis? A double-blind, randomized, placebo-controlled study on 160 patients. Multiple Sclerosis 2004;10(4):434-41.

+ Zajicek J, Fox P, Sanders H, Wright D, Vickery J, Nunn A, Thompson A, on behalf of the UK MS Research Group. Cannabinoids for treatment of spasticity and other symptoms related to multiple sclerosis (CAMS study): multicentre randomised placebo-controlled trial. Lancet 2003; 362(9385): 1517-1526.

+ Zajicek JP, Sanders HP, Wright DE, Vickery PJ, Ingram WM, Reilly SM, Nunn AJ, Teare LJ, Fox PJ, Thompson AJ. Cannabinoids in multiple sclerosis (CAMS) study: safety and efficacy data for 12 months follow up. J Neurol Neurosurg Psychiatry 2005;76(12):1664-9.

+ Wade DT, Makela PM, House H, Bateman C, Robson P. Long-term use of a cannabis-based medicine in the treatment of spasticity and other symptoms in multiple sclerosis. Mult Scler 2006;12(5):639-45.

+ Collin C, Ambler Z, Kent R, McCalla R. A randomised controlled study of Sativex® in patients with symptoms of spasticity due to multiple sclerosis. 22nd Congress of the ECTRIMS, 27-30 September 2006, Madrid, Spain.

+ Collin C, Davies P, Mutiboko IK, Ratcliffe S, for the Sativex Spasticity in MS Study Group. Randomized controlled trial of cannabis-based medicine in spasticity caused by multiple sclerosis. Eur J Neurology 2007;14(3):290–296.

+ Conte A, Bettolo CM, Onesti E, Frasca V, Iacovelli E, Gilio F, Giacomelli E, Gabriele M, Aragona M, Tomassini V, Pantano P, Pozzilli C, Inghilleri M. Cannabinoid-induced effects on the nociceptive system: a neurophysiological study in patients with secondary progressive multiple sclerosis. Eur J Pain 2009;13(5):472-7.

o Centonze D, Mori F, Koch G, Buttari F, Codecà C, Rossi S, Cencioni MT, Bari M, Fiore S, Bernardi G, Battistini L, Maccarrone M. Lack of effect of cannabis-based treatment on clinical and laboratory measures in multiple sclerosis. Neurol Sci 2009;30(6):531-4.

+ Novotna A, Mares J, Ratcliffe S, Novakova I, Vachova M, Zapletalova O, Gasperini C, Pozzilli C, Cefaro L, Comi G, Rossi P, Ambler Z, Stelmasiak Z, Erdmann A, Montalban X, Klimek A, Davies P; the Sativex Spasticity Study Group. A randomized, double-blind, placebo-controlled, parallel-group, enriched-design study of nabiximols* (Sativex(®) ), as add-on therapy, in subjects with refractory spasticity caused by multiple sclerosis. Eur J Neurol 2011;18(9):1122-1131.

 

Cannabis (smoked)

 

+ Meinck HM, Schönle PWA, Conrad B. Effect of cannabinoids on spasticity and ataxia in multiple sclerosis. Journal of Neurology 1989;236:120-122.

– Greenberg HS, Werness SAS, Pugh JE, Andrus RO, Anderson DJ, Domino EF. Short-term effects of smoking marijuana on balance in patients with multiple sclerosis and normal volunteers. Clinical Pharmacology and Therapeutics 1994;55:324-328.

 

Case Reports, Surveys

Dronabinol

 

+ Deutsch SI, Rosse RB, Connor JM, Burket JA, Murphy ME, Fox FJ. Current status of cannabis treatment of multiple sclerosis with an illustrative case presentation of a patient with MS, complex vocal tics, paroxysmal dystonia, and marijuana dependence treated with dronabinol. CNS Spectr 2008;13(5):393-403.

 

Cannabis (smoked)

 

+ Consroe P, Musty R, Rein J, Tillery W, Pertwee R. The perceived effects of smoked cannabis on patients with multiple sclerosis. European Neurology 1997;38:44-48.

+ Page SA, Verhoef MJ, Stebbins RA, Metz LM, Levy JC. Cannabis use as described by people with multiple sclerosis. Can J Neurol Sci 2003;30(3):201-5.

+ Chong MS, Wolff K, Wise K, Tanton C, Winstock A, Silber E. Cannabis use in patients with multiple sclerosis. Mult Scler 2006;12(5):646-51.

+ Hodges C. Personal account of medical use of cannabis. J Cannabis Ther 2002;2(3-4):155-60.

 

Spasticity – Spinal Cord Injury

Controlled Studies

Dronabinol

 

+ Hanigan WC, Destree R, Truong XT. The effect of D9-THC on human spasticity. Clinical Pharmacology and Therapeutics 1986;39:198.

+ Maurer M, Henn V, Dittrich A, Hofmann A. Delta-9-tetrahydrocannabinol shows antispastic and analgesic effects in a single case double-blind trial. European Archives of Psychiatry and Clinical Neuroscience 1990;240:1-4.

+ Hagenbach U, Luz S, Ghafoor N, Berger JM, Grotenhermen F, Brenneisen R, Mäder M. The treatment of spasticity with Delta9-tetrahydrocannabinol in persons with spinal cord injury. Spinal Cord 2007;45(8):551-62.

 

Controlled Studies

Nabilone

 

+ Pooyania S, Ethans K, Szturm T, Casey A, Perry D. A randomized, double-blinded, crossover pilot study assessing the effect of nabilone on spasticity in persons with spinal cord injury. Arch Phys Med Rehabil 2010;91(5):703-7.

 

Uncontrolled Studies

Dronabinol

 

+ Kogel RW, Johnson PB, Chintam R, Robinson CJ, Nemchausky BA. Treatment of spasticity in spinal cord injury with dronabinol, a tetrahydrocannabinol derivative. American Journal of Therapeutics 1995;2(10):799-805.

 

Case Reports, Surveys

Cannabis (smoked)

 

+ Malec J, Harvey RF, Cayner JJ. Cannabis effect on spasticity in spinal cord injury. Archives of Physical Medicine and Rehabilitation 1982;63:116-118.

+ Consroe P, Tillery W, Rein J, Musty RE. Reported Marijuana effects in patients with spinal cord injury. 1998 Symposium on the Cannabinoids. Burlington: International Cannabinoid Research Society, 1998, p. 64.

+ Dunn M, Davis R. The perceived effects of marijuana on spinal cord injured males. Paraplegia 1974;12:175.

 

Spasticity – Different Causes

Controlled Studies

Cannabis (oral, sublingual)

 

+ Wade DT, Robson P, House H, Makela P, Aram J. A preliminary controlled study to determine whether whole-plant cannabis extracts can improve intractable neurogenic symptoms. Clinical Rehabilition 2003;17:18-26.

 

Uncontrolled Studies

Dronabinol

 

+ Brenneisen R, Egli A, Elsohly MA, Henn V, Spiess Y. The effect of orally and rectally administered delta-9-tetrahydrocannabinol on spasticity: a pilot study with 2 patients. International Journal of Clinical Pharmacology and Therapeutics 1996;34:446-452.

 

Case Reports, Surveys

Dronabinol

 

+ Lorenz R. A casuistic rationale for the treatment of spastic and myocloni in a childhood neurodegenerative disease: neuronal ceroid lipofuscinosis of the type Jansky-Bielschowsky. Neuro Endocrinol Lett 2002;23(5-6):387-90.

+ Gottschling S. [Cannabinoids in children] [Article in German] Cannabinoide bei Kindern. Angewandte Schmerztherapie und Palliativmedizin 2011;(1):55-57.

 

Cannabis (smoked)

 

+ Petro DJ. Marihuana as a therapeutic agent for muscle spasm or spasticity. Psychosomatics 1980;21:81-85.

+ Randall RC, ed. Muscle Spasm, Pain & Marijuana Therapy. Washington, DC: Galen Press, 1991.· Schweizer A, Bircher HP. Reposition of a dislocated shoulder under use of cannabis. Wilderness Environ Med 2009;20(3):301-2.

 

Pain – Chronic, Neuropathic/Multiple Sclerosis

Controlled Studies

Dronabinol

 

+ Brenneisen R, Egli A, Elsohly MA, Henn V, Spiess Y. The effect of orally and rectally administered delta-9-tetrahydrocannabinol on spasticity: a pilot study with 2 patients. International Journal of Clinical Pharmacology and Therapeutics 1996;34:446-452.

+ Maurer M, Henn V, Dittrich A, Hofmann A. Delta-9-THC shows antispastic and analgesic effects in a single case double blind trial. European Archives of Psychiatry and Clinical Neuroscience 1990;240:1-4.

