Institute of Psychopharmacology, Central Institute of Mental Health, Faculty of Medicine Mannheim, University of Heidelberg, Germany.
Behavioral Genetics Research Group, Central Institute of Mental Health, Germany.
Neuropharmacology. 2021 Sep 15;196:108680. doi: 10.1016/j.neuropharm.2021.108680. Epub 2021 Jun 26.
Cannabinoids are used for numerous disease indications. However, cannabinoids can also produce adverse effects; for example, they can disturb physiological functions such as sleep and appetite. The medical use of cannabinoids refers to a wide variety of preparations and products. Approved cannabinoid products include dronabinol ((-)-trans-Δ-tetrahydrocannabinol (THC), nabilone (a THC analogue), and cannabidiol (CBD) that differ in their pharmacology and may thus have different adverse effects on sleep and appetite.
Here we ask if (i) cannabinoids decrease sleep and appetite in somatic patients or patients that suffer from mental illness and if (ii) there is a difference between THC products (nabilone, dronabinol), vs. CBD in disturbing these physiological functions.
In order to answer these two questions, we performed a comparative systematic review (SR) for nabilone, dronabinol, and CBD. For the comparative SR we searched PubMed, Medline, Embase, and PsycINFO for randomized controlled trials (RCTs) and extracted information for adverse side effects or outcomes reporting a negative impact on sleep and appetite. RCT evidence was calculated as odds ratios (ORs) via fixed effects meta-analyses. Evidence quality was assessed by the Cochrane Risk of Bias and GRADE tools. This study is registered at PROSPERO (CRD42021229932).
A total of 17 RCTs (n = 1479) and 15 RCTs (n = 1974) were included for sleep and appetite, respectively. Pharmaceutical THC (nabilone, dronabinol) does not affect sleep or appetite. In contrast, there is moderate evidence that CBD decreases appetite (OR = 2.46 [1.74:4.01] but has also no effect on sleep.
Our comparative systematic study shows that approved cannabinoids can decrease appetite as a negative side effect - an effect that seems to be driven by CBD. Approved cannabinoid products do not negatively affect sleep in somatic and psychiatric patients. This article is part of the special Issue on "Cannabinoids".
大麻素被用于多种疾病的治疗。然而，大麻素也会产生不良反应，例如，它们会干扰睡眠和食欲等生理功能。医用大麻素是指各种制剂和产品。已批准的大麻素产品包括屈大麻酚（(-)-反式-Δ-四氢大麻酚（THC））、那比隆（一种 THC 类似物）和大麻二酚（CBD），它们在药理学上有所不同，因此可能对睡眠和食欲产生不同的不良反应。
我们想知道医用大麻素是否会(i) 减少躯体疾病患者或精神疾病患者的睡眠和食欲，以及 (ii) THC 产品（那比隆、屈大麻酚）与 CBD 在干扰这些生理功能方面是否存在差异。
为了回答这两个问题，我们对那比隆、屈大麻酚和 CBD 进行了比较系统评价（SR）。对于比较性 SR，我们在 PubMed、Medline、Embase 和 PsycINFO 中搜索了随机对照试验（RCT），并提取了报告对睡眠和食欲产生负面影响的不良副作用或结果的信息。通过固定效应荟萃分析计算 RCT 证据为比值比（ORs）。使用 Cochrane 风险偏倚和 GRADE 工具评估证据质量。本研究在 PROSPERO（CRD42021229932）上注册。
共有 17 项 RCT（n=1479）和 15 项 RCT（n=1974）分别纳入睡眠和食欲分析。药用 THC（那比隆、屈大麻酚）不影响睡眠或食欲。相反，有中等质量证据表明 CBD 会减少食欲（OR=2.46 [1.74:4.01]），但对睡眠没有影响。
我们的比较系统研究表明，已批准的大麻素可能会因作为一种负性副作用而导致食欲下降，这种作用似乎是由 CBD 驱动的。已批准的大麻素产品在躯体和精神疾病患者中不会对睡眠产生负面影响。本文是“大麻素”特刊的一部分。
