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Erschienen in: Der Schmerz 4/2004

01.08.2004 | Übersichten

Cannabinoide in der Behandlung von Übelkeit und Erbrechen

verfasst von: Prof. Dr. L. Radbruch, F. Nauck

Erschienen in: Der Schmerz | Ausgabe 4/2004

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Zusammenfassung

Cannabinoide werden zur Behandlung von Übelkeit und Erbrechen eingesetzt. Die Wirkung scheint über Cannabinoidrezeptoren im Nucleus tractus solitarius vermittelt zu werden.
Zum Einsatz von Cannabinoiden bei Übelkeit und Erbrechen nach Chemotherapie liegen Studienergebnisse vor. In keiner dieser Studien wurden allerdings Cannabinoide mit den neueren Serotoninantagonisten verglichen. In anderen Indikationen ist die antiemetische Effektivität der Cannabinoide bisher nur ungenügend untersucht worden.
In den meisten Studien wurde unter der Cannabinoidmedikation allerdings über deutlich mehr oder stärkere Nebenwirkungen gegenüber der Vergleichsmedikation berichtet. Bei einigen Studien nach Chemotherapie oder Strahlentherapie brachen Patienten wegen Nebenwirkungen häufiger die Cannabinoidmedikation ab.
Obwohl in klinischen Studien für die Cannabinoide eine deutliche antiemetische Effektivität nachgewiesen wurde, sprechen Häufigkeit und Stärke der Nebenwirkungen gegen einen Einsatz als Mittel der ersten Wahl. Bei Patienten, die mit den herkömmlichen Antiemetika nicht ausreichend behandelt werden können, können Cannabinoide aber eine wertvolle Ergänzung der antiemetischen Therapie sein.
Literatur
1.
Zurück zum Zitat Ahmedzai S, Carlyle DL, Calder IT, Moran F (1983) Anti-emetic efficacy and toxicity of nabilone, a synthetic cannabinoid, in lung cancer chemotherapy. Br J Cancer 48(5):657–663 Ahmedzai S, Carlyle DL, Calder IT, Moran F (1983) Anti-emetic efficacy and toxicity of nabilone, a synthetic cannabinoid, in lung cancer chemotherapy. Br J Cancer 48(5):657–663
2.
Zurück zum Zitat Chan HS, Correia JA, MacLeod SM (1987) Nabilone versus prochlorperazine for control of cancer chemotherapy-induced emesis in children: a double-blind, crossover trial. Pediatrics 79(6):946–952PubMed Chan HS, Correia JA, MacLeod SM (1987) Nabilone versus prochlorperazine for control of cancer chemotherapy-induced emesis in children: a double-blind, crossover trial. Pediatrics 79(6):946–952PubMed
3.
Zurück zum Zitat Chang AE, Shiling DJ, Stillman RC, Goldberg NH, Seipp CA, Barofsky I, Rosenberg SA (1981) A prospective evaluation of delta-9-tetrahydrocannabinol as an antiemetic in patients receiving adriamycin and cytoxan chemotherapy. Cancer 47(7):1746–1751PubMed Chang AE, Shiling DJ, Stillman RC, Goldberg NH, Seipp CA, Barofsky I, Rosenberg SA (1981) A prospective evaluation of delta-9-tetrahydrocannabinol as an antiemetic in patients receiving adriamycin and cytoxan chemotherapy. Cancer 47(7):1746–1751PubMed
4.
Zurück zum Zitat Chang AE, Shiling DJ, Stillman RC, Goldberg NH, Seipp CA, Barofsky I, Simon RM, Rosenberg SA (1979) Delata-9-tetrahydrocannabinol as an antiemetic in cancer patients receiving high-dose methotrexate. A prospective, randomized evaluation. Ann Intern Med 91(6):819–824PubMed Chang AE, Shiling DJ, Stillman RC, Goldberg NH, Seipp CA, Barofsky I, Simon RM, Rosenberg SA (1979) Delata-9-tetrahydrocannabinol as an antiemetic in cancer patients receiving high-dose methotrexate. A prospective, randomized evaluation. Ann Intern Med 91(6):819–824PubMed
5.
