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Epilepsy is a disorder of recurrent unprovoked seizures. More than half of seizures can be controlled by anti‐epileptic medications. For the remaining patients, they may wish to try other agents to obtain better control. Marijuana, or cannabinoids, may be one such agent. This review assessed the efficacy of marijuana, or cannabinoids, as a treatment for epilepsy. No reliable conclusions can be drawn at present regarding the efficacy of cannabinoids as a treatment for epilepsy. Further trials are needed.

Cochrane Database of Systematic Reviews: Plain Language Summaries [Internet] - John Wiley & Sons, Ltd.

Version: March 5, 2014

Cannabinoids are compounds derived from the cannabis plant (Cannabis sativa). Laboratory studies have indicated that cannabinoids may regulate some of the processes that lead to neurodegeneration. This suggests that cannabinoids could be useful in the treatment of neurodegenerative dementias such as Alzheimer's disease. So far, only one small randomized controlled trial has assessed the efficacy of cannabinoids in the treatment of dementia. This study had poorly presented results and did not provide sufficient data to draw any useful conclusions.

Cochrane Database of Systematic Reviews: Plain Language Summaries [Internet] - John Wiley & Sons, Ltd.

Version: April 15, 2009

Cannabinoid medication might be useful in the treatment of the symptoms in patients with Tourette's syndrome. At the present time only two relevant studies have been conducted. Both studies used tetrahydrocannabinol (Δ9THC). In both studies Δ9THC was associated with tic reduction. However the sample size was small and a large number of multiple comparisons were made . There were only 28 participants in total, since eight participants took part in both studies. Possibly the patients who derived the greatest benefit and experienced the least adverse effects would be the most inclined to participate in further studies. There were a high number of drop outs/exclusions in the six week study and it is unclear whether intention to treat analysis (ITT) was performed. The results that are reported are analyses done on the patients who remained in the study on the study medication at the correct dose. In reality, patients do opt not to continue treatment if there is limited efficacy or unpalatable side effects. This introduces attrition bias. Whilst there were some significant results, the authors themselves accept that very few of these results are significant if a Bonferroni correction is performed. It is possible that cannabinoid medication has a beneficial effect which is too weak to be detected using ITT and such a small sample size. There is some weak evidence that cannabinoid medication may have an effect on obsessive compulsive behaviour but the measure used was an addition to the TSSL which has not been validated.There were no data on the effect of Δ9THC on quality of life.There is not enough evidence to support the use of cannabinoids in treating tics and obsessive compulsive behaviour in people with Tourette's syndrome.

Cochrane Database of Systematic Reviews: Plain Language Summaries [Internet] - John Wiley & Sons, Ltd.

Version: October 7, 2009

Long‐term use of nicotine can upset the endocannabinoid system in the brain, which controls food intake and energy balance. Rimonabant and similar drugs may help smokers to quit by rebalancing the system, which then reduces nicotine and food cravings. We searched our own specialised register of controlled trials. We also contacted Sanofi Aventis, the manufacturers of rimonabant, and researchers who presented early findings at conferences. We found two randomized controlled trials (RCTs) of rimonabant for smoking cessation, covering 1567 smokers, and one RCT of rimonabant for relapse prevention covering 1661 quitters. The available information shows that rimonabant at the 20 mg dose increased by 1½‐fold the chances of not smoking at one year, compared with placebo. Rimonabant 5 mg did no better than placebo at any time point. In the relapse prevention trial, smokers who quit successfully with rimonabant 20 mg were 1½ times more likely to remain abstinent on active treatment (5 mg or 20 mg for 42 weeks) than on placebo. For those who quit successfully on 5 mg, neither active nor placebo treatment appeared to benefit them in avoiding relapse. This inconsistent picture makes it difficult to find a clear benefit for rimonabant in preventing relapse. One trial of taranabant (317 smokers) did not find a benefit for treatment over placebo, and the taranabant group suffered more side effects than the placebo group. Main side effects for rimonabant included nausea and upper respiratory tract infections, and serious harms were reported to be low. For taranabant, the main side effects included problems with digestive, nervous, psychiatric, skin and blood vessel organ systems. For both drugs, the number and severity of the side effects increased in those taking higher doses. Although the evidence on weight change is sparse in these trials, weight gain was reported to be significantly lower among the rimonabant 20 mg quitters than in the 5 mg or placebo quitters. During treatment, overweight or obese smokers tended to lose weight on 20 mg, while normal weight smokers did not. Taranabant also limited weight gain during cessation attempts. In 2008 both rimonabant and taranabant were withdrawn by the manufacturers, because of links to mental disorders and unacceptable side effects.