+ Wade DT, Robson P, House H, Makela P, Aram J. A preliminary controlled study to determine whether whole-plant cannabis extracts can improve intractable neurogenic symptoms. Clinical Rehabilitation 2003;17:18-26.

+ Berman JS, Symonds C, Birch R. Efficacy of two cannabis based medicinal extracts for relief of central neuropathic pain from brachial plexus avulsion: results of a randomised controlled trial. Pain 2004;112(3):299-306.

+ Svendsen KB, Jensen TS, Bach FW. Does the cannabinoid dronabinol reduce central pain in multiple sclerosis? Randomised double blind placebo controlled crossover trial. BMJ 2004;329(7460):253.o Rintala DH, Fiess RN, Tan G, Holmes SA, Bruel BM. Effect of dronabinol on central neuropathic pain after spinal cord injury: a pilot study. Am J Phys Med Rehabil 2010;89(10):840-8.

 

Nabilone

 

+ Wissel J, Haydn T, Müller J, Brenneis C, Berger T, Poewe W, Schelosky LD. Low dose treatment with the synthetic cannabinoid Nabilone significantly reduces spasticity-related pain : a double-blind placebo-controlled cross-over trial. J Neurol 2006;253(10):1337-41.

± Frank B, Serpell MG, Hughes J, Matthews JN, Kapur D. Comparison of analgesic effects and patient tolerability of nabilone and dihydrocodeine for chronic neuropathic pain: randomised, crossover, double blind study. BMJ 2008;336(7637):199-201.

 

Cannabis (oral, sublingual)

 

+ Wade DT, Robson P, House H, Makela P, Aram J. A preliminary controlled study to determine whether whole-plant cannabis extracts can improve intractable neurogenic symptoms. Clinical Rehabilitation 2003;17:18-26

+ Berman J, Lee J, Cooper M, Cannon A, Sach J, McKerral S, Taggart M, Symonds C, Fishel K, Birch R. Efficacy of two cannabis-based medicinal extracts for relief of central neuropathic pain from brachial plexus avulsion: results of a randomised controlled trial. Anaesthesia, 2003;58:938.

+ Rog DJ, Nurmikko TJ, Friede T, Young CA. Randomized, controlled trial of cannabis-based medicine in central pain in multiple sclerosis. Neurology 2005;65(6):812-9.

± Ernst G, Denke C, Reif M, Schnelle M, Hagmeister H. Standardized cannabis extract in the treatment of postherpetic neuralgia: a randomized, double-blind, placebo-controlled cross-over study. IACM 3rd Conference on Cannabinoids in Medicine, 9-10 September 2005, Leiden, International Association for Cannabis as Medicine.

+ Nurmikko TJ, Serpell MG, Hoggart B, Toomey PJ, Morlion BJ, Haines D. Sativex successfully treats neuropathic pain characterised by allodynia: a randomised, double-blind, placebo-controlled clinical trial. Pain 2007;133(1-3):210-20.

+ Selvarajah D, Gandhi R, Emery CJ, Tesfaye S. Randomised Placebo Controlled Double Blind Clinical Trial of Cannabis Based Medicinal Product (Sativex) in Painful Diabetic Neuropathy: Depression is a Major Confounding Factor. Diabetes Care 2010;33(1):128-30.

 

Cannabis (smoked)

 

+ Abrams DI, Jay CA, Shade SB, Vizoso H, Reda H, Press S, Kelly ME, Rowbotham MC, Petersen KL. Cannabis in painful HIV-associated sensory neuropathy: A randomized placebo-controlled trial. Neurology 2007;68(7):515-21.

+ Wilsey B, Marcotte T, Tsodikov A, Millman J, Bentley H, Gouaux B, Fishman S. A randomized, placebo-controlled, crossover trial of cannabis cigarettes in neuropathic pain. J Pain 2008;9(6):506-21.

+ Ellis RJ, Toperoff W, Vaida F, van den Brande G, Gonzales J, Gouaux B, Bentley H, Atkinson JH. Smoked medicinal cannabis for neuropathic pain in HIV: a randomized, crossover clinical trial. Neuropsychopharmacology 2009;34(3):672-680.

+ Ware MA, Wang T, Shapiro S, Robinson A, Ducruet T, Huynh T, Gamsa A, Bennett GJ, Collet JP. Smoked cannabis for chronic neuropathic pain: a randomized controlled trial. CMAJ 2010;182(14):E694-701.

 

Cannabidiol

 

± Lindstrom P, Lindblom U, Boreus L. Lack of effect of cannabidiol in sustained neuropathia. Paper presented at '87 International Conference on Cannabis, Melbourne, September 2-4, 1987. Cited from: Consroe P, Sandyk R. Potential role of cannabinoids for therapy of neurological disorders. In: Murphy L, Bartke A, eds. Marijuana/Cannabinoids. Neurobiology and Neurophysiology. Boca Raton, CRC Press, 1992:459-524.

 

CT-3 (Ajulemic Acid)

 

+ Karst M, Salim K, Burstein S, Conrad I, Hoy L, Schneider U. Analgesic effect of the synthetic cannabinoid CT-3 on chronic neuropathic pain: a randomized controlled trial. JAMA 2003;290(13):1757-62.

 

Uncontrolled Studies

Dronabinol

 

± Clermont-Gnamien S, Atlani S, Attal N, Le Mercier F, Guirimand F, Brasseur L. [The therapeutic use of D9-tetrahydrocannabinol (dronabinol) in refractory neuropathic pain] [Article in French] Presse Med 2002;31(39 Pt 1):1840-5.

+ Finnegan-Ling D, Musty RE. Marinol and phantom limb pain; a case study. In: 1994 Symposium on the Cannabinoids. Burlington, Vermont: International Cannabinoid Research Society, p. 53.o Attal N, Brasseur L, Guirimand D, Clermond-Gnamien S, Atlami S, Bouhassira D. Are oral cannabinoids safe and effective in refractory neuropathic pain? Eur J Pain 2004;8:173–177.

 

Cannabis (oral, sublingual)

 

+ Rog DJ, Nurmikko TJ, Young CA. Oromucosal delta-9-tetrahydrocannabinol/cannabidiol for neuropathic pain associated with multiple sclerosis: an uncontrolled, open-label, 2-year extension trial. Clin Ther 2007;29(9):2068-79.

 

Nabilone (oral)

 

+ Toth C, Au S. A prospective identification of neuropathic pain in specific chronic polyneuropathy syndromes and response to pharmacological therapy. Pain 2008;138(3):657-66.· Bestard JA, Toth CC. An Open-Label Comparison of Nabilone and Gabapentin as Adjuvant Therapy or Monotherapy in the Management of Neuropathic Pain in Patients with Peripheral Neuropathy. Pain Pract 2011;11(4):353-68.

 

Case Reports, Surveys

Cannabis (smoked)

 

+ Dunn M, Davis R. The perceived effects of marijuana on spinal cord injured males. Paraplegia 1974;12:175.· Consroe P, Musty R, Rein J, Tillery W, Pertwee R. The perceived effects of smoked cannabis on patients with multiple sclerosis. European Neurology 1997;38:44-48.

+ Petro DJ. Marihuana as a therapeutic agent for muscle spasm or spasticity. Psychosomatics 1980;21:81-85.· Page SA, Verhoef MJ, Stebbins RA, Metz LM, Levy JC. Cannabis use as described by people with multiple sclerosis. Can J Neurol Sci 2003;30(3):201-5.

+ Prentiss D, Power R, Balmas G, Tzuang G, Israelski DM. Patterns of marijuana use among patients with HIV/AIDS followed in a public health care setting. J Acquir Immune Defic Syndr 2004;35(1):38-45.

+ Woolridge E, Barton S, Samuel J, Osorio J, Dougherty A, Holdcroft A. Cannabis use in HIV for pain and other medical symptoms. J Pain Symptom Manage 2005;29(4):358-67.

+ Chong MS, Wolff K, Wise K, Tanton C, Winstock A, Silber E. Cannabis use in patients with multiple sclerosis. Mult Scler 2006;12(5):646-51.

 

Pain – Chronic, Cancer

Controlled Studies

Dronabinol

 

+ Noyes R, Brunk SF, Baram DA, Canter A. Analgesic effects of delta-9-THC. Journal of Clinical Pharmacology 1975;15:139-143.

+ Noyes R, Brunk ST, Avery DH, Canter A. The analgesic properties of delta-9-tetrahydrocannabinol and codeine. Clinical Pharmacology and Therapeutics 1975;18:84-89.

± Johnson JR, Burnell-Nugent M, Lossignol D, Ganae-Motan ED, Potts R, Fallon MT. Multicenter, Double-Blind, Randomized, Placebo-Controlled, Parallel-Group Study of the Efficacy, Safety, and Tolerability of THC:CBD Extract and THC Extract in Patients With Intractable Cancer-Related Pain. J Pain Symptom Manage 2010;39(2):167-79.