Zurück zum Zitat Colls BM (1981) Cytotoxic nausea and cannabinoids. Lancet 1 (8224):833CrossRef Colls BM (1981) Cytotoxic nausea and cannabinoids. Lancet 1 (8224):833CrossRef
6.
Zurück zum Zitat Crawford SM, Buckman R (1986) Nabilone and metoclopramide in the treatment of nausea and vomiting due to cisplatinum: a double blind study. Med Oncol Tumor Pharmacother 3(1):39–42PubMed Crawford SM, Buckman R (1986) Nabilone and metoclopramide in the treatment of nausea and vomiting due to cisplatinum: a double blind study. Med Oncol Tumor Pharmacother 3(1):39–42PubMed
7.
Zurück zum Zitat Dalzell AM, Bartlett H, Lilleyman JS (1986) Nabilone: an alternative antiemetic for cancer chemotherapy. Arch Dis Child 61(5):502–505PubMed Dalzell AM, Bartlett H, Lilleyman JS (1986) Nabilone: an alternative antiemetic for cancer chemotherapy. Arch Dis Child 61(5):502–505PubMed
8.
Zurück zum Zitat Darmani NA (2001) The cannabinoid CB1 receptor antagonist SR 141716A reverses the antiemetic and motor depressant actions of WIN 55, 212–2. Eur J Pharmacol 430(1):49–58CrossRefPubMed Darmani NA (2001) The cannabinoid CB1 receptor antagonist SR 141716A reverses the antiemetic and motor depressant actions of WIN 55, 212–2. Eur J Pharmacol 430(1):49–58CrossRefPubMed
9.
Zurück zum Zitat Doblin RE, Kleiman MA (1991) Marijuana as antiemetic medicine: a survey of oncologists‘ experiences and attitudes. J Clin Oncol 9(7):1314–1319PubMed Doblin RE, Kleiman MA (1991) Marijuana as antiemetic medicine: a survey of oncologists‘ experiences and attitudes. J Clin Oncol 9(7):1314–1319PubMed
10.
Zurück zum Zitat Einhorn LH, Nagy C, Furnas B, Williams SD (1981) Nabilone: an effective antiemetic in patients receiving cancer chemotherapy. J Clin Pharmacol 21(8–9) [suppl]:64S–69S Einhorn LH, Nagy C, Furnas B, Williams SD (1981) Nabilone: an effective antiemetic in patients receiving cancer chemotherapy. J Clin Pharmacol 21(8–9) [suppl]:64S–69S
11.
Zurück zum Zitat Frytak S, Moertel CG, O’Fallon JR, Rubin J, Creagan ET, O’Connell MJ, Schutt AJ, Schwartau NW (1979) Delta-9-tetrahydrocannabinol as an antiemetic for patients receiving cancer chemotherapy. A comparison with prochlorperazine and a placebo. Ann Intern Med 91(6):825–830PubMed Frytak S, Moertel CG, O’Fallon JR, Rubin J, Creagan ET, O’Connell MJ, Schutt AJ, Schwartau NW (1979) Delta-9-tetrahydrocannabinol as an antiemetic for patients receiving cancer chemotherapy. A comparison with prochlorperazine and a placebo. Ann Intern Med 91(6):825–830PubMed
12.
Zurück zum Zitat George M, Pejovic MH, Thuaire M, Kramar A, Wolff JP (1983) [Randomized comparative trial of a new anti-emetic: nabilone, in cancer patients treated with cisplatin]. Biomed Pharmacother 37(1):24–27PubMed George M, Pejovic MH, Thuaire M, Kramar A, Wolff JP (1983) [Randomized comparative trial of a new anti-emetic: nabilone, in cancer patients treated with cisplatin]. Biomed Pharmacother 37(1):24–27PubMed
13.