Cochrane Database of Systematic Reviews: Plain Language Summaries [Internet] - John Wiley & Sons, Ltd.

Version: March 16, 2011

Bibliographic details: Sevilla Guerra S.  Are cannabinoids more effective than placebo in decreasing MS-related bladder dysfunction? British Journal of Neuroscience Nursing 2012; 8(2): 71-78 Available from: http://www.bjnn.co.uk/cgi-bin/go.pl/library/abstract.html?uid=91163

Database of Abstracts of Reviews of Effects (DARE): Quality-assessed Reviews [Internet] - Centre for Reviews and Dissemination (UK).

Version: 2012

Cannabis and cannabinoid use during cancer is often done for symptom management. Learn more about use of cannabis and cannabinoids during cancer in this expert-reviewed summary.

PDQ Cancer Information Summaries [Internet] - National Cancer Institute (US).

Version: December 20, 2017

Cannabis has been used medicinally for millennia, but has not been approved by the U.S. Food and Drug Administration to treat any medical condition. Cannabinoids are the components in cannabis; some are commercially available to treat symptoms. Get detailed information in this clinician summary.

PDQ Cancer Information Summaries [Internet] - National Cancer Institute (US).

Version: August 16, 2018

Chronic pain is a complex, severe and debilitating condition which can lead to a considerable reduction in function and quality of life. Patients may present with different forms of chronic pain resulting from a number of identifiable causes, including pain due to lesion or dysfunction of the nerves, spinal cord or brain (neuropathic pain), or persistent pain caused by other non-malignant conditions, such as low-back pain or pain due to inflammation of various arthritic conditions. The prevalence of chronic non-cancer pain or neuropathic pain among Canadian adults is not well known. However, prevalence estimates using large, population-based questionnaires have shown that 4% to 8% of the general population in the developed world experiences neuropathic pain, suggesting that approximately two million Canadians may be affected by this disabling condition. Chronic pain is of particular concern among Canadians aged 65 years and older; based on cross-sectional data from the 1996/1997 National Population Health Survey and the 2005 Canadian Community Health Survey, chronic pain was estimated to affect 27% and 38% of seniors living in households and health care institutions, respectively.

Rapid Response Report: Summary with Critical Appraisal - Canadian Agency for Drugs and Technologies in Health.

Version: September 21, 2016

Fibromyalgia is characterised by chronic (longer than three months) widespread pain that often co‐exists with sleep problems, problems with thinking and fatigue (exhaustion). People often report severe limitations of daily functioning and poor health‐related quality of life. Therapies focus on reducing key symptoms and disability, and improving health‐related quality of life. Cannabis has been used for 3000 years to reduce pain and other symptoms, such as loss of appetite and anxiety.

Cochrane Database of Systematic Reviews: Plain Language Summaries [Internet] - John Wiley & Sons, Ltd.

Version: July 18, 2016

The use of cannabis (marijuana), its active ingredient or synthetic forms such as dronabinol has been advocated in patients with HIV/AIDS, in order to improve the appetite, promote weight gain and lift mood. Dronabinol has been registered for the treatment of AIDS‐associated anorexia in some countries. However, the evidence for positive effects in patients with HIV/AIDS is limited, and some of that which exists may be subject to the effects of bias. Those studies that have been performed have included small numbers of participants and have focused on short‐term effects. Longer‐term data, and data showing a benefit in terms of survival, are lacking. There are insufficient data available at present to justify wide‐ranging changes to the current regulatory status of cannabis or synthetic cannabinoids.

Cochrane Database of Systematic Reviews: Plain Language Summaries [Internet] - John Wiley & Sons, Ltd.

Version: April 30, 2013

Many people with the serious mental illness schizophrenia smoke cannabis but it is not known why people do so or the effects of smoking cannabis. It is unclear what the best methods are that help people to reduce or stop smoking cannabis. Cannabis is the most consumed illicit drug in the world – amounting to 120 to 224 million users. Cannabis, which is usually smoked or eaten, gives a feeling of well‐being, but in high doses it may also cause mental illness or psychosis. Clinical evidence suggests people who have schizophrenia have a worse overall outcome from using cannabis, however, there are some people with schizophrenia who claim that using cannabis helps their symptoms and reduces the side effects of antipsychotic medication. This review aims to look at the effects of cannabis, both its use and withdrawal, in people who have schizophrenia. A search for trials was conducted in 2013, eight randomised trials, involving 530 participants were included. Five trials investigated the effects of using a specific psychotherapy aimed at reducing cannabis intake, two investigated the effects of antipsychotic medication for cannabis reduction and one investigated the use of cannbidiol (a compound found in cannabis) as a treatment for the symptoms of schizophrenia.

