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Palliativmedizin

Übelkeit & Erbrechen

Die durch eine Chemo- und Radiotherapie auftretenden Nebenwirkungen gelten als gut behandelbar mit Medizinischem Cannabis. 17 THC kann bei der Behandlung von Übelkeit und Erbrechen bei Krebs im Endstadium sehr wirksam sein.18 Zudem zeigt sich bei Verwendung von THC, dass es Übelkeit lindern kann, welche auf die Behandlung mit herkömmlichen Medikamenten nicht anspricht.19 In einer 2006 durchgeführten Umfrage hielt die große Mehrheit der Befragten Cannabis für äußerst wirksam als Therapie gegen Übelkeit (93%) und Erbrechen (75%).20 Medizinisches Cannabis kann auch als eine zusätzliche Option neben anderen antiemetischen Medikamenten zu einer Verbesserung von Übelkeit & Erbrechen führen.21 Medizinisches Cannabis wird auch gerne bei anderen Formen von Übelkeit und Erbrechen eingesetzt. Es kommt oft zum Einsatz bei AIDS, Hepatitis, aber auch bei Schwangerschaftserbrechen.22

Appetitlosigkeit & Anorexie

Oft kommt es durch verschiedenste Erkrankungen zu einer Appetitlosigkeit, die stark ausgeprägt nicht selten zu einer Abmagerung führt. Bereits bei einer niedrigen Tagesdosis von THC (5mg) kommt es zu einem ausgeprägten appetitanregenden Effekt.23 Bei den meisten Krebspatienten kommt es zu einer deutlichen Zunahme des Appetits und gleichzeitig zur Abnahme der Übelkeit.24 Hinzu kommt die, hier gewollte, Gewichtzunahme.25

Referenzen

Referenzen:



