Synopsis

Source of validity: Scientific
Rating (out of 5): 4

Phytocannabinoids, notably delta-9-tetrahydrocannabinol (THC) and cannabidiol (CBD), have scientific validation for their use in supporting and treating nausea and vomiting, particularly in specific clinical contexts. The strongest evidence comes from studies involving chemotherapy-induced nausea and vomiting (CINV) in cancer patients. Several randomized controlled trials and meta-analyses have found that cannabinoid-based medicines (such as dronabinol and nabilone, synthetic analogues of THC) are effective in reducing nausea and vomiting resistant to conventional antiemetic treatments. Based on this evidence, regulatory agencies in some countries have approved these compounds for CINV.

The mechanism of action is thought to involve activation of cannabinoid receptors (CB1) in the central nervous system, which modulate the vomiting reflex. There is also some evidence supporting the use of phytocannabinoids for nausea and vomiting associated with HIV/AIDS therapies and, to a lesser extent, in palliative care. However, their use in other forms of nausea (such as pregnancy-related morning sickness) is not well supported and is generally not recommended due to safety concerns.

Adverse effects, including euphoria, dizziness, and cognitive impairment, can limit tolerability, and the risk-benefit ratio must be considered. Overall, while phytocannabinoids are not first-line antiemetics, they represent a scientifically validated option for refractory cases, especially in oncology settings.

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