Efficacy of tetrahydrocannabinol in patients refractory to standard antiemetic therapy.
Oral delta-9-tetrahydrocannabinol (THC), 15 mg/m2, was compared to prochlorperazine (PCZ), 10 mg. for the control of cancer chemotherapy-related emesis. Thirty-six patients whose vomiting was refractory to standard antiemetic therapy were entered in this randomized comparative cross-over study. THC decreased nausea and vomiting in 23 of 36 (64%) patients compared to 1 of 36 receiving PCZ. THC efficacy was not dependent on the class of antineoplastic-agent inducing the emetic symptoms, age of patients or type of sensorial change experienced. Using the 15 mg/m2 dose, all patients experienced transient sensorial changes, characterized as a pleasant "high" in 19 or a variable state of dysphoria in 17 cases. This study confirms the usefulness of THC in patients whose chemotherapy-induced nausea and vomiting is refractory to other standard antiemetics. While excellent antiemetic control was achieved at the dosage 15 mg/m2, dysphoria was encountered at this dose level and we recommend that an initial dose of 5 mg/m2 which, if necessary, can be carefully increased to achieve maximum antiemetic benefit.
McCabe
M
M
Division of Medical Oncology, Vincent T. Lombardi Cancer Research Center, Georgetown University, Washington, D.C. 20007.
Smith
F P
FP
Macdonald
J S
JS
Woolley
P V
PV
Goldberg
D
D
Schein
P S
PS
D000328:Adult; D000368:Aged; D000932:Antiemetics / Q000627:therapeutic use*; D000970:Antineoplastic Agents / Q000009:adverse effects; D013759:Dronabinol / Q000627:therapeutic use*; D006801:Humans; D008875:Middle Aged; D011346:Prochlorperazine / Q000627:therapeutic use*
D000932:Antiemetics; D000970:Antineoplastic Agents; D013759:Dronabinol; D011346:Prochlorperazine