Zurück zum Zitat Gralla RJ, Tyson LB, Bordin LA, Clark RA, Kelsen DP, Kris MG, Kalman LB, Groshen S (1984) Antiemetic therapy: a review of recent studies and a report of a random assignment trial comparing metoclopramide with delta-9-tetrahydrocannabinol. Cancer Treat Rep 68(1):163–172PubMed Gralla RJ, Tyson LB, Bordin LA, Clark RA, Kelsen DP, Kris MG, Kalman LB, Groshen S (1984) Antiemetic therapy: a review of recent studies and a report of a random assignment trial comparing metoclopramide with delta-9-tetrahydrocannabinol. Cancer Treat Rep 68(1):163–172PubMed
14.
Zurück zum Zitat Herman TS, Einhorn LH, Jones SE, Nagy C, Chester AB, Dean JC, Furnas B, Williams SD, Leigh SA, Dorr RT, Moon TE (1979) Superiority of nabilone over prochlorperazine as an antiemetic in patients receiving cancer chemotherapy. N Engl J Med 300(23):1295–1297PubMed Herman TS, Einhorn LH, Jones SE, Nagy C, Chester AB, Dean JC, Furnas B, Williams SD, Leigh SA, Dorr RT, Moon TE (1979) Superiority of nabilone over prochlorperazine as an antiemetic in patients receiving cancer chemotherapy. N Engl J Med 300(23):1295–1297PubMed
15.
Zurück zum Zitat Himmi T, Dallaporta M, Perrin J, Orsini JC (1996) Neuronal responses to delta 9-tetrahydrocannabinol in the solitary tract nucleus. Eur J Pharmacol 312(3):273–279CrossRefPubMed Himmi T, Dallaporta M, Perrin J, Orsini JC (1996) Neuronal responses to delta 9-tetrahydrocannabinol in the solitary tract nucleus. Eur J Pharmacol 312(3):273–279CrossRefPubMed
16.
Zurück zum Zitat Hutcheon AW, Palmer JB, Soukop M, Cunningham D, McArdle C, Welsh J, Stuart F, Sangster G, Kaye S, Charlton D et al. (1983) A randomized multicentre single blind comparison of a cannabinoid anti-emetic (levonantradol) with chlorpromazine in patients receiving their first cytotoxic chemotherapy. Eur J Cancer Clin Oncol 19(8):1087–1090PubMed Hutcheon AW, Palmer JB, Soukop M, Cunningham D, McArdle C, Welsh J, Stuart F, Sangster G, Kaye S, Charlton D et al. (1983) A randomized multicentre single blind comparison of a cannabinoid anti-emetic (levonantradol) with chlorpromazine in patients receiving their first cytotoxic chemotherapy. Eur J Cancer Clin Oncol 19(8):1087–1090PubMed
17.
Zurück zum Zitat Jones RT, Benowitz NL, Herning RI (1981) Clinical relevance of cannabis tolerance and dependence. J Clin Pharmacol 21(8–9) [suppl]:143S–152S Jones RT, Benowitz NL, Herning RI (1981) Clinical relevance of cannabis tolerance and dependence. J Clin Pharmacol 21(8–9) [suppl]:143S–152S
18.
Zurück zum Zitat Kluin-Neleman JC, Neleman FA, Meuwissen OJ, Maes RA (1979) Delta 9-Tetrahydrocannabinol (THC) as an antiemetic in patients treated with cancerchemotherapy; a double-blind cross-over trial against placebo. Vet Hum Toxicol 21(5):338–340PubMed Kluin-Neleman JC, Neleman FA, Meuwissen OJ, Maes RA (1979) Delta 9-Tetrahydrocannabinol (THC) as an antiemetic in patients treated with cancerchemotherapy; a double-blind cross-over trial against placebo. Vet Hum Toxicol 21(5):338–340PubMed
19.