1. Light, M. K., A. Orens, B. Lewandowski, and T. P. Market size and demand for marijuana in Colorado. (2014).
2. Ilgen, M. A. et al. Characteristics of adults seeking medical marijuana certification. Drug Alcohol Depend. 132, 654–659 (2013).
3. Boehnke, K. F., Litinas, E. & Clauw, D. J. Medical Cannabis Use Is Associated with Decreased Opiate Medication Use in a Retrospective Cross-Sectional Survey of Patients with Chronic Pain. J. Pain 17, 739–744 (2016).
4. Whiting, P. F. et al. Cannabinoids for medical use: A systematic review and meta-analysis. JAMA - J. Am. Med. Assoc. 313, 2456–2473 (2015).
5. Ware, M. A. et al. Smoked cannabis for chronic neuropathic pain: A randomized controlled trial. Cmaj 182, (2010).
6. Mechtler, L. L., Gengo, F. M. & Bargnes, V. H. Cannabis and Migraine: It’s Complicated. Curr. Pain Headache Rep. 25, 1–13 (2021).
7. Rhyne, D. N., Anderson, S. L., Gedde, M. & Borgelt, L. M. Effects of Medical Marijuana on Migraine Headache Frequency in an Adult Population. Pharmacotherapy 36, 505–510 (2016).
8. Russo, E. Cannabis for migraine treatment: The once and future prescription? An historical and scientific review. Pain 76, 3–8 (1998).
9. Cuttler, C., Spradlin, A., Cleveland, M. J. & Craft, R. M. Short- and Long-Term Effects of Cannabis on Headache and Migraine. J. Pain 21, 722–730 (2020).
10. Baron, E. P. Medicinal Properties of Cannabinoids, Terpenes, and Flavonoids in Cannabis, and Benefits in Migraine, Headache, and Pain: An Update on Current Evidence and Cannabis Science. Headache 58, 1139–1186 (2018).
11. Serpell, M. et al. A double-blind, randomized, placebo-controlled, parallel group study of THC/CBD spray in peripheral neuropathic pain treatment. Eur. J. Pain (United Kingdom) 18, 999–1012 (2014).
12. Hoch, E. et al. How effective and safe is medical cannabis as a treatment of mental disorders? A systematic review. Eur. Arch. Psychiatry Clin. Neurosci. 269, 87–105 (2019).
13. Bachhuber, M., Arnsten, J. H. & Wurm, G. Use of Cannabis to Relieve Pain and Promote Sleep by Customers at an Adult Use Dispensary. J. Psychoactive Drugs 51, 400–404 (2019).
14. Shannon, S., Lewis, N., Lee, H. & Hughes, S. Cannabidiol in Anxiety and Sleep: A Large Case Series. Perm. J. 23, 18–041 (2019).
15. Piper, B. J. et al. Substitution of medical cannabis for pharmaceutical agents for pain, anxiety, and sleep. J. Psychopharmacol. 31, 569–575 (2017).
16. Corroon, J. M., Mischley, L. K. & Sexton, M. Cannabis as a substitute for prescription drugs - A cross-sectional study. J. Pain Res. 10, 989–998 (2017).
17. Duran, M. et al. Preliminary efficacy and safety of an oromucosal standardized cannabis extract in chemotherapy-induced nausea and vomiting. Br. J. Clin. Pharmacol. 70, 656–663 (2010).
18. Hernandez, S. L., Sheyner, I., Stover, K. T. & Stewart, J. T. Dronabinol Treatment of Refractory Nausea and Vomiting Related to Peritoneal Carcinomatosis. Am. J. Hosp. Palliat. Med. 32, 5–7 (2015).
19. Merriman, A. R. & Oliak, D. A. Use of medical marijuana for treatment of severe intractable nausea after laparoscopic Roux-en-Y gastric bypass surgery. Surg. Obes. Relat. Dis. 4, 550–551 (2008).
20. Westfall, R. E., Janssen, P. A., Lucas, P. & Capler, R. Reprint of: 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. 15, 242–246 (2009).
21. Gonzalez-Rosales, F. & Walsh, D. Intractable nausea and vomiting due to gastrointestinal mucosal metastases relieved by tetrahydrocannabinol (Dronabinol). J. Pain Symptom Manage. 14, 311–314 (1997).
22. Green, S., Nathwani, D., Goldberg, D. & Kennedy, D. Nabilone as effective therapy for intractable nausea and vomiting in AIDS [letter]. Br. J. Clin. Pharmacol. 28, 494–495 (1989).
23. Dejesus, E., Rodwick, B. M., Bowers, D., Cohen, C. J. & Pearce, D. Use of dronabinol improves appetite and reverses weight loss in HIV/AIDS-infected patients. J. Int. Assoc. Physicians AIDS Care 6, 95–100 (2007).
24. Zutt, M., Hänßle, H., Emmert, S., Neumann, C. & Kretschmer, L. Dronabinol zur supportiven Therapie metastasierter maligner Melanome mit Lebermetastasen. Hautarzt 57, 423–427 (2006).
25. Volicer, L., Stelly, M., Morris, J., McLaughlin, J. & Volicer, B. J. Effects of dronabinol on anorexia and disturbed behavior in patients with Alzheimer’s disease. Int. J. Geriatr. Psychiatry 12, 913–919 (1997).
26. Cooper, R. E. et al. Cannabinoids in attention-deficit/hyperactivity disorder: a randomised-controlled trial. Eur. Neuropsychopharmacol. 26, S130 (2016).
27. Aharonovich, E. et al. Concurrent cannabis use during treatment for comorbid ADHD and cocaine dependence: Effects on outcome. Am. J. Drug Alcohol Abuse 32, 629–635 (2006).
28. Hupli, A. M. M. Medical Cannabis for Adult Attention Deficit Hyperactivity Disorder: Sociological Patient Case Report of Cannabinoid Therapeutics in Finland. Med. Cannabis Cannabinoids 1, 112–118 (2019).
29. Prentiss, D., Power, R., Balmas, G., Tzuang, G. & Israelski, D. M. Patterns of Marijuana Use among Patients with HIV/AIDS Followed in a Public Health Care Setting. J. Acquir. Immune Defic. Syndr. 35, 38–45 (2004).
30. Consroe, P. M. R. R. J. T. W. P. R. The Perceived Effects of Smoked Cannabis on Patients with Multiple Sclerosis. Eur. Neurol. (1997) doi:10.1159/000112901.
31. Linares, I. M. P. et al. No acute effects of Cannabidiol on the sleep-wake cycle of healthy subjects: A randomized, double-blind, placebo-controlled, crossover study. Front. Pharmacol. 9, 1–8 (2018).
32. Bonaccorso, S., Ricciardi, A., Zangani, C., Chiappini, S. & Schifano, F. Cannabidiol (CBD) use in psychiatric disorders: A systematic review. Neurotoxicology 74, 282–298 (2019).
33. Neubauer, D., Perkovic Benedik, M. & Osredkar, D. Cannabidiol for treatment of refractory childhood epilepsies: Experience from a single tertiary epilepsy center in Slovenia. Epilepsy Behav. 81, 79–85 (2018).
34. Devinsky, O. et al. Cannabidiol in patients with treatment-resistant epilepsy: an open-label interventional trial. Lancet Neurol. 15, 270–278 (2016).
35. Szaflarski, J. P. et al. Long-term safety and treatment effects of cannabidiol in children and adults with treatment-resistant epilepsies: Expanded access program results. Epilepsia 59, 1540–1548 (2018).
36. Hausman-Kedem, M., Menascu, S. & Kramer, U. Efficacy of CBD-enriched medical cannabis for treatment of refractory epilepsy in children and adolescents – An observational, longitudinal study. Brain Dev. 40, 544–551 (2018).

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