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Cannabinoide in der Behandlung von Übelkeit und Erbrechen

Review of cannabinoids in the treatment of nausea and vomiting

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Zusammenfassung

Cannabinoide werden zur Behandlung von Übelkeit und Erbrechen eingesetzt. Die Wirkung scheint über Cannabinoidrezeptoren im Nucleus tractus solitarius vermittelt zu werden.

Zum Einsatz von Cannabinoiden bei Übelkeit und Erbrechen nach Chemotherapie liegen Studienergebnisse vor. In keiner dieser Studien wurden allerdings Cannabinoide mit den neueren Serotoninantagonisten verglichen. In anderen Indikationen ist die antiemetische Effektivität der Cannabinoide bisher nur ungenügend untersucht worden.

In den meisten Studien wurde unter der Cannabinoidmedikation allerdings über deutlich mehr oder stärkere Nebenwirkungen gegenüber der Vergleichsmedikation berichtet. Bei einigen Studien nach Chemotherapie oder Strahlentherapie brachen Patienten wegen Nebenwirkungen häufiger die Cannabinoidmedikation ab.

Obwohl in klinischen Studien für die Cannabinoide eine deutliche antiemetische Effektivität nachgewiesen wurde, sprechen Häufigkeit und Stärke der Nebenwirkungen gegen einen Einsatz als Mittel der ersten Wahl. Bei Patienten, die mit den herkömmlichen Antiemetika nicht ausreichend behandelt werden können, können Cannabinoide aber eine wertvolle Ergänzung der antiemetischen Therapie sein.

Abstract

Cannabinoids are used to treat nausea and vomiting. The effect appears to be mediated by cannabinoid receptors in the nucleus tractus solitarius.

Results are available from studies on the use of cannabinoids to manage nausea and vomiting after chemotherapy. None of these studies, however, compared cannabinoids with the newer serotonin antagonists. The antiemetic efficacy of cannabinoids for other indications has not yet been studied sufficiently.

Most of the studies report significantly more or stronger side effects with cannabinoid medication in comparison to similar medication. In some of the studies on treatment after chemotherapy or radiotherapy, the patients terminated the cannabinoid therapy more frequently due to side effects.

Although clinical studies have provided clear evidence for the antiemetic efficacy of cannabinoids, the frequency and severity of side effects argue against their use as the method of first choice. For patients who cannot be adequately treated with conventional antiemetic agents, cannabinoids can represent a valuable adjunct to the antiemetic regimen.

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Danksagung

Die Universitätsprofessur für Palliativmedizin der Universität Aachen (Lukas Radbruch) wird durch die Grünenthal-Stiftung für Palliativmedizin gefördert.

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Authors and Affiliations

  1. Klinik für Palliativmedizin, Universitätsklinikum Aachen

    L. Radbruch

  2. Zentrum für Palliativmedizin, Malteser-Krankenhaus Bonn

    F. Nauck

  3. Klinik für Palliativmedizin, Rheinisch-Westfälische Technische Hochschule, 52074, Aachen

    L. Radbruch

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Correspondence to L. Radbruch.

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Radbruch, L., Nauck, F. Cannabinoide in der Behandlung von Übelkeit und Erbrechen. Schmerz 18, 306–310 (2004). https://doi.org/10.1007/s00482-004-0315-5

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  • DOI: https://doi.org/10.1007/s00482-004-0315-5

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