Zurück zum Zitat Lane M, Vogel CL, Ferguson J, Krasnow S, Saiers JL, Hamm J, Salva K, Wiernik PH, Holroyde CP, Hammill S et al. (1991) Dronabinol and prochlorperazine in combination for treatment of cancer chemotherapy-induced nausea and vomiting. J Pain Symptom Manage 6(6):352–359PubMed Lane M, Vogel CL, Ferguson J, Krasnow S, Saiers JL, Hamm J, Salva K, Wiernik PH, Holroyde CP, Hammill S et al. (1991) Dronabinol and prochlorperazine in combination for treatment of cancer chemotherapy-induced nausea and vomiting. J Pain Symptom Manage 6(6):352–359PubMed
20.
Zurück zum Zitat Levitt M (1982) Nabilone vs. placebo in the treatment of chemotherapy-induced nausea and vomiting in cancer patients. Cancer Treat Rev 9 [suppl B]:49–53 Levitt M (1982) Nabilone vs. placebo in the treatment of chemotherapy-induced nausea and vomiting in cancer patients. Cancer Treat Rev 9 [suppl B]:49–53
21.
Zurück zum Zitat Lewis IH, Campbell DN, Barrowcliffe MP (1994) Effect of nabilone on nausea and vomiting after total abdominal hysterectomy. Br J Anaesth 73(2):244–246PubMed Lewis IH, Campbell DN, Barrowcliffe MP (1994) Effect of nabilone on nausea and vomiting after total abdominal hysterectomy. Br J Anaesth 73(2):244–246PubMed
22.
Zurück zum Zitat Lucraft HH, Palmer MK (1982) Randomized clinical trial of levonantradol and chlorpromazine in the prevention of radiotherapy-induced vomiting. Clin Radiol 33(6):621–622PubMed Lucraft HH, Palmer MK (1982) Randomized clinical trial of levonantradol and chlorpromazine in the prevention of radiotherapy-induced vomiting. Clin Radiol 33(6):621–622PubMed
23.
Zurück zum Zitat McCabe M, Smith FP, Macdonald JS, Woolley PV, Goldberg D, Schein PS (1988) Efficacy of tetrahydrocannabinol in patients refractory to standard antiemetic therapy. Invest New Drugs 6(3):243–246PubMed McCabe M, Smith FP, Macdonald JS, Woolley PV, Goldberg D, Schein PS (1988) Efficacy of tetrahydrocannabinol in patients refractory to standard antiemetic therapy. Invest New Drugs 6(3):243–246PubMed
24.
Zurück zum Zitat Neidhart JA, Gagen MM, Wilson HE, Young DC (1981) Comparative trial of the antiemetic effects of THC and haloperidol. J Clin Pharmacol 21(8–9) [suppl]:38S–42S Neidhart JA, Gagen MM, Wilson HE, Young DC (1981) Comparative trial of the antiemetic effects of THC and haloperidol. J Clin Pharmacol 21(8–9) [suppl]:38S–42S
25.
Zurück zum Zitat Niederle N, Schutte J, Schmidt CG (1986) Crossover comparison of the antiemetic efficacy of nabilone and alizapride in patients with nonseminomatous testicular cancer receiving cisplatin therapy. Klin Wochenschr 64(8):362–365PubMed Niederle N, Schutte J, Schmidt CG (1986) Crossover comparison of the antiemetic efficacy of nabilone and alizapride in patients with nonseminomatous testicular cancer receiving cisplatin therapy. Klin Wochenschr 64(8):362–365PubMed
26.
Zurück zum Zitat Niiranen A, Mattson K (1985) A cross-over comparison of nabilone and prochlorperazine for emesis induced by cancer chemotherapy. Am J Clin Oncol 8(4):336–340PubMed Niiranen A, Mattson K (1985) A cross-over comparison of nabilone and prochlorperazine for emesis induced by cancer chemotherapy. Am J Clin Oncol 8(4):336–340PubMed
27.