 

Cannabis (oral, sublingual)

 

+ Johnson JR, Burnell-Nugent M, Lossignol D, Ganae-Motan ED, Potts R, Fallon MT. Multicenter, Double-Blind, Randomized, Placebo-Controlled, Parallel-Group Study of the Efficacy, Safety, and Tolerability of THC:CBD Extract and THC Extract in Patients With Intractable Cancer-Related Pain. J Pain Symptom Manage 2010;39(2):167-79.

 

Benzopyranoperidine

 

± Jochimsen PR, Lawton RL, VerSteeg K, Noyes Jr R. Effect of benzopyranoperidine, a delta-9-THC congener, on pain. Clinical Pharmacology and Therapeutics 1978;24:223-7.

 

NIB

 

+ Staquet M, Gantt C, Machin D. Effect of a nitrogen analog of tetrahydrocannabinol on cancer pain. Clinical Pharmacology and Therapeutics 1978;23:397-401.

 

Uncontrolled Studies

Dronabinol

 

+ Butler JR Peek LA Regelson W Moore MM Lubin LA. Treatment effects of delta-9-THC in an advanced cancer population. In: Cohen S, Stillman RC, eds. The therapeutic potential of marihuana. Plenum Medical Book, New York 1976.

 

Nabilone

 

+ Maida V. The synthetic cannabinoid nabilone improves pain and symptom management in cancer patients. Abstract of San Antonio Breast Cancer Symposium, 15 December 2006.

+ Maida V, Ennis M, Irani S, Corbo M, Dolzhykov M. Adjunctive nabilone in cancer pain and symptom management: a prospective observational study using propensity scoring. J Support Oncol 2008;6(3):119-24.

 

Pain – Rheumatic

Controlled Studies

Cannabis (oral, sublingual)

 

+ Blake DR, Robson P, Ho M, Jubb RW, McCabe CS. Preliminary assessment of the efficacy, tolerability and safety of a cannabis-based medicine (Sativex) in the treatment of pain caused by rheumatoid arthritis. Rheumatology (Oxford) 2006;45(1):50-2.

 

Pain - Fibromyalgia

Controlled Studies

Nabilone

 

+ Skrabek RQ, Galimova L, Ethans K, Perry D. Nabilone for the treatment of pain in fibromyalgia. J Pain 2008;9(2):164-73.· Ware MA, Fitzcharles MA, Joseph L, Shir Y. The effects of nabilone on sleep in fibromyalgia: results of a randomized controlled trial. Anesth Analg 2010;110(2):604-10.

 

Uncontrolled Studies

Dronabinol

 

+ Schley M, Legler A, Skopp G, Schmelz M, Konrad C, Rukwied R. Delta-9-THC based monotherapy in fibromyalgia patients on experimentally induced pain, axon reflex flare, and pain relief. Curr Med Res Opin 2006;22(7):1269-1276.

· Fiz J, Durán M, Capellà D, Carbonell J, Farré M. Cannabis use in patients with fibromyalgia: effect on symptoms relief and health-related quality of life. PLoS One 2011;6(4):e18440.

 

Case Reports, Surveys

Cannabis (smoked)

 

+ Fiz J, Duran M, Langohr K, Capellà D, Farré M. Symptoms relief and improved mental health in fibromyalgia patients using cannabis. Results of an observational study. IACM 4th Conference on Cannabinoids in Medicine, 5-6 October 2007, Cologne, International Association for Cannabis as Medicine.

 

Pain – Chronic

Controlled Studies

Dronabinol

 

+ Notcutt W, Price M, Miller R, Newport S, Phillips C, Simmons S, Sansom C. Initial experiences with medicinal extracts of cannabis for chronic pain: results from 34 'N of 1' studies. Anaesthesia 2004;59(5):440-52.

 

+ Narang S, Gibson D, Wasan AD, Ross EL, Michna E, Nedeljkovic SS, Jamison RN. Efficacy of dronabinol as an adjuvant treatment for chronic pain patients on opioid therapy. J Pain 2008;9(3):254-64.

 

Cannabis (oral, sublingual)

 

+ Holdcroft A, Smith M, Jacklin A, Hodgson H, Smith B, Newton M, Evans F. Pain relief with oral cannabinoids in familial Mediterranean fever. Anaesthesia 1997;52:483-488.

+ Notcutt W, Price M, Miller R, Newport S, Phillips C, Simmons S, Sansom C. Initial experiences with medicinal extracts of cannabis for chronic pain: results from 34 'N of 1' studies. Anaesthesia 2004;59(5):440-52.

 

Cannabis (smoked)

 

+ Ware MA, Ducruet T, Robinson AR. Evaluation of herbal cannabis characteristics by medical users: a randomized trial. Harm Reduct J 2006;3(1):32

 

Nabilone

 

+ Pinsger M, Schimetta W, Volc D, Hiermann E, Riederer F, Polz W. [Benefits of an add-on treatment with the synthetic cannabinomimetic nabilone on patients with chronic pain - a randomized controlled trial.] [Article in German] Wien Klin Wochenschr 2006;118(11-12):327-35.

 

N-palmitoylethanolamine (topical)

 

+ Phan NQ, Siepmann D, Gralow I, Ständer S. Adjuvant topical therapy with a cannabinoid receptor agonist in facial postherpetic neuralgia. J Dtsch Dermatol Ges 2010;8(2):88-91.

 

Uncontrolled Studies

Cannabis (oral, sublingual)

 

+ Haroutiunian S, Rosen G, Shouval R, Davidson E. Open-label, add-on study of tetrahydrocannabinol for chronic nonmalignant pain. J Pain Palliat Care Pharmacother 2008;22(3):213-7.

 

Nabilone

 

+ Hamann W, di Vadi PP. Analgesic effect of the cannabinoid analogue nabilone is not mediated by opioid receptors. Lancet 1999;353(9152):560.

 

Case Reports, Surveys

Dronabinol

 

+ Elsner F, Radbruch L, Sabatowski R. [Tetrahydrocannabinol for treatment of chronic pain] [Article in German]. Pain 2001;15(3):200-4.

 

Cannabis (smoked)

 

+ Noyes R, Baram DA. Cannabis analgesia. Comprehensive Psychiatry 1974:15:531-535.

+ Ware MA, Doyle CR, Woods R, Lynch ME, Clark AJ. Cannabis use for chronic non-cancer pain: results of a prospective survey. Pain 2003;102(1-2):211-216.

+ Lynch ME, Clark AJ. Cannabis reduces opioid dose in the treatment of chronic non-cancer pain. J Pain Symptom Manage 2003;25(6):496-8.· Howard J, Anie KA, Holdcroft A, Korn S, Davies SC. Cannabis use in sickle cell disease: a questionnaire study. Br J Haematol 2005;131(1):123-8.

+ Russo EB, Mathre ML, Byrne A, Velin R, Bach PJ, Sanchez-Ramos J, et al. Chronic cannabis use in the Compassionate Investigational New Drug Program: An examination of benefits and adverse effects of legal clinical cannabis. J Cannabis Ther 2002;2(1):3-57.

+ Aggarwal SK, Carter GT, Sullivan MD, ZumBrunnen C, Morrill R, Mayer JD. Characteristics of patients with chronic pain accessing treatment with medical cannabis in Washington State. J Opioid Manag 2009;5(5):257-86.

 

Pain – Acute, Surgery

Controlled Studies

Dronabinol

 

± Raft D, Gregg J, Ghia J, Harris L. Effects of intravenous tetrahydrocannabinol on experimental and surgical pain: psychological correlates of the analgesic response. Clinical Pharmacology and Therapeutics 1977;21:26-33.

± Buggy DJ, Toogood L, Maric S, Sharpe P, Lambert DG, Rowbotham DJ. Lack of analgesic efficacy of oral delta-9-tetrahydrocannabinol in postoperative pain. Pain 2003;106(1-2):169-72.

± Seeling W, Kneer L, Buchele B, Gschwend JE, Maier L, Nett C, Simmet T, Steffen P, Schneider M, Rockemann M. [(9)-tetrahydrocannabinol and the opioid receptor agonist piritramide do not act synergistically in postoperative pain.] [Article in German]. Anaesthesist 2006;55(4):391-400.

 

Cannabis (oral, sublingual)

 

+ Holdcroft A, Maze M, Dore C, Tebbs S, Thompson S. A multicenter dose-escalation study of the analgesic and adverse effects of an oral cannabis extract (Cannador) for postoperative pain management. Anesthesiology 2006;104(5):1040-1046.

