HEP (2005) 168:719–756
©cSpringer-Verlag 2005
Human Studies of Cannabinoids and Medicinal Cannabis
P. Robson
Department of Psychiatry, Oxford University, Warneford Hospital, Oxford OX3 7JX, UK
[email protected]
1Introduction.................................... 720
2 Review of Clinical Research............................ 723
2.1 SymptomaticReliefinMultipleSclerosisandSpinalCordInjury ....... 723
2.2 SymptomaticReliefinOtherNeurologicalConditions ............. 728
2.3 ChronicPain.................................... 729
2.4 EffectsonNauseaandVomiting ......................... 732
2.5 AppetiteStimulation ............................... 734
2.6 AppetiteSuppressioninObesity ......................... 736
2.7 Glaucoma ..................................... 736
2.8 Epilepsy ...................................... 737
2.9 PsychiatricDisorders ............................... 738
2.10 Asthma ...................................... 739
3 Safety Issues with Cannabis-Based Medicines ................. 739
3.1 Cognitive/MotorEffects ............................. 740
3.2 Dependency/Abuse ................................ 741
3.3 EffectsonMentalHealth ............................. 743
4FutureDirections................................. 744
4.1 InflammatoryConditions............................. 745
4.2 ChronicNociceptivePain............................. 746
4.3 Neuroprotection.................................. 746
4.4 Anti-cancerEffects ................................ 747
4.5 DrugWithdrawalTreatments........................... 748
4.6 Migraine...................................... 748
4.7 IntractableBreathlessness ............................ 748
References ........................................ 749
AbstractCannabishasbeenknownasamedicineforseveralthousandyearsacross
many cultures. It reached a position of prominence within Western medicine in
the nineteenth century but became mired in disrepute and legal controls early in
the twentieth century. Despite unremitting world-wide suppression, recreational
cannabis exploded into popular culture in the 1960s and has remained easily ob-
tainableontheblackmarketinmostcountrieseversince.Thisreadyavailabilityhas
allowed many thousands of patients to rediscover the apparent power of the drug
to alleviate symptoms of some of the most cruel and refractory diseases known to