Zurück zum Zitat Orr LE, McKernan JF, Bloome B (1980) Antiemetic effect of tetrahydrocannabinol. Compared with placebo and prochlorperazine in chemotherapy-associated nausea and emesis. Arch Intern Med 140(11):1431–1433PubMed Orr LE, McKernan JF, Bloome B (1980) Antiemetic effect of tetrahydrocannabinol. Compared with placebo and prochlorperazine in chemotherapy-associated nausea and emesis. Arch Intern Med 140(11):1431–1433PubMed
28.
Zurück zum Zitat Pomeroy M, Fennelly JJ, Towers M (1986) Prospective randomized double-blind trial of nabilone versus domperidone in the treatment of cytotoxic-induced emesis. Cancer Chemother Pharmacol 17(3):285–288PubMed Pomeroy M, Fennelly JJ, Towers M (1986) Prospective randomized double-blind trial of nabilone versus domperidone in the treatment of cytotoxic-induced emesis. Cancer Chemother Pharmacol 17(3):285–288PubMed
29.
Zurück zum Zitat Priestman SG, Priestman TJ, Canney PA (1987) A double-blind randomized cross-over comparison of nabilone and metoclopramide in the control of radiation-induced nausea. Clin Radiol 38(5):543–544PubMed Priestman SG, Priestman TJ, Canney PA (1987) A double-blind randomized cross-over comparison of nabilone and metoclopramide in the control of radiation-induced nausea. Clin Radiol 38(5):543–544PubMed
30.
Zurück zum Zitat Priestman TJ, Priestman SG (1984) An initial evaluation of nabilone in the control of radiotherapy-induced nausea and vomiting. Clin Radiol 35(4):265–266PubMed Priestman TJ, Priestman SG (1984) An initial evaluation of nabilone in the control of radiotherapy-induced nausea and vomiting. Clin Radiol 35(4):265–266PubMed
31.
Zurück zum Zitat Sallan SE, Cronin C, Zelen M, Zinberg NE (1980) Antiemetics in patients receiving chemotherapy for cancer: a randomized comparison of delta-9-tetrahydrocannabinol and prochlorperazine. N Engl J Med 302(3):135–138PubMed Sallan SE, Cronin C, Zelen M, Zinberg NE (1980) Antiemetics in patients receiving chemotherapy for cancer: a randomized comparison of delta-9-tetrahydrocannabinol and prochlorperazine. N Engl J Med 302(3):135–138PubMed
32.
Zurück zum Zitat Sallan SE, Zinberg NE, Frei E 3rd (1975) Antiemetic effect of delta-9-tetrahydrocannabinol in patients receiving cancer chemotherapy. N Engl J Med 293(16):795–797 Sallan SE, Zinberg NE, Frei E 3rd (1975) Antiemetic effect of delta-9-tetrahydrocannabinol in patients receiving cancer chemotherapy. N Engl J Med 293(16):795–797
33.
Zurück zum Zitat Schnelle M, Grotenhermen F, Reif M, Gorter RW (1999) [Results of a standardized survey on the medical use of cannabis products in the German-speaking area]. Forsch Komplementarmed 6 [suppl 3]:28–36 Schnelle M, Grotenhermen F, Reif M, Gorter RW (1999) [Results of a standardized survey on the medical use of cannabis products in the German-speaking area]. Forsch Komplementarmed 6 [suppl 3]:28–36
34.
Zurück zum Zitat Schwartz RH, Beveridge RA (1994) Marijuana as an antiemetic drug: how useful is it today? Opinions from clinical oncologists. J Addict Dis 13(1):53–65PubMed Schwartz RH, Beveridge RA (1994) Marijuana as an antiemetic drug: how useful is it today? Opinions from clinical oncologists. J Addict Dis 13(1):53–65PubMed
35.
Zurück zum Zitat Shook JE, Burks TF (1989) Psychoactive cannabinoids reduce gastrointestinal propulsion and motility in rodents. J Pharmacol Exp Ther 249(2):444–449PubMed Shook JE, Burks TF (1989) Psychoactive cannabinoids reduce gastrointestinal propulsion and motility in rodents. J Pharmacol Exp Ther 249(2):444–449PubMed
36.
