Background: Cannabis-based medications have been a
topic of intense study since the endogenous cannabinoid
system was discovered two decades ago. In 2011, for the
first time, a cannabis extract was approved for clinical use
in Germany.
Methods: Selective literature review
Results: Cannabis-based medications exert their effects
mainly through the activation of cannabinoid receptors
(CB1 and CB2). More than 100 controlled clinical trials of
cannabinoids or whole-plant preparations for various indications have been conducted since 1975. The findings of
these trials have led to the approval of cannabis-based
medicines (dronabinol, nabilone, and a cannabis extract
[THC:CBD=1:1]) in several countries. In Germany, a cannabis extract was approved in 2011 for the treatment of
moderate to severe refractory spasticity in multiple
sclerosis. It is commonly used off label for the treatment
of anorexia, nausea, and neuropathic pain. Patients can
also apply for government permission to buy medicinal
cannabis flowers for self-treatment under medical supervision. The most common side effects of cannabinoids are
tiredness and dizziness (in more than 10% of patients),
psychological effects, and dry mouth. Tolerance to these
side effects nearly always develops within a short time.
Withdrawal symptoms are hardly ever a problem in the
therapeutic setting.
Conclusion: There is now clear evidence that cannabinoids
are useful for the treatment of various medical conditions.