 

Nabilone

 

± Beaulieu P. Effects of nabilone, a synthetic cannabinoid, on postoperative pain. Can J Anaesth 2006;53(8):769-75.

 

Levonantradol

 

+ Jain AK, Ryan JR, McMahon FG, Smith G. Evaluation of intramuscular levonantradol and placebo in acute postoperative pain. Journal of Clinical Pharmacology 1981;21(suppl 8-9):S320-S326.· Kantor TG, Hopper M. A study of levonantradol, a cannabinol derivative, for analgesia in post operative pain. Pain 1981; (suppl): S37.GW842166

+ Ostenfeld T, Price J, Albanese M, Bullman J, Guillard F, Meyer I, Leeson R, Costantin C, Ziviani L, Nocini PF, Milleri S. A randomized, controlled study to investigate the analgesic efficacy of single doses of the cannabinoid receptor-2 agonist GW842166, ibuprofen or placebo in patients with acute pain following third molar tooth extraction. Clin J Pain 2011;27(8):668-76.

 

Pain – Acute, Healthy Subjects

Controlled Studies

Dronabinol

 

± Naef M, Curatolo M, Petersen-Felix S, Arendt-Nielsen L, Zbinden A, Brenneisen R. The analgesic effect of oral delta-9-tetrahydrocannabinol (THC), morphine, and a THC-morphine combination in healthy subjects under experimental pain conditions. Pain 2003;105(1-2):79-88.

+ Roberts JD, Gennings C, Shih M. Synergistic affective analgesic interaction between delta-9-tetrahydrocannabinol and morphine. Eur J Pharmacol 2006;530(1-2):54-8.

 

Nabilone

 

± Redmond WJ, Goffaux P, Potvin S, Marchand S. Analgesic and antihyperalgesic effects of nabilone on experimental heat pain. Curr Med Res Opin 2008;24(4):1017-24.

 

Cannabis (smoked)

 

+ Greenwald MK, Stitzer ML Antinociceptive, subjective and behavioral effects of smoked marijuana in humans. Drug Alcohol Depend 2000;59(3):261-75.· Wallace M, Schulteis G, Atkinson JH, Wolfson T, Lazzaretto D, Bentley H, Gouaux B, Abramson I. Dose-dependent effects of smoked cannabis on capsaicin-induced pain and hyperalgesia in healthy volunteers. Anesthesiology 2007;107(5):785-796.

 

Cannabis (oral, sublingual)

 

± Kraft B, Frickey NA, Kaufmann RM, Reif M, Frey R, Gustorff B, Kress HG. Lack of analgesia by oral standardized cannabis extract on acute inflammatory pain and hyperalgesia in volunteers. Anesthesiology 2008;109(1):101-10.

 

Uncontrolled Studies

Cannabis (smoked)

 

± Hill SY, Schwin R, Goodwin DW, Powell B. Marihuana and pain. J Pharmacol Exp Ther 1974;188:415-8.o Clark WC, Janal MN, Zeidenberg P, Nahas GG. Effects of moderate and high doses of marihuana on thermal pain: a sensory decision theory analysis. J Clin Pharmacol 1981;21(8-9 Suppl):299S-310S.

 

Headache/Migraine

Case Reports, Surveys

Dronabinol

 

+ Raby WN, Modica PA, Wolintz RJ, Murtaugh K. Dronabinol reduces signs and symptoms of idiopathic intracranial hypertension: a case report. J Ocul Pharmacol Ther 2006;22(1):68-75.· Robbins MS, Tarshish S, Solomon S, Grosberg BM. Cluster Attacks Responsive to Recreational Cannabis and Dronabinol. Headache 2009;49(6):914-6.

 

Cannabis (smoked)

 

+ Raby WN, Modica PA, Wolintz RJ, Murtaugh K. Dronabinol reduces signs and symptoms of idiopathic intracranial hypertension: a case report. J Ocul Pharmacol Ther 2006;22(1):68-75.· Robbins MS, Tarshish S, Solomon S, Grosberg BM. Cluster Attacks Responsive to Recreational Cannabis and Dronabinol. Headache 2009;49(6):914-6.

 

Cannabis (historical)

 

+ Russo EB. Hemp for headache: An in-depth historical and scientific review of cannabis in migraine treatment. J Cannabis Ther 2001;1(2):21-92.

 

Amyotrophic Lateral Sclerosis

Controlled Studies

Dronabinol

 

± Weber M, Goldman B, Truniger S. Tetrahydrocannabinol (THC) for cramps in amyotrophic lateral sclerosis: a randomised, double-blind crossover trial. J Neurol Neurosurg Psychiatry 2010;81(10):1135-40.

 

Case Reports, Surveys

Cannabis (smoked)

 

+ Amtmann D, Weydt P, Johnson KL, Jensen MP, Carter GT. Survey of cannabis use in patients with amyotrophic lateral sclerosis. Am J Hosp Palliat Care 2004;21(2):95-104.

 

Bladder Dysfunction

Controlled Studies

Dronabinol

 

+ Hagenbach U, Ghafoor N, Brenneisen R, Luz S, Mäder M. Clinical investigation of D-9-tetrahydrocannabinol (THC) as an alternative therapy for overactive bladders in spinal cord injury (SCI) patients? Abstract, 2001 Congress on Cannabis and the Cannabinoids, International Association for Cannabis as Medicine, 25-27 October 2001, Cologne, Germany.

+ Freeman RM, Adekanmi O, Waterfield MR, Waterfield AE, Wright D, Zajicek J. The effect of cannabis on urge incontinence in patients with multiple sclerosis: a multicentre, randomised placebo-controlled trial (CAMS-LUTS). Int Urogynecol J Pelvic Floor Dysfunct 2006;17(6):636-41.

 

Cannabis (oral, sublingual)

 

+ Brady CM, DasGupta R, Dalton C, Wiseman OJ, Berkley KJ, Fowler CJ. An open-label pilot study of cannabis-based extracts for bladder dysfunction in advanced multiple sclerosis. Multiple Sclerosis 2004;10(4):425-33.

+ de Ridder D, Constantinescu CS,Fowler C, Kavia R, Sarantis N. Randomised controlled study of cannabis-based medicine (Sativex®) in patients suffering from multiple sclerosis associated detrusor overactivity. 22nd Congress of the ECTRIMS, 27-30 September 2006, Madrid, Spain.

+ Freeman RM, Adekanmi O, Waterfield MR, Waterfield AE, Wright D, Zajicek J. The effect of cannabis on urge incontinence in patients with multiple sclerosis: a multicentre, randomised placebo-controlled trial (CAMS-LUTS). Int Urogynecol J Pelvic Floor Dysfunct 2006;17(6):636-41.

+ Kavia RB, De Ridder D, Constantinescu CS, Stott CG, Fowler CJ. Randomized controlled trial of Sativex to treat detrusor overactivity in multiple sclerosis. Mult Scler 2010;16(11):1349-59.

 

Gastro-Oesophageal Reflux

Controlled Studies (Experimental in Healthy Subjects)

Dronabinol

 

+ Beaumont H, Jensen J, Carlsson A, Ruth M, Lehmann A, Boeckxstaens GE. Effect of Delta(9)-tetrahydrocannabinol, a cannabinoid receptor agonist, on the triggering of transient lower oesophageal sphincter relaxations in dogs and humans. Br J Pharmacol 2009;156(1):153-62.

 

Irritable Bowel Syndrome, Diarrhoea

Controlled Studies (Experimental in Healthy Subjects)

Dronabinol

 

+ Esfandyari T, Camilleri M, Busciglio I, Burton D, Baxter K, Zinsmeister AR. Effects of a cannabinoid receptor agonist on colonic motor and sensory functions in humans: a randomized, placebo-controlled study. Am J Physiol Gastrointest Liver Physiol 2007;293(1):G137-45.

± Klooker TK, Leliefeld KE, Van Den Wijngaard RM, Boeckxstaens GE. The cannabinoid receptor agonist delta-9-tetrahydrocannabinol does not affect visceral sensitivity to rectal distension in healthy volunteers and IBS patients. Neurogastroenterol Motil 2011;23(1):30-5, e2.

+ Wong BS, Camilleri M, Busciglio I, Carlson P, Szarka LA, Burton D, Zinsmeister AR. Pharmacogenetic Trial of a Cannabinoid Agonist Shows Reduced Fasting Colonic Motility in Patients with Non-Constipated Irritable Bowel Syndrome. Gastroenterology, 28. Juli 2011 [im Druck]

 

Crohn's Disease

Case Reports, Surveys

Cannabis

 

+ Lal S, Prasad N, Ryan M, Tangri S, Silverberg MS, Gordon A, Steinhart H. Cannabis use amongst patients with inflammatory bowel disease. Eur J Gastroenterol Hepatol 2011;23(10):891-6.

