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Drugs & Therapy Perspectives

, Volume 35, Issue 10, pp 486–490 | Cite as

Individualize treatment when prescribing medical cannabis to older patients as efficacy data remains limited

  • Adis Medical WritersEmail author
Practical Issues and Updates
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Abstract

There is a growing interest in the use of cannabis for medical purposes, especially in older patients who experience pain, sleep difficulties, mood disturbances or neurological disorders that are poorly managed by current treatment options. However, efficacy data on the use of medical cannabis remains limited, yet the risk of known and potential adverse events are considerably high. Treatment should be individualized based on the characteristics of the patient and be closely monitored.

Notes

Compliance with ethical standards

Conflict of interest

The article was adapted from Drugs & Aging 2019;36(1):39–51 [1] by employees of Adis International Ltd./Springer Nature, who are responsible for the article content and declare no conflicts of interest.

Funding

The preparation of this review was not supported by any external funding.

References

  1. 1.
    Minerbi A, Hauser W, Fitzcharles MA. Medical cannabis for older patients. Drugs Aging. 2019;36(1):39–51.CrossRefPubMedGoogle Scholar
  2. 2.
    Lucas CJ, Galettis P, Schneider J. The pharmacokinetics and the pharmacodynamics of cannabinoids. Br J Clin Pharmacol. 2018;84(11):2477–82.CrossRefPubMedGoogle Scholar
  3. 3.
    Abuhasira R, Schleider LB, Mechoulam R, et al. Epidemiological characteristics, safety and efficacy of medical cannabis in the elderly. Eur J Intern Med. 2018;49:44–50.CrossRefPubMedGoogle Scholar
  4. 4.
    Johnson JR, Burnell-Nugent M, Lossignol D, et al. Multicenter, double-blind, randomized, placebo-controlled, parallel-group study of the efficacy, safety, and tolerability of THC:CBD extract and THC extract in patients with intractable cancer-related pain. J Pain Symptom Manage. 2010;39(2):167–79.CrossRefPubMedGoogle Scholar
  5. 5.
    Portenoy RK, Ganae-Motan ED, Allende S, et al. Nabiximols for opioid-treated cancer patients with poorly-controlled chronic pain: a randomized, placebo-controlled, graded-dose trial. J Pain. 2012;13(5):438–49.CrossRefPubMedGoogle Scholar
  6. 6.
    Lavie-Ajayi M, Shvartzman P. Restored self: a phenomenological study of pain relief by cannabis. Pain Med. 2018.  https://doi.org/10.1093/pm/pny176.CrossRefPubMedGoogle Scholar
  7. 7.
    Hauser W, Petzke F, Fitzcharles MA. Efficacy, tolerability and safety of cannabis-based medicines for chronic pain management: an overview of systematic reviews. Eur J Pain. 2018;22(3):455–70.CrossRefPubMedGoogle Scholar
  8. 8.
    van den Elsen GA, Ahmed AI, Lammers M, et al. Efficacy and safety of medical cannabinoids in older subjects: a systematic review. Ageing Res Rev. 2014;14:56–64.CrossRefPubMedGoogle Scholar
  9. 9.
    Whiting PF, Wolff RF, Deshpande S, et al. Cannabinoids for medical use: a systematic review and meta-analysis. JAMA. 2015;313(24):2456–73.CrossRefPubMedGoogle Scholar
  10. 10.
    Nugent SM, Morasco BJ, O’Neil ME, et al. The effects of cannabis among adults with chronic pain and an overview of general harms: a systematic review. Ann Intern Med. 2017;167(5):319–31.CrossRefPubMedGoogle Scholar
  11. 11.
    Mucke M, Phillips T, Radbruch L, et al. Cannabis-based medicines for chronic neuropathic pain in adults. Cochrane Database Syst Rev. 2018;3:CD012182.Google Scholar
  12. 12.