Cochrane Database of Systematic Reviews: Plain Language Summaries [Internet] - John Wiley & Sons, Ltd.

Version: October 14, 2014

As many as three‐quarters of people who receive chemotherapy experience nausea (feeling sick) and vomiting (being sick), which many find distressing. While conventional anti‐sickness medicines are effective, they do not work for everyone, all of the time. Therapeutic drugs based on the active ingredient of cannabis, known as THC (delta‐9‐tetrahydrocannabinol), have been approved for use as anti‐sickness medicines in some countries.

Cochrane Database of Systematic Reviews: Plain Language Summaries [Internet] - John Wiley & Sons, Ltd.

Version: November 12, 2015

This summary of a Cochrane review presents what we know from research about the effect of neuromodulators on pain in patients with rheumatoid arthritis.

Cochrane Database of Systematic Reviews: Plain Language Summaries [Internet] - John Wiley & Sons, Ltd.

Version: January 18, 2012

BACKGROUND: Various recommendations exist for the treatment of nausea and vomiting in palliative care but only few studies and even less systematic reviews look into antiemetic therapy for patients receiving palliative care.

Database of Abstracts of Reviews of Effects (DARE): Quality-assessed Reviews [Internet] - Centre for Reviews and Dissemination (UK).

Version: 2012

This systematic review aims to integrate the evidence on indications, efficacy, safety and pharmacokinetics of medical cannabinoids in older subjects. The literature search was conducted using PubMed, EMBASE, CINAHL and Cochrane Library. We selected controlled trials including solely older subjects (≥65 years) or reporting data on older subgroups. 105 (74%) papers, on controlled intervention trials, reported the inclusion of older subjects. Five studies reported data on older persons separately. These were randomized controlled trials, including in total 267 participants (mean age 47-78 years). Interventions were oral tetrahydrocannabinol (THC) (n=3) and oral THC combined with cannabidiol (n=2). The studies showed no efficacy on dyskinesia, breathlessness and chemotherapy induced nausea and vomiting. Two studies showed that THC might be useful in treatment of anorexia and behavioral symptoms in dementia. Adverse events were more common during cannabinoid treatment compared to the control treatment, and were most frequently sedation like symptoms. Although trials studying medical cannabinoids included older subjects, there is a lack of evidence of its use specifically in older patients. Adequately powered trials are needed to assess the efficacy and safety of cannabinoids in older subjects, as the potential symptomatic benefit is especially attractive in this age group.

Database of Abstracts of Reviews of Effects (DARE): Quality-assessed Reviews [Internet] - Centre for Reviews and Dissemination (UK).

Version: 2014

This generally well-conducted review concluded that cannabinoids were safe and modestly effective for chronic non-cancer (predominately neuropathic) pain, with preliminary evidence in fibromyalgia and rheumatoid arthritis. The authors' conclusions may only be reliable for short-term treatment as included trial treatment periods were relatively short (maximum of six weeks).

Database of Abstracts of Reviews of Effects (DARE): Quality-assessed Reviews [Internet] - Centre for Reviews and Dissemination (UK).

Version: 2011

This systematic review aimed to assess the safety of medical cannabinoids. The authors concluded that short-term use of medical cannabinoids appears to increase the risk of non-serious adverse events, but that risks associated with long-term use were poorly reported. Overall this was a well conducted systematic review and the authors' conclusions are likely to be reliable.

Database of Abstracts of Reviews of Effects (DARE): Quality-assessed Reviews [Internet] - Centre for Reviews and Dissemination (UK).

Version: 2008

The purpose of this Rapid Response report is to summarize the evidence of clinical efficacy for medical marijuana and synthetic cannabinoids in adult populations with PTSD, and identify any evidence-based guidelines for this population.

Rapid Response Report: Summary with Critical Appraisal - Canadian Agency for Drugs and Technologies in Health.

Version: January 11, 2017

This report serves as an update to CADTH’s 2014 Rapid Response report. This previous report reviewed four low quality studies and was unable to make any strong conclusions pertaining to the effectiveness of nabilone for non-chemotherapy nabilone for nausea or weight loss.

Rapid Response Report: Summary with Critical Appraisal - Canadian Agency for Drugs and Technologies in Health.

Version: July 27, 2017

The authors concluded that rimonabant at a dose of 20mg was associated with an increased risk of adverse events. This was generally a well-conducted review and the authors' conclusions are likely to be reliable.

Database of Abstracts of Reviews of Effects (DARE): Quality-assessed Reviews [Internet] - Centre for Reviews and Dissemination (UK).

Version: 2009

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