 

Uncontrolled Studies

Cannabis

 

+ Naftali T, Lev LB, Yablekovitz D, Half E, Konikoff FM. Treatment of Crohn's disease with cannabis: an observational study. Isr Med Assoc J 2011;13(8):455-8.

 

 

Ulcerative Colitis

Case Reports, Surveys

Cannabis

 

+ Lal S, Prasad N, Ryan M, Tangri S, Silverberg MS, Gordon A, Steinhart H. Cannabis use amongst patients with inflammatory bowel disease. Eur J Gastroenterol Hepatol 2011;23(10):891-6.

 

Obstetrics and Gynecology

Case Reports, Surveys

Cannabis (historical)

 

+ Russo E. Cannabis treatments in obstetrics and gynecology: A historical review. J Cannabis Ther 2002;2(3-4):5-35.

 

Tremor

Controlled Studies

Dronabinol

 

+ Clifford DB. Tetrahydrocannabinol for tremor in multiple sclerosis. Annals of Neurology 1983;13:669-671.

 

Cannabis (oral, sublingual)

 

± Fox P, Bain PG, Glickman S, Carroll C, Zajicek J. The effect of cannabis on tremor in patients with multiple sclerosis. Neurology 2004;62(7):1105-9.

 

Dystonia

Uncontrolled Studies

Nabilone

 

± Fox SH, Kellett M, Moore AP, Crossman AR, Brotchie JM. Randomised, double-blind, placebo-controlled trial to assess the potential of cannabinoid receptor stimulation in the treatment of dystonia. Movement Disorders 2002;17(1):145-149.

 

Cannabidiol

 

+ Snider SR, Consroe P. Treatment of Meige's syndrome with cannabidiol. Neurology 1984;34(Suppl):147.

+ Sandyk R, Snider SR, Consroe P, Elias SM. Cannabidiol in dystonic movement disorders. Psychiatry Research 1986;18:291.

+ Consroe P, Sandyk R, Snider SR. Open label evaluation of cannabidiol in dystonic movement disorders. International Journal of Neuroscience 1986;30:277-282.

 

L-Dopa-induced Dyskinesia (Tardive Dyskinesia)

Controlled Studies

Nabilone

 

+ Sieradzan KA, Fox SH, Dick J, Brotchie JM. The effects of the cannabinoid receptor agonist nabilone on L-DOPA induced dyskinesia in patients with idiopathic Parkinson's disease (PD). Movement Disorders 1998;13(Suppl 2):29.

 

Case Reports, Surveys

Cannabis (smoked)

 

+ Beckmann Y, Seçil Y, Güngör B, Yiğit T. Tardive Dystonia and the Use of Cannabis. Turk Psikiyatri Derg 2010;21(1):90-91.

 

Dronabinol

 

+ Beckmann Y, Seçil Y, Güngör B, Yiğit T. Tardive Dystonia and the Use of Cannabis. Turk Psikiyatri Derg 2010;21(1):90-91.

 

Hiccups (Singultus)

Case Reports, Surveys

Cannabis (smoked)

 

+ Gilson I, Busalacchi M. Marijuana for intractable hiccups. Lancet 1998; 351(9098): 267.

 

Tourette's Syndrome, Tics

Controlled Studies

Dronabinol

 

+ Müller-Vahl KR, Schneider U, Koblenz A, Jobges M, Kolbe H, Daldrup T, Emrich HM. Treatment of Tourette's syndrome with Delta 9-tetrahydrocannabinol (THC): a randomized crossover trial. Pharmacopsychiatry 2002;35(2):57-61.

+ Müller-Vahl KR, Schneider U, Prevedel H, Theloe K, Kolbe H, Daldrup T, Emrich HM. Delta 9-tetrahydrocannabinol (THC) is effective in the treatment of tics in Tourette syndrome: a 6-week randomized trial. Journal of Clinical Psychiatry. 2003;64(4):459-65.

 

Uncontrolled Studies

Dronabinol

 

+ Müller-Vahl KR, Schneider U, Kolbe H, Emrich HM. Treatment of Tourette-Syndrome with delta-9-Tetrahydrocannabinol. American Journal of Psychiatry 1999;156:495.

 

Case Reports, Surveys

Dronabinol

 

+ Deutsch SI, Rosse RB, Connor JM, Burket JA, Murphy ME, Fox FJ. Current status of cannabis treatment of multiple sclerosis with an illustrative case presentation of a patient with MS, complex vocal tics, paroxysmal dystonia, and marijuana dependence treated with dronabinol. CNS Spectr 2008;13(5):393-403.

+ Müller-Vahl KR, Schneider U, Emrich HM. Combined treatment of Tourette syndrome with delta-9-THC and dopamine receptor agonists. J Cannabis Ther 2002;2(3-4):145-54.

 

+ Hasan A, Rothenberger A, Münchau A, Wobrock T, Falkai P, Roessner V. Oral delta9-tetrahydrocannabinol improved refractory gilles de la tourette syndrome in an adolescent by increasing intracortical inhibition: a case report. J Clin Psychopharmacol 2010;30(2):190-2.

+ Brunnauer A, Segmiller FM, Volkamer T, Laux G, Müller N, Dehning S. Cannabinoids improve driving ability in a Tourette's patient. Psychiatry Res, 9 June 2011 [im Druck]

 

Cannabis (smoked)

 

+ Müller-Vahl KR, Kolbe H, Schneider U, Emrich HM. Cannabinoids: Possible role in pathophysiology of Gilles de la Tourette-syndrome. Acta Psychiatrica Scandinavica 1998;97:1-5.

+ Sandyk R, Awerbuch G. Marijuana and Tourette's Syndrome. Journal of Clinical Psychopharmacology 1988;8:444-445.· Hemming M, Yellowlees PM. Effective treatment of Tourette's syndrome with marijuana. J Psychopharmacol 1993; 7: 389-91.

 

Hyperkinetic Movement Disorder

Case Reports, Survey

Dronabinol

 

+ Farooq MU, Ducommun E, Goudreau J. Treatment of a hyperkinetic movement disorder during pregnancy with dronabinol. Parkinsonism Relat Disord 2009;15(3):249-51.

 

Attention-Deficit/Hyperactivity Disorder

Uncontrolled Studies

Cannabis (smoked)

 

+ Aharonovich E, Garawi F, Bisaga A, Brooks D, Raby WN, Rubin E, Nunes EV, Levin FR. Concurrent cannabis use during treatment for comorbid ADHD and cocaine dependence: effects on outcome. Am J Drug Alcohol Abuse. 2006;32(4):629-35.

 

Case Reports, Surveys

Dronabinol

 

+ Strohbeck-Kuehner P, Skopp G, Mattern R. [Fitness to drive in spite (because) of THC] [Article in German]. Arch Kriminol 2007;220(1-2):11-9.

 

Cannabis (smoked)

 

+ Strohbeck-Kuehner P, Skopp G, Mattern R. [Fitness to drive in spite (because) of THC] [Article in German]. Arch Kriminol 2007;220(1-2):11-9.

+ O'Connell TJ, Bou-Matar CB. Long term marijuana users seeking medical cannabis in California (2001-2007): demographics, social characteristics, patterns of cannabis and other drug use of 4117 applicants. Harm Reduct J 2007;4:16.

 

Obsessive Compulsive Disorder

Case Reports, Surveys

Dronabinol, Cannabis (smoked)

 

+ Schindler F, Anghelescu I, Regen F, Jockers-Scherubl M. Improvement in refractory obsessive compulsive disorder with dronabinol. Am J Psychiatry 2008;165(4):536-7.

 

Trichotillomania

Uncontrolled Studies

Dronabinol

 

+ Grant JE, Odlaug BL, Chamberlain SR, Kim SW. Dronabinol, a cannabinoid agonist, reduces hair pulling in trichotillomania: a pilot study. Psychopharmacology (Berl), 19 May 2011 [im Druck]

 

Parkinson's Disease

Controlled Studies

Cannabis (oral, sublingual)

 

± Carroll CB, Bain PG, Teare L, Liu X, Joint C, Wroath C, Parkin SG, Fox P, Wright D, Hobart J, Zajicek JP. Cannabis for dyskinesia in Parkinson disease: a randomized double-blind crossover study. Neurology 2004;63(7):1245-50.

 

Uncontrolled Studies

Cannabis (smoked)

 

± Frankel JP, Hughes A, Lees AJ, Stern GM. Marijuana for Parkinsonian tremor. Journal of Neurology, Neurosurgery and Psychiatry 1990;53:436.