    Stockings E, Campbell G, Hall WD, et al. Cannabis and cannabinoids for the treatment of people with chronic noncancer pain conditions: a systematic review and meta-analysis of controlled and observational studies. Pain. 2018;159(10):1932–54.CrossRefPubMedGoogle Scholar
  13. 13.
    Gates P, Albertella L, Copeland J. Cannabis withdrawal and sleep: a systematic review of human studies. Substain Abuse. 2016;37(1):255–69.CrossRefGoogle Scholar
  14. 14.
    Rice J, Cameron M. Cannabinoids for treatment of MS symptoms: state of the evidence. Curr Neurol Neurosci Rep. 2018;18(8):50.CrossRefPubMedGoogle Scholar
  15. 15.
    Noel C. Evidence for the use of “medical marijuana” in psychiatric and neurologic disorders. Ment Health Clin. 2017;7(1):29–38.CrossRefPubMedGoogle Scholar
  16. 16.
    Lim K, See YM, Lee J. A systematic review of the effectiveness of medical cannabis for psychiatric, movement and neurodegenerative disorders. Clin Psychopharmacol Neurosci. 2017;15(4):301–12.CrossRefPubMedPubMedCentralGoogle Scholar
  17. 17.
    Shishko I, Oliveira R, Moore TA, et al. A review of medical marijuana for the treatment of posttraumatic stress disorder: real symptom re-leaf or just high hopes? Ment Health Clin. 2018;8(2):86–94.CrossRefPubMedPubMedCentralGoogle Scholar
  18. 18.
    Mucke M, Weier M, Carter C, et al. Systematic review and meta-analysis of cannabinoids in palliative medicine. J Cachexia Sarcopenia Muscle. 2018;9(2):220–34.CrossRefPubMedPubMedCentralGoogle Scholar
  19. 19.
    Nielsen S, Germanos R, Weier M, et al. The use of cannabis and cannabinoids in treating symptoms of multiple sclerosis: a systematic review of reviews. Curr Neurol Neurosci Rep. 2018;18(2):8.CrossRefPubMedGoogle Scholar
  20. 20.
    Yadav V, Narayanaswami P. Complementary and alternative medical therapies in multiple sclerosis-the American Academy of Neurology guidelines: a commentary. Clin Ther. 2014;36(12):1972–8.CrossRefPubMedGoogle Scholar
  21. 21.
    Choi NG, Marti CN, DiNitto DM, et al. Older adults’ marijuana use, injuries, and emergency department visits. Am J Drug Alcohol Abuse. 2018;44(2):215–23.CrossRefPubMedGoogle Scholar
  22. 22.
    Asbridge M, Hayden JA, Cartwright JL. Acute cannabis consumption and motor vehicle collision risk: systematic review of observational studies and meta-analysis. BMJ. 2012;344:e536.CrossRefPubMedPubMedCentralGoogle Scholar
  23. 23.
    Beirness DJ, Beasley EE, P. B. A comparison of drug use by fatally injured drivers and drivers at risk. In: 20th International Council on Alcohol, Drugs, and Traffic Safety Conference; 2013.Google Scholar
  24. 24.
    Moore TH, Zammit S, Lingford-Hughes A, et al. Cannabis use and risk of psychotic or affective mental health outcomes: a systematic review. Lancet. 2007;370(9584):319–28.CrossRefPubMedGoogle Scholar
  25. 25.
    Borges G, Bagge CL, Orozco R. A literature review and meta-analyses of cannabis use and suicidality. J Affect Disord. 2016;195:63–74.CrossRefPubMedGoogle Scholar
  26. 26.
    Waterreus A, Di Prinzio P, Badcock JC, et al. Is cannabis a risk factor for suicide attempts in men and women with psychotic illness? Psychopharmacology (Berl). 2018;235(8):2275–85.CrossRefPubMedGoogle Scholar
  27. 27.
    Singh A, Saluja S, Kumar A, et al. Cardiovascular complications of marijuana and related substances: a review. Cardiol Ther. 2018;7(1):45–59.CrossRefPubMedGoogle Scholar
  28. 28.
    Desai R, Patel U, Sharma S, et al. Recreational marijuana use and acute myocardial infarction: insights from nationwide inpatient sample in the United States. Cureus. 2017;9(11):e1816.PubMedPubMedCentralGoogle Scholar

Copyright information

© Springer Nature Switzerland AG 2019

Authors and Affiliations

  1. 1.Springe NatureAucklandNew Zealand

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