Medicinal Cannabis Gets Low Marks for Mental Health in Active Cancer – Renal and Urology News

A recent a review found insufficient evidence to determine the efficacy and safety of medicinal cannabis in treating depression, anxiety, or stress in patients with active cancer. Findings from this review were reported in the journal Maturitas.

In this meta-analysis and systematic review (PROSPERO Identifier: CRD42022385338), researchers searched MEDLINE, Embase, CENTRAL, Web of Science, and PsychINFO databases from their inception dates to October 25, 2022. The search focused on interventional studies involving the effect of medicinal cannabis on symptoms of depression, anxiety, or stress in patients with cancer of any type or stage. The researchers also examined reference lists of relevant articles and searches of Google Scholar until May 27, 2023. 

Primary study outcomes included the incidence and severity of depression, anxiety, and stress symptoms. Additionally, several secondary outcomes were assessed, as well as estimations of levels of confidence for each finding.

The analysis included 15 studies of 18 interventions that met eligibility criteria. Of these studies, 11 were randomized trials and 4 were nonrandomized trials; the studies included a total of 1898 adult participants. Interventions varied and involved tetrahydrocannabinol (THC), synthetic cannabidiol (CBD) with or without THC, and whole-plant extracts, in addition to a variety of means of administration.

The researchers reported not finding clinically significant effects of medicinal cannabis on the primary outcomes. Higher doses of synthetic THC were associated with a greater likelihood of anxiety events, in comparison with lower doses (odds ratio [OR], 2.0; 95% CI, 1.4-2.9; P <.0001), although they rated the confidence of this finding as very low.

The likelihood of improved appetite was reportedly higher with medicinal cannabis, including synthetic THC or whole-plant extract (OR, 12.3; 95% CI, 3.5-45.5; P <.0001), which is a finding the researchers rated as having moderate confidence. Medicinal cannabis use with synthetic THC or CBD was also linked to a reduced severity of appetite loss (standardized mean loss, −0.4; 95% CI, −0.8 to −0.1; P =.009), but with very low confidence for this finding.

The researchers indicated higher doses of synthetic THC were associated with a higher likelihood of various other adverse events, such as hallucinations, drowsiness, headache, or others (OR, 0.5; 95% CI, 0.3-0.7; P <.001); but confidence in these results was also very low. Overall, medicinal cannabis was reported to have no effect on emotional functioning, mood changes, confusion, disorientation, quality of life, or gastrointestinal symptoms.

“It is possible that complex and synergistic interactions between the hundreds of chemicals in whole cannabis plant extracts might be supportive for mental health, rather than THC and/or CBD alone,” the researchers wrote in their report.

This article originally appeared on Oncology Nurse Advisor