The DOI matches its Crossref record; 141 of the 141 references it cites were found in a registry or an index.
Cannabinoids for Medical Use: A Systematic Review and Meta-analysis
Open accessAbstract
IMPORTANCE: Cannabis and cannabinoid drugs are widely used to treat disease or alleviate symptoms, but their efficacy for specific indications is not clear. OBJECTIVE: To conduct a systematic review of the benefits and adverse events (AEs) of cannabinoids. DATA SOURCES: Twenty-eight databases from inception to April 2015. STUDY SELECTION: Randomized clinical trials of cannabinoids for the following indications: nausea and vomiting due to chemotherapy, appetite stimulation in HIV/AIDS, chronic pain, spasticity due to multiple sclerosis or paraplegia, depression, anxiety disorder, sleep disorder, psychosis, glaucoma, or Tourette syndrome. DATA EXTRACTION AND SYNTHESIS: Study quality was assessed using the Cochrane risk of bias tool. All review stages were conducted independently by 2 reviewers. Where possible, data were pooled using random-effects meta-analysis. MAIN OUTCOMES AND MEASURES: Patient-relevant/disease-specific outcomes, activities of daily living, quality of life, global impression of change, and AEs. RESULTS: A total of 79 trials (6462 participants) were included; 4 were judged at low risk of bias. Most trials showed improvement in symptoms associated with cannabinoids but these associations did not reach statistical significance in all trials. Compared with placebo, cannabinoids were associated with a greater average number of patients showing a complete nausea and vomiting response (47% vs 20%; odds ratio [OR], 3.82 [95% CI, 1.55-9.42]; 3 trials), reduction in pain (37% vs 31%; OR, 1.41 [95% CI, 0.99-2.00]; 8 trials), a greater average reduction in numerical rating scale pain assessment (on a 0-10-point scale; weighted mean difference [WMD], -0.46 [95% CI, -0.80 to -0.11]; 6 trials), and average reduction in the Ashworth spasticity scale (WMD, -0.36 [95% CI, -0.69 to -0.05]; 7 trials). There was an increased risk of short-term AEs with cannabinoids, including serious AEs. Common AEs included dizziness, dry mouth, nausea, fatigue, somnolence, euphoria, vomiting, disorientation, drowsiness, confusion, loss of balance, and hallucination. CONCLUSIONS AND RELEVANCE: There was moderate-quality evidence to support the use of cannabinoids for the treatment of chronic pain and spasticity. There was low-quality evidence suggesting that cannabinoids were associated with improvements in nausea and vomiting due to chemotherapy, weight gain in HIV infection, sleep disorders, and Tourette syndrome. Cannabinoids were associated with an increased risk of short-term AEs.
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“Mild to moderate central nervous or gastro-intestinal side effects are more common with cannabinoids than with placebo but severe side effects are rare [13].”
From Cannabis, cannabinoids and health: a review of evidence on risks and medical benefits (2025) · cites this paper as [13]
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“Medical uses of THC-based cannabinoids are associated with an increased risk of short-term adverse effects, but severe side effects are rare [13].”
From Cannabis, cannabinoids and health: a review of evidence on risks and medical benefits (2025) · cites this paper as [13]
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In the citing paper
“Previous systematic reviews have been limited in their coverage of all relevant diseases, but most importantly primarily ignored the fact that medical cannabinoid products—a term that encompasses all plant-derived and synthetic derivatives—differ in their pharmacology [1–5].”
From Medical cannabinoids: a pharmacology-based systematic review and meta-analysis for all relevant medical indications. (2022) · cites this paper as [3]
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“Finally, data analysis using SMD allowed the inclusion of a large variety of measurements in the evaluation of the outcomes and allowed us to include many more RCTs for all relevant medical indications than in a previous extensive meta-analysis [3].”
From Medical cannabinoids: a pharmacology-based systematic review and meta-analysis for all relevant medical indications. (2022) · cites this paper as [3]
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“Evidence suggests that efforts to selfmanage depression with cannabis are increasing [71][72][73][74][75] (also Aaron L. Sarvet, MPH, written communication, January 2, 2018) despite lack of evidence that cannabinoids are effective for this purpose 76,77 ; prospectively, cannabis worsens the course of depressive disorders.78”
From Epidemiology of Adult DSM-5 Major Depressive Disorder and Its Specifiers in the United States (2018) · cites this paper as [75]
In the citing paper
“Several clinical studies have demonstrated the analgesic effects of cannabinoids in human disease states, including pain associated with diabetes, chemotherapy, multiple sclerosis, and fibromyalgia (Lynch and Ware, 2015;Whiting et al, 2015).”
