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Text
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<a href="http://doi.org/10.1503/cmaj.071178" target="_blank" rel="noreferrer">http://doi.org/10.1503/cmaj.071178</a>
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Title
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Adverse effects of medical cannabinoids: a systematic review
Publisher
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Canadian Medical Association Journal
Date
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2008
Subject
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Humans; Canada; Adverse Drug Reaction Reporting Systems; Drug Prescriptions; Cannabinoids/adverse effects; Cannabinoids/therapeutic use; Pain/drug therapy
Creator
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Wang T; Collet J; Shapiro S; Ware M
Description
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BACKGROUND: The therapeutic use of cannabis and cannabis-based medicines raises safety concerns for patients, clinicians, policy-makers, insurers, researchers and regulators. Although the efficacy of cannabinoids is being increasingly demonstrated in randomized controlled trials, most safety information comes from studies of recreational use. METHODS: We performed a systematic review of safety studies of medical cannabinoids published over the past 40 years to create an evidence base for cannabis-related adverse events and to facilitate future cannabis research initiatives. We critically evaluated the quality of published studies with a view to identifying ways to improve future studies. RESULTS: A total of 321 articles were eligible for evaluation. After excluding those that focused on recreational cannabis use, we included 31 studies (23 randomized controlled trials and 8 observational studies) of medical cannabis use in our analysis. In the 23 randomized controlled trials, the median duration of cannabinoid exposure was 2 weeks (range 8 hours to 12 months). A total of 4779 adverse events were reported among participants assigned to the intervention. Most (4615 [96.6%]) were not serious. Of the 164 serious adverse events, the most common was relapse of multiple sclerosis (21 events [12.8%]), vomiting (16 events [9.8%]) and urinary tract infection (15 events [9.1%]). The rate of nonserious adverse events was higher among participants assigned to medical cannabinoids than among controls (rate ratio [RR] 1.86, 95% confidence interval [CI] 1.57-2.21); the rates of serious adverse events did not differ significantly between these 2 groups (RR 1.04, 95% CI 0.78-1.39). Dizziness was the most commonly reported nonserious adverse event (714 events [15.5%]) among people exposed to cannabinoids. INTERPRETATION: Short-term use of existing medical cannabinoids appeared to increase the risk of nonserious adverse events. The risks associated with long-term use were poorly characterized in published clinical trials and observational studies. High-quality trials of long-term exposure are required to further characterize safety issues related to the use of medical cannabinoids.
2008
Identifier
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<a href="http://doi.org/10.1503/cmaj.071178" target="_blank" rel="noreferrer">10.1503/cmaj.071178</a>
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Article information provided for research and reference use only. PedPalASCNET does not hold any rights over the resource listed here. All rights are retained by the journal listed under publisher and/or the creator(s).
Type
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Journal Article
2008
Adverse Drug Reaction Reporting Systems
Backlog
Canada
Canadian Medical Association Journal
Cannabinoids/adverse effects
Cannabinoids/therapeutic use
Collet J
Drug Prescriptions
Humans
Journal Article
Pain/drug Therapy
Shapiro S
Wang T
Ware M