 

Huntington's Disease

Controlled Studies

Cannabidiol

 

± Consroe P, Laguna J, Allender J, Snider S, Stern L, Sandyk R, Kennedy K, Schram K. Controlled clincal trial of cannabidiol in Huntington's disease. Pharmacology, Biochemistry and Behavior. 1991;40(3):701-8.

 

Uncontrolled Studies

Nabilone

 

– Müller-Vahl KR, Schneider U, Emrich HM. Nabilone deteriorates choreatic movements in Huntington`s disease. Movement Disorders 1999b;14:1038-40.

 

Case Reports, Surveys

Dronabinol/Cannabis (smoked)

 

+ Beckmann Y, Seçil Y, Güngör B, Yiğit T. Tardive Dystonia and the Use of Cannabis.Turk Psikiyatri Derg 2010;21(1):90-91.

 

Traumatic Brain Injury

Controlled Studies

Dexanabinol

 

± Maas AI, Murray G, Henney H 3rd, Kassem N, Legrand V, Mangelus M, Muizelaar JP, Stocchetti N, Knoller N; Pharmos TBI investigators. Efficacy and safety of dexanabinol in severe traumatic brain injury: results of a phase III randomised, placebo-controlled, clinical trial. Lancet Neurol 2006;5(1):38-45.

 

Tinnitus

Case Reports, Surveys

Dronabinol/Cannabis (smoked)

 

+ Raby WN, Modica PA, Wolintz RJ, Murtaugh K. Dronabinol reduces signs and symptoms of idiopathic intracranial hypertension: a case report. J Ocul Pharmacol Ther 2006;22(1):68-75.

 

Pruritus

Uncontrolled Studies

Cream with Endocannabinoids

 

+ Szepietowski JC, Szepietowski T, Reich A. Efficacy and tolerance of the cream containing structured physiological lipids with endocannabinoids in the treatment of uremic pruritus: a preliminary study. Acta Dermatovenerol Croat 2005;13(2):97-103.

+ Ständer S, Reinhardt HW, Luger TA. [Topical cannabinoid agonists: An effective new possibility for treating chronic pruritus.] [Article in German]. Hautarzt 2006;57(9):801-7.

 

Case Reports, Surveys

Dronabinol

 

+ Neff GW, O'Brien CB, Reddy KR, Bergasa NV, Regev A, Molina E, Amaro R, Rodriguez MJ, Chase V, Jeffers L, Schiff E. Preliminary observation with dronabinol in patients with intractable pruritus secondary to cholestatic liver disease. Am J Gastroenterol 2002;97(8):2117-9.

 

Night Sweats

Uncontrolled Studies

Nabilone

 

+ Maida V. Nabilone for the treatment of paraneoplastic night sweats: a report of four cases. J Palliat Med 2008;11(6):929-34.

 

Epilepsy

Controlled Studies

Cannabidiol

 

+ Cunha JM, Carlini EA, Pereira AE, Ramos OL, Pimentel C, Gagliardi R, Sanvito WL, Lander N, Mechoulam R. Chronic administration of cannabidiol to healthy volunteers and epileptic patients. Pharmacology 1980;21(3):175-85.

 

Uncontrolled Studies

Cannabis (smoked)

 

+ Consroe PF, Wood GC, Buchsbaum H. Anticonvulsant nature of marihuana smoking. JAMA 1975;234(3):306-7.

 

Cannabidiol

 

± Ames FR, Cridland S.: Anticonvulsant effect of cannabidiol [letter]. South African Medical Journal 1986;69:14.

± Trembly B, Sherman M. Double-blind clinical study of cannabidiol as a secondary anticonvulsant. Conference on Cannabis and Cannabinoids, Kolympari/Crete, July 1990, cited according to: Consroe P, Sandyk R. Potential role of cannabinoids for therapy of neurological disorders. In: Murphy L, Bartke A, eds. Marijuana/Cannabinoids, Neurobiology and Neurophysiology. Boca Raton: CRC Press 1992, 459-524. [Commentary: No effect of Cannabidiol (300 mg/day) in 10 patients.]

+ Trembly B, Sherman M. Double-blind clinical study of cannabidiol as a secondary anticonvulsant. Conference on Cannabis and Cannabinoids, Kolympari/Crete, July 1990, cited according to: Consroe P, Sandyk R. Potential role of cannabinoids for therapy of neurological disorders. In: Murphy L, Bartke A, eds. Marijuana/Cannabinoids, Neurobiology and Neurophysiology. Boca Raton: CRC Press 1992, 459-524. [Commentary: Reduction in Reduzierung in frequency of seizures with cannabidiol (900-1200 mg/day) in one patient.]

 

Case Reports, Surveys

Cannabis (smoked)

 

+ Corral VL. Differential effects of medical marijuana based on strain and route of administration: A three-year observational study. J Cannabis Ther 2001;1(3-4):43-59.

+ Mortati K, Dworetzky B, Devinsky O. Marijuana: an effective antiepileptic treatment in partial epilepsy? A case report and review of the literature. Rev Neurol Dis 2007;4(2):103-6.

 

Isaacs' Syndrome

Case Report

Dronabinol

 

+ Meyniel C, Ollivier Y, Hamidou M, Péréon Y, Derkinderen P. Dramatic improvement of refractory Isaacs' syndrome after treatment with dronabinol. Clin Neurol Neurosurg 2011;113(4):323-4.

 

Intraocular Pressure - Glaucoma

Controlled Studies

Cannabis (smoked)

 

+ Crawford WJ, Merritt JC. Effects of tetrahydrocannabinol on arterial and intraocular hypertension. International Journal of Clinical Pharmacololgy and Biopharmacy 1979;17(5):191-196.

+ Merritt JC, Crawford WJ, Alexander PC, Anduze AL, Gelbart SS. Effect of marihuana on intraocular and blood pressure in glaucoma. Ophthalmology 1980;87(3):222-8.

 

Dronabinol

 

+ Tomida I, Azuara-Blanco A, House H, Flint M, Pertwee RG, Robson PJ. Effect of sublingual application of cannabinoids on intraocular pressure: a pilot study. J Glaucoma 2006;15(5):349-353.

 

Cannabidiol

 

± Tomida I, Azuara-Blanco A, House H, Flint M, Pertwee RG, Robson PJ. Effect of sublingual application of cannabinoids on intraocular pressure: a pilot study. J Glaucoma 2006;15(5):349-353.

 

Uncontrolled Studies

Cannabis (smoked)

 

+ Hepler RS, Frank IM, Petrus R. Ocular effects of marijuana smoking. In: Braude MC, Szara S, eds. The pharmacology of marihuana. Raven Press: New York: 1976;815-828.

 

Case Reports, Surveys

Cannabis (smoked)

 

+ Russo EB, Mathre ML, Byrne A, Velin R, Bach PJ, Sanchez-Ramos J, et al. Chronic cannabis use in the Compassionate Investigational New Drug Program: An examination of benefits and adverse effects of legal clinical cannabis. J Cannabis Ther 2002;2(1):3-57.

 

Topical Administration

Dronabinol

 

± Merritt JC, Perry DD, Russell DN, Jones BF. Topical delta 9-tetrahydrocannabinol and aqueous dynamics in glaucoma. Journal of Clinical Pharmacololgy 1981;21(8-9 Suppl):467S-471S.

 

Intraocular Pressure - Healthy Subjects

Controlled Studies

Dronabinol

 

+ Cooler P, Gregg JM. Effect of delta-9-tetrahydrocannabinol on intraocular pressure in humans. Southern Medical Journal 1977;70(8):951-954.

+ Jones RT, Benowitz N, Herning RI. The clinical relevance of cannabis tolerance and dependence. Journal of Clinical Pharmacology 1981;21:143S-152S.

± Levitt M, Wilson A, Bowman D, Kemel S, Krepart G, Marks V, Schipper H, Thomson G, Weinerman B, Weinerman R. Physiologic observations in a controlled clinical trial of the antiemetic effectiveness of 5, 10, and 15 mg of delta 9-tetrahydrocannabinol in cancer chemotherapy. Ophthalmologic implications. J Clin Pharmacol 1981;21(8-9 Suppl):103S-109S.

 

Delta-9-THC, Delta-8-THC, 11-OH-THC, CBD, CBN

 

+ Perez-Reyes M, Wagner D, Wall ME. Davis KH. Intravenous administration of cannabinoids and intraocular pressure. In: Braude MC, Szara S, ed. Pharmacology of marihuana. New York: Raven Press, 1976;829-832.

 

Uncontrolled Studies

Dronabinol

 

+ Plange N, Arend KO, Kaup M, Doehmen B, Adams H, Hendricks S, Cordes A, Huth J, Sponsel WE, Remky A. Dronabinol and retinal hemodynamics in humans. Am J Ophthalmol 2007;143(1):173-4.