From The endogenous cannabinoid system: a budding source of targets for treating inflammatory and neuropathic pain (2018) · cites this paper as Whiting et al, 2015
In the citing paper
“A comprehensive meta-analysis shows that medicinal cannabis and cannabinoids effectively alleviate different types of pain, such as neuropathic, fibromyalgia, multiple sclerosis, cancer, diabetic neuropathy, refractory pain due to multiple sclerosis or other neurological conditions, rheumatoid arthritis, noncancer pain, central pain, musculoskeletal problems, and chemotherapy-induced pain (Whiting”
From The endogenous cannabinoid system: a budding source of targets for treating inflammatory and neuropathic pain (2018) · cites this paper as Whiting et al, 2015
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“Although several studies show that 'medical cannabis' can improve various types of pain, cannabimimetic side effects, which include drowsiness or fatigue, dizziness, dry mouth, nausea, and cognitive effects, have also been reported (Whiting et al, 2015).”
From The endogenous cannabinoid system: a budding source of targets for treating inflammatory and neuropathic pain (2018) · cites this paper as Whiting et al, 2015
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Citations
Cites
Meta-analysis in clinical trials
DerSimonian, R., & Laird, N. (1986) · Controlled Clinical Trials · doi:10.1016/0197-2456(86)90046-2 · Cited by 39,552
Quantifying heterogeneity in a meta‐analysis
Higgins, J. P. T., & Thompson, S. G. (2002) · Statistics in Medicine · doi:10.1002/sim.1186 · Cited by 36,763
The Cochrane Collaboration's tool for assessing risk of bias in randomised trials
Higgins, J. P. T., Altman, D. G., Gotzsche, P. C., Juni, P., Moher, D., Oxman, A. D., Savovic, J., Schulz, K. F., Weeks, L., Sterne, J. A. C., et al. (2011) · BMJ · doi:10.1136/bmj.d5928 · Cited by 33,817
Cochrane Handbook for Systematic Reviews of Interventions: Cochrane Book Series
(2008) · doi:10.1002/9780470712184 · Cited by 25,048
Cochrane Handbook for Systematic Reviews of Interventions
Higgins, J. P. T., Green, S., & Ben Van Den, A. (2020) · International Coaching Psychology Review · doi:10.53841/bpsicpr.2020.15.2.123 · Cited by 5,670
Interrater Reliability of a Modified Ashworth Scale of Muscle Spasticity
Bohannon, R. W., & Smith, M. B. (1987) · Physical Therapy · doi:10.1093/ptj/67.2.206 · Cited by 5,461
GRADE guidelines: 4. Rating the quality of evidence—study limitations (risk of bias)
Guyatt, G. H., Oxman, A. D., Vist, G., Kunz, R., Brozek, J., Alonso-Coello, P., Montori, V., Akl, E. A., Djulbegovic, B., & Falck-Ytter, Y. (2011) · Journal of Clinical Epidemiology · doi:10.1016/j.jclinepi.2010.07.017 · Cited by 2,798
Meta-analyses involving cross-over trials: methodological issues
Elbourne, D. R., Altman, D. G., Higgins, J. P., Curtin, F., Worthington, H. V., & Vail, A. (2002) · International Journal of Epidemiology · doi:10.1093/ije/31.1.140 · Cited by 2,305
Cannabidiol enhances anandamide signaling and alleviates psychotic symptoms of schizophrenia
Leweke, F. M., Piomelli, D., Pahlisch, F., Muhl, D., Gerth, C. W., Hoyer, C., Klosterkötter, J., Hellmich, M., & Koethe, D. (2012) · Translational Psychiatry · doi:10.1038/tp.2012.15 · Cited by 1,059
Zajicek, J., Fox, P., Sanders, H., Wright, D., Vickery, J., Nunn, A., & Thompson, A. (2003) · The Lancet · doi:10.1016/s0140-6736(03)14738-1 · Cited by 827
Research works printed but not linked: 20
- [8]8. Canadian Agency for Drugs and Technologies in Health. CADTH Peer Review Checklist for Search Strategies (Internet). Ottawa, Canada: CADTH; 2013. https://www.cadth.ca/resources/finding-evidence /cadth-peer-review-checklist-search-strategies. Accessed March 17, 2014.
- [14]14. Broder LE, Lean NL, Hilsenbeck SG. A randomized blinded clinical trial comparing delta-9-tetrahydrocannabinol (THC) and hydroxizine (HZ) as antiemetics (AE) for cancer chemotherapy (CT). Proc Am Assoc Cancer Res. 1982;23:514.
