Both THC and CBD reduce chemotherapy-induced nausea and vomiting by inhibiting serotonin release from intestinal cells, with CBD offering the advantage of no psychoactive effects.
Oncologists, cancer patients experiencing CINV, and researchers studying cannabinoid antiemetics.
CBD: antiemetic without the high
What the researchers found
Cannabinoids reduce CINV primarily by inhibiting serotonin release from enterochromaffin cells in the small intestine, disrupting the vomiting reflex. While THC is well-studied for this indication, CBD may offer comparable antiemetic effects without psychoactive properties, plus additional benefits for pain and appetite.
Why it matters
CINV remains one of the most debilitating chemotherapy side effects. CBD's potential as a non-psychoactive antiemetic could expand cannabinoid medicine to patients who cannot tolerate THC's cognitive effects.
The numbers in context
The review covers multiple mechanisms of action including serotonin inhibition, along with secondary benefits for organ toxicity, pain, and appetite loss during chemotherapy.
How the study worked
Narrative review of preclinical and clinical studies on cannabinoid use for CINV, with emphasis on CBD's mechanisms and its potential advantages over THC-based preparations.
What this study cannot tell us
Much of the CBD-specific evidence for CINV is preclinical. Clinical trial data on CBD alone for nausea is limited. Optimal dosing and formulation for antiemetic CBD use have not been established.
How to read the evidence
Moderate: comprehensive review of mechanisms and evidence, but limited clinical data specific to CBD for CINV.
When this study was published
Published in 2019.
The bigger picture
Current FDA-approved cannabinoid antiemetics (dronabinol, nabilone) are THC-based and carry psychoactive effects. A CBD-based alternative could be more widely acceptable to both patients and oncologists.
Questions still open
- At what dose does CBD become an effective antiemetic? Would CBD be more effective combined with low-dose THC for CINV?
Common questions
How do cannabinoids prevent chemo nausea?
Can CBD prevent nausea without making you high?
Read the original research
Cannabinoids: the lows and the highs of chemotherapy-induced nausea and vomiting.
Future oncology (London, England), 15(9), 1035-1049
Citation
Mortimer, Toni Leigh; Mabin, Tom; Engelbrecht, Anna-Mart. (2019). Cannabinoids: the lows and the highs of chemotherapy-induced nausea and vomiting.. Future oncology (London, England), 15(9), 1035-1049. https://doi.org/10.2217/fon-2018-0530
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