How effective and safe is medical cannabis as a treatment of mental disorders? A systematic review
Hoch et al.·European Archives of Psychiatry and Clinical NeuroscienceImpact 2.9
GemischtGRADEHoch129 Zitate
Stichprobek = 18 Studien n = 1.629 Pat.
DauerSuchzeitraum 2006-August 2018
KontrollePlacebo oder aktive Kontrolle
EndpunktSymptomschwere
Verblindungunklar
DesignSystematic Review
”Kernaussage
THC- und CBD-basierte Medikamente waren mit Symptomverbesserungen mehrerer psychischer Störungen assoziiert, aber nicht mit Remission; Nebenwirkungen traten auf, schwere Nebenwirkungen nur in Einzelfällen.
Zusammenfassung
Umbrella Review zu medizinischen Cannabinoiden bei psychiatrischen Störungen; k=18 Studien (4 SRs über 11 RCTs + 14 eigenständige RCTs), n=1.629 Teilnehmende. Diagnosen umfassen u.a. Demenz, Cannabisabhängigkeit, Psychosen, PTBS, Anorexie, ADHS, Tourette. THC- und CBD-basierte Medikamente als Adjuvans zeigten Verbesserungen einzelner Symptome, aber keine Remission. Schwere Nebenwirkungen nur in Einzelfällen. Heterogene Outcomes, keine Meta-Analyse möglich; narrative Synthese angewandt.
We conducted a review of systematic reviews (SRs) and randomized-controlled trials (RCTs) to analyze efficacy and safety of cannabis-based medication in patients with mental disorders. Five data bases were systematically searched (2006-August 2018); 4 SRs (of 11 RCTs) and 14 RCTs (1629 participants) were included. Diagnoses were: dementia, cannabis and opioid dependence, psychoses/schizophrenia, general social anxiety, posttraumatic stress disorder, anorexia nervosa, attention-deficit hyperactivity disorder, and Tourette;s disorder. Outcome variables were too heterogeneous to conduct a meta-analysis. A narrative synthesis method was applied. The study quality was assessed using the risk-of-bias tool and SIGN-checklists. THC- and CBD-based medicines, given as adjunct to pharmaco- and psychotherapy, were associated with improvements of several symptoms of mental disorders, but not with remission. Side effects occurred, but severe adverse effects were mentioned in single cases only. In order to provide reliable treatment recommendations, more and larger RCTs with follow-up assessments, consistent outcome measures and active comparisons are needed.