- [16]16. Hagenbach U, Luz S, Brenneisen R, Mäder M. The treatment of spasticity with D9-tetrahydrocannabinol (D9-THC) in patients with spinal cord injury. Paper presented at: IACM 2nd Conference on Cannabinoids in Medicine; September 12-13, 2003; Cologne, Germany.
- [18]18. Denver, CO. Am J Respir Crit Care Med. 2011;183(1):A2720.
- [46]46. Ungerleider JT, Andrysiak T, Fairbanks L, Goodnight J, Sarna G, Jamison K. Cannabis and cancer chemotherapy: a comparison of oral delta-9-THC and prochlorperazine. Cancer. 1982;50 (4):636-645.
- [48]48. Harden-Harrison MM, Munsell MF, Fisch MJ, et al. Dronabinol for the prevention of nausea from cyclophosphamide and/or adriamycin. Paper presented at: International MASCC/ISOO Symposium: Supportive Care in Cancer; June 28-30, 2012; New York, NY. Support Care Cancer. 2012;20:S209-S210.
- [50]50. Lane M, Vogel CL, Ferguson J, et al. Dronabinol and prochlorperazine in combination are better than either single agent alone for treatment of chemotherapy-induced nausea and vomiting. Proc Am Soc Clin Oncol. 1989;8:326.
- [52]52. Chan HS, MacLeod SM, Correia JA. Nabilone vs prochlorperazine for control of cancer chemotherapy-induced emesis in children. Proc Am Soc Clin Oncol. 1984;3:108.
- [54]54. Frytak S, Moertel CG, Ofallon JR. Comparison of delta-9-tetrahydrocannabinol (THC), prochlorperazine (PCP) and placebo as anti-emetics for cancer-chemotherapy. Proc Am Assoc Cancer Res. 1979;20:391.
- [56]56. McCabe M, Smith FP, Goldberg D, et al. Comparative trial of oral 9 tetrahydrocannabinol and prochlorperazine for cancer chemotherapy related nausea and vomiting. Proc Am Assoc Cancer Res and Am Soc Clin Oncol. 1981;22:416.
- [63]63. Ware M, Fitzcharles MA, Joseph L, Shir Y. The effects of nabilone on sleep in fibromyalgia: results of a randomized controlled trial. Paper presented at: Canadian Rheumatology Association Meeting; February 18-21, 2009; Kananaskis, AB: Canada. Abstract 149 J Rheumatol. 2009;36(11):2607.
- [80]80. Rog DJ, Nurmikko TJ, Friede T, Young CA. Randomized, controlled trial of cannabis-based medicine in central pain in multiple sclerosis. Neurology. 2005;65(6):812-819.
- [90]90. Abrams DI, Jay CA, Vizoso H, et al. Smoked cannabis therapy for HIV-related painful peripheral neuropathy: results of a randomized, placebo-controlled clinical trial. Paper presented at: IACM 3rd Conference on Cannabinoids in Medicine; September 9-10, 2005; Leiden, the Netherlands.
- [116]116. Cambridge Laboratories Ltd. A randomised, crossover, double blind comparison of the analgesic effect and patient tolerability of nabilone and dihydrocodeine in chronic neuropathic pain. metaRegister of Controlled Trials. http://isrctn.org /ISRCTN15330757. Accessed April 7, 2014.
- [136]136. Zajicek J, Reif M, Schnelle M; UK MUSEC Study Investigators. Cannabis extract in the treatment of muscle stiffness and other symptoms in multiple sclerosis -results of the MUSEC study. Paper presented at: IACM 5th Conference on Cannabinoids in Medicine; October 2-3, 2009; Cologne, Germany. 137.
- [93]93. Collin C, Ambler Z, Kent R, McCalla R. A randomised controlled study of Sativex® in patients with symptoms of spasticity due to multiple sclerosis. Paper presented at: 22nd Congress of the ECTRIMS; September 27-30, 2006; Madrid, Spain. 138. Robson P, Wade D, Makela P, House H, Bateman C. Cannabis-based medicinal extract (Sativex) produced significant improvements in a subjective measure of spasticity which were maintained on long-term treatment with no evidence of tolerance. Paper presented at: IACM 3rd Conference on Cannabinoids in Medicine; September 9-10, 2005; Leiden, the Netherlands. 139. Center for Medicinal Cannabis Research. Short-term effects of medicinal cannabis therapy on spasticity in multiple sclerosis. ClinicalTrials.gov. http://ClinicalTrials.gov/show/NCT00248378. Accessed April 7, 2014. 140. Institut fur Klinische Forschung Germany;
- [155]155. Rohleder C, Pahlisch F, Schaefer C, et al. The endocannabinoid system as a pharmacological target for antipsychotic treatment and more? Paper presented at: 8th International Conference on Early Psychosis: From Neurobiology to Public Policy; October 11-13, 2012; San Francisco, CA. Early Interv Psychiatry. 2012;6(suppl 1):7 doi:10.1111/j.1751-7893 .2012.00392.x. · DOI
- [164]164. International Conference on Harmonisation of Technical Requirements for Registration of Pharmaceuticals for Human Use. MeDRA (Medical Dictionary for Regulatory Activities). http://www .meddra.org/. Accessed September 2, 2014.
