Hallucinations cannabinoids

I. 18-1.62), number-needed-to-treat (NNT) was 6 for complete control of nausea relative risk was 1.28 (Cl 1.08-1.51), NNT 8 for complete control of vomiting. Cannabinoids were not more effective in patients receiving very low or very high emetogenic chemotherapy. In crossover trials, patients preferred cannabinoids for future chemotherapy cycles relative risk 2.39 (2.05-2.78), NNT 3. Some potentially beneficial side effects occurred more often with cannabinoids high 10.6 (6.86-16.5), NNT 3 sedation or drowsiness 1.66 (1.46-1.89), NNT 5 euphoria 12.5 (3-52.1), NNT 7. Harmful side effects also occurred more often with cannabinoids dizziness 2.97 (2.31-3.83), NNT 3 dysphoria or depression 8.06 (3.38-19.2), NNT 8 hallucinations 6.10 (2.41-15.4), NNT 17 paranoia 8.58 (6.38-... 

Cannabinoids Marijuana derivatives, including dronabinol [droe NAB i nol] and nabilone, are effective against moderately emetogenic chemotherapy. However, they are seldom first-line antiemetics because of their serious side effects, including dysphoria, hallucinations, sedation, vertigo, and disorientation. In spite of their psychotropic properties (see p. 105), the antiemetic action of cannabinoids may not involve the brain synthetic cannabinoids having no psychotropic activity, nevertheless are antiemetic. 

Thirty randomized, controlled trials from 1975 to 1996 were analyzed to quantify the antiemetic efficacy and adverse effects of cannabis when given to 1366 patients receiving chemotherapy. Oral nabUone, oral dronabinol, and intramuscular levonantradol were compared with conventional antiemetics (prochlorperazine, metoclopramide, chlor-promazine, thiethylperazine, haloperidol, domperidone, and aliza-pride) or placebo. Across all trials, cannabinoids were slightly more effective than active comparators and placebo when the chemotherapy regimen was of moderate emetogenic potential, and patients preferred them. No dose-response relationships were evident to the authors. The cannabinoids were also more toxic side effects included euphoria, drowsiness, sedation, somnolence, dysphoria, depression, hallucinations, and paranoia. The efficacy of cannabinoids as compared to SSRls has not been studied. Use of these agents should be considered when other regimens do not provide desired efficacy. 

Dronabinol is a cannabinoid with antiemetic effects and is used in a dosage of 5 mg/m p.o. 1 to 3 hours prior to administration of antineoplastic agents. Dronabinol is excreted primarily in feces via the biliary tract. Dronabinol may cause euphoria, drowsiness, altered thinking, hallucination, confusion, and impaired coordination (see also Figures 73 and 81). In addition, dronabinol is used to stimulate appetite in anorexia associated with AIDS-related weight loss. 

---