Efficacy of tetrahydrocannabinol in patients refractory to standard antiemetic therapy
Oral delta-9-tetrahydrocannabinol (THC), 15 mg/m2, was compared to prochlorperazine (PCZ), 10 mg. for the control of cancer chemotherapy-related emesis. Thirty-six patients whose vomiting was refractory to standard antiemetic therapy were entered in this randomized comparative cross-over study. THC decreased nausea and vomiting in 23 of 36 (64%) patients compared to 1 of 36 receiving PCZ. THC efficacy was not dependent on the class of antineoplastic-agent inducing the emetic symptoms, age of patients or type of sensorial change experienced. Using the 15 mg/m2 dose, all patients experienced transient sensorial changes, characterized as a pleasant “high” in 19 or a variable state of dysphoria in 17 cases. This study confirms the usefulness of THC in patients whose chemotherapy-induced nausea and vomiting is refractory to other standard antiemetics. While excellent antiemetic control was achieved at the dosage 15 mg/m2, dysphoria was encountered at this dose level and we recommend that an initial dose of 5 mg/m2 which, if necessary, can be carefully increased to achieve maximum antiemetic benefit.
Key wordstetrahydrocannabinol antiemetic therapy
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- 1.Harris JG: Nausea, vomiting and cancer treatment. Cancer 28:194–201, 1978Google Scholar
- 2.Whitehead VM: Cancer treatment needs better antiemetics. N Eng J Med 293:199–200, 1975Google Scholar
- 3.Moertel CG, Reitemeier RJ, and Gage BP: A controlled clinical investigation of antiemetic drugs. J Amer Med Assoc 186: 116–118, 1963Google Scholar
- 4.Sallan SE, Zinberg NE, and Frei E: Antiemetic effect of delta-9-tetrahydrocannabinol in patients receiving cancer chemotherapy. N Eng J Med 293:795–797, 1975Google Scholar
- 5.Chang AE, Shiling DJ, and Stillman RC: Delta-9-tetrahydrocannabinol as an antiemetic in cancer patients receiving high-dose methotrexate. Ann Int Med 91:819–824, 1979Google Scholar
- 6.Lucas VS, and Laszlo J: Delta-9-tetrahydrocannabinol for refractory vomiting induced by cancer chemotherapy. J Amer Med Assoc 243:1241–1243, 1980Google Scholar
- 7.Frytak S, Moertel CG, O'Fallon JR, Rubin J, Creagon ET, O'Connell MJ, Schutt AJ, Schwartau NW: Delta-9-tetrahydrocannabinol as an antiemetic for patients receiving cancer chemotherapy. Ann Int Med 91:825–830, 1979Google Scholar
- 8.Sallan WE, Cronin C, Zelen M, Zinberg NE: Antiemetics in patients receiving chemotherapy for cancer: A randomized comparison of delta-9-tetrahydrocannabinol and prochlorperazine. N Eng J Med 302:135–138, 1980Google Scholar
- 9.Stanton W: Antiemetic efficacy and safety of delta-9-tetrahydrocannabinol (THC): effect of dose and anticancer regimen. (Abstr). Proc Am Soc Clin Oncol 2:94, 1983Google Scholar