- [178]178. Canadian Agency for Drugs and Technologies in Health (CADTH). Cannabinoids as Co-Analgesics: Review of Clinical Effectiveness. Ottawa, Canada: Canadian Agency for Drugs and Technologies in Health;2010.
- [179]179. Canadian Agency for Drugs and Technologies in Health (CADTH). Cannabinoids for the Management of Neuropathic Pain: Review of Clinical Effectiveness. Ottawa, Canada: Canadian Agency for Drugs and Technologies in Health);2010.
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Metadata
- Authors
- Whiting, P. F., Wolff, R. F., Deshpande, S., Di Nisio, M., Duffy, S., Hernandez, A. V., Keurentjes, J. C., Lang, S., Misso, K., Ryder, S., Schmidlkofer, S., Westwood, M., & Kleijnen, J.
- Affiliations
- University Hospitals Bristol NHS Foundation Trust (GB)
- Kleijnen Systematic Reviews (United Kingdom) (GB)
- Department of Medical, Oral, and Biotechnological Sciences, University “G. D'Annunzio” of Chieti-Pescara, Chieti, Italy5Department of Vascular Medicine, Academic Medical Center, Amsterdam, the Netherlands
- Medical School, Universidad Peruana de Ciencias Aplicadas (UPC), Lima, Peru7Health Outcomes and Clinical Epidemiology Section, Department of Quantitative Health Sciences, Lerner Research Institute, Cleveland Clinic, Cleveland, Ohio
- Radboud University Medical Center (NL)
- Institut für Epidemiologie und kongenitale Erkrankungen, Cepicon GmbH, Hamburg, Germany
- Maastricht University (NL)
- ORCID
- Venue
- JAMA
- Publisher
- American Medical Association (AMA)
- Published
- 2015-06-23
- Volume
- 313
- Issue
- 24
- Pages
- 2456
- ISSN
- 0002-9955 (ISSN-L)
- 0098-7484
- OpenAlex
- W2120227293
- Semantic Scholar
- 029bce497e0633eb2a7895cfd3b315f9c462dd5f
- Cited by
- 2,169
- References
- 137
- Citations by year
- 2026: 119 · 2025: 166 · 2024: 168 · 2023: 200 · 2022: 220 · 2021: 262 · 2020: 272 · 2019: 230 · 2018: 209 · 2017: 159 · 2016: 131 · 2015: 33
- FWCI
- 22.34
- Type
- journal article
- Language
- en
- Open access
- bronze
- doi.org
- Locations
- JAMA (publishedVersion)
- PubMed (publishedVersion)
- Pure Amsterdam UMC (publishedVersion, other-oa)
- Bristol Research (University of Bristol) (publishedVersion)
- Zenodo (CERN European Organization for Nuclear Research) (submittedVersion, cc-by)
- Data Archiving and Networked Services (DANS) (submittedVersion)
- Americanae (AECID Library) (submittedVersion, other-oa)
- Research Publications (Maastricht University) (submittedVersion, other-oa)
- LA Referencia (Red Federada de Repositorios Institucionales de Publicaciones Científicas) (submittedVersion, cc-by)
- Explore Bristol Research (submittedVersion)
- Topics
- Health Sciences › Medicine › Pharmacology (medical) › Cannabis and Cannabinoid Research
- Health Sciences › Medicine › Surgery › Nausea and vomiting management
- Health Sciences › Medicine › Complementary and alternative medicine › Complementary and Alternative Medicine Studies
- Keywords
- cannabinoids, medical cannabis, nausea and vomiting, chemotherapy-induced nausea, chronic pain, spasticity, multiple sclerosis, depression, anxiety, sleep disorders, psychosis, glaucoma, Tourette syndrome, adverse events, quality of life, activities of daily living, risk of bias, placebo comparison
- MeSH terms
- Anorexia, Mental Disorders, Cannabinoids, Tourette Syndrome, Glaucoma, Humans, Muscle Spasticity, Nausea, Randomized Controlled Trials as Topic, Chronic Pain, Medical Marijuana
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