Zurück zum Zitat Simoneau, II, Hamza MS, Mata HP, Siegel EM, Vanderah TW, Porreca F, Makriyannis A, Malan TP jr (2001) The cannabinoid agonist WIN55,212–2 suppresses opioid-induced emesis in ferrets. Anesthesiology 94(5):882–887PubMed Simoneau, II, Hamza MS, Mata HP, Siegel EM, Vanderah TW, Porreca F, Makriyannis A, Malan TP jr (2001) The cannabinoid agonist WIN55,212–2 suppresses opioid-induced emesis in ferrets. Anesthesiology 94(5):882–887PubMed
37.
Zurück zum Zitat Soderpalm AH, Schuster A, de Wit H (2001) Antiemetic efficacy of smoked marijuana: subjective and behavioral effects on nausea induced by syrup of ipecac. Pharmacol Biochem Behav 69(3–4):343–350 Soderpalm AH, Schuster A, de Wit H (2001) Antiemetic efficacy of smoked marijuana: subjective and behavioral effects on nausea induced by syrup of ipecac. Pharmacol Biochem Behav 69(3–4):343–350
38.
Zurück zum Zitat Steele N, Gralla RJ, Braun DW jr, Young CW (1980) Double-blind comparison of the antiemetic effects of nabilone and prochlorperazine on chemotherapy-induced emesis. Cancer Treat Rep 64(2–3):219–224 Steele N, Gralla RJ, Braun DW jr, Young CW (1980) Double-blind comparison of the antiemetic effects of nabilone and prochlorperazine on chemotherapy-induced emesis. Cancer Treat Rep 64(2–3):219–224
39.
Zurück zum Zitat Tramer MR, Carroll D, Campbell FA, Reynolds DJ, Moore RA, McQuay HJ (2001) Cannabinoids for control of chemotherapy induced nausea and vomiting: quantitative systematic review. BMJ 323(7303):16–21CrossRefPubMed Tramer MR, Carroll D, Campbell FA, Reynolds DJ, Moore RA, McQuay HJ (2001) Cannabinoids for control of chemotherapy induced nausea and vomiting: quantitative systematic review. BMJ 323(7303):16–21CrossRefPubMed
40.
Zurück zum Zitat Twycross R, Back I (1998) Nausea and vomiting in advanced cancer. Eur J Pall Care 5:39–45 Twycross R, Back I (1998) Nausea and vomiting in advanced cancer. Eur J Pall Care 5:39–45
41.
Zurück zum Zitat Ungerleider JT, Andrysiak T, Fairbanks L, Goodnight J, Sarna G, Jamison K (1982) Cannabis and cancer chemotherapy: a comparison of oral delta-9-THC and prochlorperazine. Cancer 50(4):636–645PubMed Ungerleider JT, Andrysiak T, Fairbanks L, Goodnight J, Sarna G, Jamison K (1982) Cannabis and cancer chemotherapy: a comparison of oral delta-9-THC and prochlorperazine. Cancer 50(4):636–645PubMed
42.
Zurück zum Zitat Vincent BJ, McQuiston DJ, Einhorn LH, Nagy CM, Brames MJ (1983) Review of cannabinoids and their antiemetic effectiveness. Drugs 25 [suppl 1]:52–62 Vincent BJ, McQuiston DJ, Einhorn LH, Nagy CM, Brames MJ (1983) Review of cannabinoids and their antiemetic effectiveness. Drugs 25 [suppl 1]:52–62
Metadaten
Titel
Cannabinoide in der Behandlung von Übelkeit und Erbrechen
verfasst von
Prof. Dr. L. Radbruch
F. Nauck
Publikationsdatum
01.08.2004
Verlag
Springer-Verlag
Erschienen in
Der Schmerz / Ausgabe 4/2004
Print ISSN: 0932-433X
Elektronische ISSN: 1432-2129
DOI
https://doi.org/10.1007/s00482-004-0315-5

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