 

Cannabis (smoked)

 

+ Hepler RS, Frank IM. Marihuana smoking and intraocular pressure. Journal of the American Medical Association 1971;217:1392.· Flom MC, Adams AJ, Jones RT. Marijuana smoking and reduced intraocular pressure in human eye: Drug action or epiphenomenon? Investigative Ophthalmology 1975;14:52-55.

+ Hepler R S, Frank I M, Petrus R. Ocular effects of marijuana smoking. In: Braude MC, Szara S, eds. The pharmacology of marihuana. New York: Raven Press, 1976;815-828.

 

Night Vision

Controlled Studies

Dronabinol

 

+ Russo EB, Merzouki A, Molero Mesa J, Frey KA, Bach PJ. Cannabis improves night vision: A pilot study of dark adaptometry and scotopic sensitivity in kif smokers of the Rif Mountains of Northern Morocco. J Ethnopharmacol 2004;93(1):99-104.

 

Uncontrolled Studies

Cannabis (smoked)

 

+ Russo EB, Merzouki A, Molero Mesa J, Frey KA, Bach PJ. Cannabis improves night vision: A pilot study of dark adaptometry and scotopic sensitivity in kif smokers of the Rif Mountains of Northern Morocco. J Ethnopharmacol 2004;93(1):99-104.

 

Asthma

Controlled Studies

Dronabinol

 

+ Tashkin DP, Reiss S, Shapiro BJ, Calvarese B, Olsen JL, Lodge JW. Bronchial effects of aerosolized delta 9-tetrahydrocannabinol in healthy and asthmatic subjects. American Review of Respiratory Disease 1977;115(1):57-65.

+ Williams SJ, Hartley JP, Graham JD. Bronchodilator effect of delta1-tetrahydrocannabinol administered by aerosol of asthmatic patients. Thorax 1976;31(6):720-723.

 

Cannabis (smoked)

 

+ Tashkin DP, Shapiro BJ, Lee YE, Harper CE. Effects of smoked marijuana in experimentally induced asthma. American Review of Respiratory Disease 1975;112(3):377-386.

+ Vachon L, Mikus P, Morrissey W, FitzGerald M, Gaensler E. Bronchial effect of marihuana smoke in asthma. In: Braude MC, Szara S, eds. The pharmacology of marihuana. Raven Press: New York: 1976;777-784.

 

Nabilone

 

± Gong H Jr, Tashkin DP, Calvarese B. Comparison of bronchial effects of nabilone and terbutaline in healthy and asthmatic subjects. Journal of Clinical Pharmacology 1983;23(4):127-133

 

Uncontrolled Studies

Dronabinol

 

+ Tashkin DP, Shapiro BJ, Frank IM. Acute effects of smoked marijuana and oral delta9-tetrahydrocannabinol on specific airway conductance in asthmatic subjects. American Review for Respiratory Diseases. 1974 Apr;109(4):420-8.

 

Cannabis (smoked)

 

+ Tashkin DP, Shapiro BJ, Frank IM. Acute effects of smoked marijuana and oral delta9-tetrahydrocannabinol on specific airway conductance in asthmatic subjects. American Review for Respiratory Diseases 1974 Apr;109(4):420-8.

 

Bronchodilation - Healthy Subjects

Controlled Studies

 

Dronabinol

 

+ Gong H Jr, Tashkin DP, Simmons MS, Calvarese B, Shapiro BJ. Acute and subacute bronchial effects of oral cannabinoids. Clinical Pharmacology and Therapeutics 1984;35(1):26-32.

+ Tashkin DP, Reiss S, Shapiro BJ, Calvarese B, Olsen JL, Lodge JW. Bronchial effects of aerosolized delta 9-tetrahydrocannabinol in healthy and asthmatic subjects. American Review of Respiratory Disease 1977;115(1):57-65.

 

Nabilone

 

+ Gong H Jr, Tashkin DP, Calvarese B. Comparison of bronchial effects of nabilone and terbutaline in healthy and asthmatic subjects. Journal of Clinical Pharmacology 1983;23(4):127-133.

 

COPD (Chronic Obstructive Pulmonary Disease)

Controlled Studies

Cannabis (oral, sublingual )

 

+ Pickering EE, Semple SJ, Nazir MS, Murphy K, Snow TM, Cummin AR, Moosavi S, Guz A, Holdcroft A. Cannabinoid effects on ventilation and breathlessness: A pilot study of efficacy and safety. Chron Respir Dis 2011;8(2):109-18.

 

Blood Pressure/Hypertension

Case Reports, Surveys

Cannabis (smoked)

 

+ Vandrey R, Umbricht A, Strain EC. Increased Blood Pressure Following Abrupt Cessation of Daily Cannabis Use. J Addict Med 2011;5(1):16-20.

 

Cancer

Uncontrolled Studies

Dronabinol

 

+ Guzmán M, Duarte MJ, Blázquez C, Ravina J, Rosa MC, Galve-Roperh I, Sánchez C, Velasco G, González-Feria L. A pilot clinical study of Delta9-tetrahydrocannabinol in patients with recurrent glioblastoma multiforme. Br J Cancer 2006;95(2):197-203.

 

Case Reports, Surveys

Cannabis (smoked)

 

+ Liang C, McClean MD, Marsit C, Christensen B, Peters E, Nelson HH, Kelsey KT. A population-based case-control study of marijuana use and head and neck squamous cell carcinoma. Cancer Prev Res (Phila Pa) 2009;2(8):759-68.

+ Foroughi M, Hendson G, Sargent MA, Steinbok P. Spontaneous regression of septum pellucidum/forniceal pilocytic astrocytomas-possible role of Cannabis inhalation. Childs Nerv Syst 2011;27(4):671-9.

 

Alzheimer's Disease

Controlled Studies

Dronabinol

 

+ Volicer L, Stelly M, Morris J, McLaughlin J, Volicer BJ. Effects of dronabinol on anorexia and disturbed behavior in patients with Alzheimer's disease. International Journal of Geriatric Psychiatry 1997;12:913-919.

 

Uncontrolled Studies

Dronabinol

 

+ Patel S, Shua-Haim JR, Pass M. Safety and efficacy of dronabinol in the treatment of agitation in patients with Alzheimer’s disease with anorexia: A retrospective chart review. Abstract, 11th International Conference of the IPA, 17-22 August 2003, Chicago.

+ Ross JS, Shua-Haim JR. Open-label study of dronabinol in the treatment of refractory agitation in Alzheimer’s disease: a pilot study. Abstract, ASCP's 34th Annual Meeting, 12-15 November 2003, San Antonio, USA.· Walther S, Mahlberg R, Eichmann U, Kunz D. Delta-9-tetrahydrocannabinol for nighttime agitation in severe dementia. Psychopharmacology (Berl) 2006;185(4):524-8.

 

Nabilone

 

+ Passmore MJ. The cannabinoid receptor agonist nabilone for the treatment of dementia-related agitation. Int J Geriatr Psychiatry 2008;23(1):116-7.

 

Neuroprotection

Case Reports, Surveys

Cannabis (smoked)

 

+ Jacobus J, McQueeny T, Bava S, Schweinsburg BC, Frank LR, Yang TT, Tapert SF. White matter integrity in adolescents with histories of marijuana use and binge drinking. Neurotoxicol Teratol 2009;31(6):349-55.

 

Schizophrenic Psychosis

Controlled Studies

Cannabidiol

 

+ Leweke FM, Koethe D, Gerth CW, Nolden BM, Schreiber D, Hänsel A, Neatby MA, Juelicher A, Hellmich M, Klosterkötter J. Cannabidiol as an antipsychotic. A double-blind, controlled clinical trial on cannabidiol vs. amisulpride in acute schizophrenia. IACM 3rd Conference on Cannabinoids in Medicine, 9-10 September 2005, Leiden, International Association for Cannabis as Medicine.

± Zuardi AW, Hallak JE, Dursun SM, Morais SL, Faria Sanches R, Musty RE, Crippa JA. Cannabidiol monotherapy for treatment-resistant schizophrenia. J Psychopharmacol 2006;20(5):683-6.

 

Uncontrolled Studies

Cannabidiol

 

+ Zuardi AW, Morais SL, Guimarães FS, Mechoulam R. Antipsychotic effect of cannabidiol. Journal of Clinical Psychiatry 1995;56:485-486.

 

Case Reports, Surveys

Dronabinol

 

+ Schwarcz G, Karajgi B, McCarthy R. Synthetic delta-9-tetrahydrocannabinol (dronabinol) can improve the symptoms of schizophrenia. J Clin Psychopharmacol 2009;29(3):255-8.· Schwarcz G, Karajgi B. Improvement in refractory psychosis with dronabinol: four case reports. J Clin Psychiatry. 2010;71(11):1552-3.

