Cannabinoids Appetite stimulation and body weight gain are well-recognized effects of the use of marijuana and its derivatives. Dronabinol is the synthetic, oral form of tetrahydrocannabinol (THC), which is the active ingredient responsible for this effect.86-88,90 Dronabinol and Marinol (in the United States) and Nabilone (in Canada) have been used as antiemetics in cancer, with many studies demonstrating their efficiency in treating chemotherapy-induced nausea and vomiting.90 Several studies of THC in advanced cancer-associated anorexia have shown some improvement in mood and appetite with either no or some improvement in body weight.122,123 Randomized, controlled trials are needed to better determine the efficacy and usefulness of THC in cancer cachexia. It has been shown that almost 20 percent of the cancer patients receiving chemotherapy along with dronabinol as an antiemetic experienced side effects, such as euphoria, dizziness, somnolence, and confusion resulting in a dose reduction or less frequently in withdrawal of the treatment.88 The drug could be taken at bedtime to avoid some psychotomimetic effects and might produce long-lasting appetite stimulation for 24-hour periods.86 The mechanism by which cannabinoids exert their effect has yet to be clarified. It was postulated that they might act via endorphin receptors, by inhibiting prostaglandin synthesis or by inhibiting IL-1 secretion.88 Recent studies demonstrate that endogenous cannabinoids are present in the hypothalamus, which may tonically activate CB1 cannabinoid receptors to maintain food intake and form part of the neural circuitry regulated by leptin.124 Applicable References: 86. Nelson KA. The cancer anorexia-cachexia syndrome. Semin Oncol 2000;27:64-68. 87. Gagnon B, Bruera E. A review of the drug treatment of cachexia associated with cancer. Drugs 1998;55:675-688. 88. Argiles JM, Meijsing SH, Pallares-Trujillo J, et al. Cancer cachexia: A therapeutic approach. Med Res Rev 2001;21:83-101. 90. Fainsinger R. Pharmacological approach to cancer anorexia and cachexia. In: Bruera E, Higginson I, eds. Cachexia-anorexia in cancer patients. Oxford, England: Oxford University Press;1996:128-140. 122. Nelson K, Walsh D, Deeter P, et al. A phase II study of delta-9-tetrahydrocannabinol for appetite stimulation in cancer-associated anorexia. J Palliat Care 1994;10:14-18. 123. Plasse TF, Gorter RW, Krasnow SH, et al. Recent clinical experience with dronabinol. Pharmacol Biochem Behav 1991;40:695-700. 124. Di Marzo V, Goparaju SK, Wang L, et al. Leptin-regulated endocannabinoids are involved in maintaining food intake. Nature 2001;410:822-825. Remember we are NOT Doctors and have NO medical training. This site is like an Encylopedia - there are many pages, many links on many topics. Support our work with any size DONATION - see left side of any page - for how to donate. You can help raise awareness of CAM.