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大麻和大麻素在美国的临床应用。

Clinical uses of cannabis and cannabinoids in the United States.

作者信息

Levinsohn Erik A, Hill Kevin P

机构信息

Department of Psychiatry, Beth Israel Deaconess Medical Center, 330 Brookline Avenue, Boston, MA 02215, USA.

Addiction Psychiatry, Department of Psychiatry, Beth Israel Deaconess Medical Center, 330 Brookline Avenue, Boston, MA 02215, USA.

出版信息

J Neurol Sci. 2020 Apr 15;411:116717. doi: 10.1016/j.jns.2020.116717. Epub 2020 Jan 30.

Abstract

The role of cannabis in medicine is rapidly evolving. Medical cannabis is now legal in a majority of states, and THC and CBD, the prominent cannabinoids found in cannabis, have both been utilized in the development of FDA-approved drugs. Due to the complicated legal status of cannabis and cannabinoids, as well as regulations that vary from state to state, the appropriate use of these substances for both patients as well as clinicians is often unclear. Advancements in the understanding of the pharmacology of cannabis have led to numerous proposed uses of these drugs, including as antidepressant or analgesic agents. However, clinical trial data for these substances suggests that many purported indications of cannabis and cannabinoids are not supported by good clinical data. Furthermore, cannabis and several cannabinoid-based medications have potentially concerning side effect profiles that may limit their use in certain patient populations. As the legal status and clinical database of these medications continue to evolve, physicians will need to continue to balance the real potential of these compounds with their limitations and adverse effects.

摘要

大麻在医学中的作用正在迅速演变。医用大麻目前在大多数州都是合法的,大麻中发现的主要大麻素四氢大麻酚(THC)和大麻二酚(CBD)都已被用于开发美国食品药品监督管理局(FDA)批准的药物。由于大麻和大麻素的法律地位复杂,以及各州法规不同,患者和临床医生对这些物质的合理使用往往并不明确。对大麻药理学认识的进展导致了这些药物的众多潜在用途,包括作为抗抑郁药或镇痛药。然而,这些物质的临床试验数据表明,大麻和大麻素的许多所谓适应症并没有良好的临床数据支持。此外,大麻和几种基于大麻素的药物有潜在的不良副作用,这可能会限制它们在某些患者群体中的使用。随着这些药物的法律地位和临床数据库不断发展,医生将需要继续在这些化合物的实际潜力与它们的局限性和不良反应之间取得平衡。

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