 

Case Reports, Surveys

Cannabis (smoked)

 

+ Schwarcz G, Karajgi B, McCarthy R. Synthetic delta-9-tetrahydrocannabinol (dronabinol) can improve the symptoms of schizophrenia. J Clin Psychopharmacol 2009;29(3):255-8.· Schwarcz G, Karajgi B. Improvement in refractory psychosis with dronabinol: four case reports. J Clin Psychiatry. 2010;71(11):1552-3.

 

Bipolar Disorder

Case Reports, Surveys

Cannabis (smoked)

 

+ Grinspoon L, Bakalar JB. The use of cannabis as a mood stabilizer in bipolar disorder: anecdotal evidence and the need for clinical research. Journal of Psychoactive Drugs 1998;30(2):171-7.

± El-Mallakh RS, Brown C. The effect of extreme marijuana use on the long-term course of bipolar I illness: a single case study. J Psychoactive Drugs 2007;39(2):201-2.

+ Ringen PA, Vaskinn A, Sundet K, Engh JA, Jónsdóttir H, Simonsen C, Friis S, Opjordsmoen S, Melle I, Andreassen OA. Opposite relationships between cannabis use and neurocognitive functioning in bipolar disorder and schizophrenia. Psychol Med 2010;40(8):1337-47.

 

Depression

Controlled Studies

Dronabinol

 

+ Regelson W, Butler JR, Schulz J, Kirk T, Peek L, Green ML, Zalis MO. Delta-9-tetrahydrocannabinol as an effective antidepressant and appetite-stimulating agent in advanced cancer patients. In: Braude MC, Szara S, editors. Pharmacology of marihuana. Vol 2. New York: Raven Press, 1976. p. 763-776.

 

Case Reports, Surveys

Cannabis (smoked)

 

+ Ware MA, Adams H, Guy GW. The medicinal use of cannabis in the UK: results of a nationwide survey. Int J Clin Pract 2005;59(3):291-5.

 

Anxiety

Controlled Studies

Cannabidiol

 

+ Bergamaschi MM, Queiroz RH, Chagas MH, de Oliveira DC, De Martinis BS, Kapczinski F, Quevedo J, Roesler R, Schröder N, Nardi AE, Martín-Santos R, Hallak JE, Zuardi AW, Crippa JA. Cannabidiol Reduces the Anxiety Induced by Simulated Public Speaking in Treatment-Naïve Social Phobia Patients. Neuropsychopharmacology. 2011 Feb 9. [Epub ahead of print]

+ Crippa JA, Derenusson GN, Ferrari TB, Wichert-Ana L, Duran FL, Martin-Santos R, Simões MV, Bhattacharyya S, Fusar-Poli P, Atakan Z, Santos Filho A, Freitas-Ferrari MC, McGuire PK, Zuardi AW, Busatto GF, Hallak JE. Neural basis of anxiolytic effects of cannabidiol (CBD) in generalized social anxiety disorder: a preliminary report. J Psychopharmacol 2011;25(1):121-30.

 

Posttraumatic Stress Disorder

Case Reports, Surveys

Cannabis (smoked)

 

+ Villagonzalo KA, Dodd S, Ng F, Mihaly S, Langbein A, Berk M. The relationship between substance use and posttraumatic stress disorder in a methadone maintenance treatment program. Compr Psychiatry 2011;52(5):562-6.

+ Cornelius JR, Kirisci L, Reynolds M, Clark DB, Hayes J, Tarter R. PTSD contributes to teen and young adult cannabis use disorders. Addict Behav 2010;35(2):91-4.

+ Reznik I. Medical cannabis use in post-traumatic stress disorder: a naturalistic observational study. Abstract presented at the Cannabinoid Conference 2011, 8-10 September, Bonn, Germany.

 

Alcohol Dependency

Case Reports, Surveys

Cannabis (smoked)

 

+ Mikuriya TH. Cannabis substitution. An adjunctive therapeutic tool in the treatment of alcoholism. Medical Times 1970;98(4):187-91. · Mikuriya TH. Cannabis as a substitute for alcohol: a harm-reduction approach. J Cannabis Ther 2004;4(1):79-93.· Reiman A. Cannabis as a substitute for alcohol and other drugs Harm Reduct J 2009;6:35.

 

Opioid Dependency

Case Reports, Surveys

Cannabis (smoked)

 

± Hermann D, Klages E, Welzel H, Mann K, Croissant B. Low efficacy of non-opioid drugs in opioid withdrawal symptoms. Addict Biol 2005;10(2):165-9.

+ O'Connell TJ, Bou-Matar CB. Long term marijuana users seeking medical cannabis in California (2001-2007): demographics, social characteristics, patterns of cannabis and other drug use of 4117 applicants. Harm Reduct J 2007;4:16.

 

Uncontrolled Studies

Cannabis (smoked)

 

+ Raby WN, Carpenter KM, Rothenberg J, Brooks AC, Jiang H, Sullivan M, Bisaga A, Comer S, Nunes EV Intermittent marijuana use is associated with improved retention in naltrexone treatment for opiate-dependence. Am J Addict 2009;18(4):301-8.

 

Cocaine/Crack Dependency

Uncontrolled Studies

Cannabis (smoked)

 

+ Aharonovich E, Garawi F, Bisaga A, Brooks D, Raby WN, Rubin E, Nunes EV, Levin FR. Concurrent cannabis use during treatment for comorbid ADHD and cocaine dependence: effects on outcome. Am J Drug Alcohol Abuse. 2006;32(4):629-35.

+ Labigalini E Jr, Rodrigues LR, Da Silveira DX. Therapeutic use of cannabis by crack addicts in Brazil. J Psychoactive Drugs 1999;31(4):451-5.

 

Case Reports, Surveys

Cannabis (smoked)

 

+ Dreher M. Crack heads and roots daughters: The therapeutic use of cannabis in Jamaica. J Cannabis Ther 2002;2(3-4):121-33.

 

Cannabis Dependency

Controlled Studies

Dronabinol

 

+ Haney M, Hart CL, Vosburg SK, Nasser J, Bennett A, Zubaran C, Foltin RW. Marijuana withdrawal in humans: effects of oral THC or divalproex. Neuropsychopharmacology 2004;29(1):158-70.

 

Case Reports, Surveys

Dronabinol

 

+ Levin FR, Kleber HD. Use of dronabinol for cannabis dependence: two case reports and review. Am J Addict 2008;17(2):161-4.

 

Sleep

Controlled Studies

Dronabinol, Cannabidiol

 

+ Nicholson AN, Turner C, Stone BM, Robson PJ. Effect of Delta-9-tetrahydrocannabinol and cannabidiol on nocturnal sleep and early-morning behavior in young adults. J Clin Psychopharmacol 2004;24(3):305-13.

 

Different Diseases

Case Reports, Surveys

Cannabis (smoked)

 

+ Grinspoon L, Bakalar JB. Marihuana, the forbidden medicine. Rev. and exp. ed. New Haven: Yale University Press; 1997.· Randall RC, O'Leary AM. Marijuana Rx: The patients' fight for medicinal pot. New York: Thunder's Mouth Press; 1998.

+ Corral VL. Differential effects of medical marijuana based on strain and route of administration: A three-year observational study. J Cannabis Ther 2001;1(3-4):43-59.

+ Grotenhermen F, Schnelle M. Survey on the medical use of cannabis and THC in Germany. J Cannabis Ther 2003;3(2):17-40.

+ Gieringer D. Medical use of cannabis: Experience in California. In: Grotenhermen F, Russo E, editors. Cannabis and cannabinoids: Pharmacology, toxicology, and therapeutic potential. Binghamton, NY: Haworth Press; 2001. p. 153-70.

+ Ware MA, Adams H, Guy GW. The medicinal use of cannabis in the UK: results of a nationwide survey. Int J Clin Pract 2005;59(3):291-5.

+ Russo EB, Mathre ML, Byrne A, Velin R, Bach PJ, Sanchez-Ramos J, et al. Chronic cannabis use in the Compassionate Investigational New Drug Program: An examination of benefits and adverse effects of legal clinical cannabis. J Cannabis Ther 2002;2(1):3-57.

+ O'Connell TJ, Bou-Matar CB. Long term marijuana users seeking medical cannabis in California (2001-2007): demographics, social characteristics, patterns of cannabis and other drug use of 4117 applicants. Harm Reduct J 2007;4:16.

+ Bottorff JL, Johnson JL, Moffat BM, Mulvogue T. Relief oriented use of marijuana by teens. Subst Abuse Treat Prev Policy 2009;4(1):7.