A Comprehensive Review Found THC and Synthetic Cannabinoids Outperformed Placebo for Chemotherapy Nausea
A 1983 review concluded that THC was superior to both placebo and prochlorperazine for chemotherapy-induced nausea, with effectiveness linked to the psychological "high," while synthetic cannabinoids nabilone and levonantradol offered additional options.
Quick Facts
What This Study Found
This review synthesized the growing body of evidence on cannabinoid antiemetics. THC, isolated in 1964 and first used for chemotherapy nausea in the 1970s, had accumulated enough clinical trial data for meaningful assessment.
In controlled trials, THC was superior to both placebo and prochlorperazine (a standard antiemetic). A notable finding was that antiemetic effectiveness correlated with the subjective "high" experienced by patients. THC worked across multiple chemotherapy regimens, including high-dose methotrexate and the doxorubicin-cyclophosphamide-fluorouracil combination, though cisplatin-based regimens were more resistant.
Two synthetic alternatives showed promise: nabilone, which was more active than prochlorperazine even against cisplatin regimens, and levonantradol, which could be given intramuscularly as well as orally, offering flexibility for outpatient use. Side effects for all three cannabinoids were generally well tolerated but could be dose-limiting, particularly dysphoria in elderly patients.
Key Numbers
THC isolated in 1964, first used for nausea in the 1970s. THC superior to placebo and prochlorperazine. Nabilone more active than prochlorperazine including against cisplatin. Marijuana used medicinally for over 2 centuries.
How They Did This
Narrative review of controlled clinical trials evaluating THC, nabilone, and levonantradol as antiemetics for cancer chemotherapy. Covered mechanisms of action, efficacy data, and side effect profiles.
Why This Research Matters
This review consolidated the evidence that moved cannabinoid antiemetics from experimental curiosity to clinical reality. The finding that effectiveness correlated with the "high" raised important mechanistic questions about whether the antiemetic and psychoactive effects could be separated.
The Bigger Picture
This review appeared two years before dronabinol's FDA approval and captured the state of evidence that supported that approval. The question it raised, whether the "high" is inseparable from the antiemetic effect, remains relevant to efforts to develop non-psychoactive cannabinoid medicines.
What This Study Doesn't Tell Us
Narrative review format means no systematic quality assessment of included studies. The correlation between "high" and efficacy could reflect unblinding rather than a true mechanistic link.
Questions This Raises
- ?Can the antiemetic effect be separated from the psychoactive high?
- ?Why are cisplatin regimens more resistant to cannabinoid antiemetics?
- ?Would combining cannabinoids with other antiemetics produce synergistic effects?
Trust & Context
- Key Stat:
- THC was superior to both placebo and prochlorperazine in controlled trials
- Evidence Grade:
- A narrative review synthesizing multiple controlled trials. Provides good evidence synthesis but without systematic methodology.
- Study Age:
- Published in 1983. Modern antiemetic regimens and cannabinoid formulations have evolved substantially.
- Original Title:
- Review of cannabinoids and their antiemetic effectiveness.
- Published In:
- Drugs, 25 Suppl 1, 52-62 (1983)
- Authors:
- Vincent, B J, McQuiston, D J, Einhorn, L H(2), Nagy, C M, Brames, M J
- Database ID:
- RTHC-00026
Evidence Hierarchy
Summarizes existing research on a topic.
What do these levels mean? →Frequently Asked Questions
Did THC work against all types of chemotherapy nausea?
It worked across many regimens, but cisplatin-based chemotherapy was more resistant to THC. The synthetic cannabinoid nabilone showed better activity against cisplatin regimens.
Is the "high" necessary for the antiemetic effect?
This review found effectiveness correlated with the high, but could not determine whether they are mechanistically linked or just co-occurring effects of the same dose.
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Cite This Study
https://rethinkthc.com/research/RTHC-00026APA
Vincent, B J; McQuiston, D J; Einhorn, L H; Nagy, C M; Brames, M J. (1983). Review of cannabinoids and their antiemetic effectiveness.. Drugs, 25 Suppl 1, 52-62.
MLA
Vincent, B J, et al. "Review of cannabinoids and their antiemetic effectiveness.." Drugs, 1983.
RethinkTHC
RethinkTHC Research Database. "Review of cannabinoids and their antiemetic effectiveness." RTHC-00026. Retrieved from https://rethinkthc.com/research/vincent-1983-review-of-cannabinoids-and
Access the Original Study
Study data sourced from PubMed, a service of the U.S. National Library of Medicine, National Institutes of Health.
This study breakdown was produced by the RethinkTHC research team. We analyze and report published research findings without making health recommendations. All interpretations are based solely on the published abstract and study data.