Antiemetics in Patients Receiving Chemotherapy for Cancer

Abstract

Delta-9-tetrahydrocannabinol (THC) is an effective antiemetic as compared with placebos in patients receiving chemotherapy for cancer. In this study we compared THC with prochlorperazine (compazine) in a randomized, double-blind, crossover trial with patients who had failed to benefit from standard antiemetic therapy. Regardless of the emetic activity of the chemotherapeutic agents, there were more complete responses to THC courses (in 36 of 79 courses) than to prochlorperazine (in 16 of 78 courses). Of 25 patients who were treated with both drugs and who expressed a preference, 20 preferred THC (P = 0.005). Among patients under 20 years of age there was a higher proportion of complete responses to THC courses (15 of 20) than among older patients (21 of 59 courses; P = 0.004). Increased food intake occurred more frequently with THC (P = 0.008) and was associated with the presence of a "high." Of 36 THC courses resulting in complete antiemetic responses, 32 were associated with a high. We conclude that THC is an effective antiemetic in many patients who receive chemotherapy for cancer and for whom other antiemetics are ineffective. (N Engl J Med 302:135--138, 1980).

Delta‐9‐tetrahydrocannabinol delays the gastric emptying of solid food in humans: a double‐blind, randomized study

“…One hour prior to the ingestion of the test meal, either the drug, THC, or a visually identical placebo was administered to each subject in a double‐blind randomized manner. The dose of THC administered to the subjects was 10 mg/m 2 of the body surface area, a dose often used in studies addressing the effectiveness of THC in prevention of chemotherapy‐induced nausea and vomiting 3 , . 7 …”

“…It is an effective agent in the prevention of chemotherapy‐induced nausea and vomiting 1 . It has been shown to be superior to conventional anti‐emetic agents such as prochlorperazine in numerous controlled studies 2 –4 . Metoclopramide, a dopamine antagonist, is also effective as an anti‐emetic agent in this setting 5 .…”

Single, High-Dose Intravenous Dexamethasone as an Antiemetic in Cancer Chemotherapy

“…prevention of chemotherapeutically induced nausea and vomiting [7], and other, more effective agents and combinations are being sought. In addition to the phenothiazine derivatives [8], a number of other agents or their derivatives have been studied, including: trimethobenzamide [9], dimenhydrinate [5], benzquinamide [6,10], tetrahydrocannabinol [11 13], nabilone [14], metoclopramidc [15,16], halopcridol [17,18], droperidol [19], pyridoxine [6], and various gluco corticoids [20 22],…”

The medicinal uses of cannabis and its constituents

“…Table 1 shows some of the clinical trials obtained using A'-THC compared to other well-known drugs. A'-THC has been shown, to be superior in its anti-emetic effectiveness than either placebo or chlorperazine (Orr et al, 1980;Herman et al, 1979;Lucas and Lazlo, 1980;Frytak et al, 1979;Sallan et al, 1980). Sallan et al (1980) observed that younger patients, 20 years of age or less, were more likely to experience a complete anti-emetic response with THC than older patients.…”

“…Various side effects were experienced by subjects ranging from psychological 'high' (Lucas and Lazlo, 1980;Orr et al, 1980;Sallan et al, 1980;Chang et al, 1979) to sedation, somnolence, orthostatic hypotension, increased heart rate, and dysphoria (Chang et al, 1979;Sallan et al, 1975). Frytak et al (1979) observed that patients suffered from blurred vision, depression, visual hallucination, nightmares, amnesia, mental confusion and fainting.…”