cannabidiol and Anorexia

Topics: Aged; Anorexia; Antineoplastic Agents; Cancer Pain; Cannabidiol; Cannabinoid Receptor Agonists; Cannabinoids; Dizziness; Dose-Response Relationship, Drug; Dronabinol; Humans; Middle Aged; Multiple Sclerosis; Nausea; Neurodegenerative Diseases; Pain; Perceptual Disorders; Randomized Controlled Trials as Topic; Regression Analysis; Self Report; Vomiting

Appetite influences perceived quality of life for a dog or cat with cancer. Inappetence often is multifactorial, complicating treatment. Cancer-related anorexia/cachexia syndrome is a metabolic, paraneoplastic syndrome characterized by decreased food intake, involuntary weight loss, and loss of fat and muscle. If weight loss/cachexia has an impact on canine and feline cancer patients as in humans, management may improve survival times and quality of life. The challenge is having effective, proved therapies available for clinical use. Recent Food and Drug Administration approvals for appetite stimulation have renewed interest and discussion and has the potential to alter the course of case management.

Topics: Animals; Anorexia; Antineoplastic Combined Chemotherapy Protocols; Appetite Stimulants; Cachexia; Cannabidiol; Cat Diseases; Cats; Chronic Disease; Dog Diseases; Dogs; Neoplasms; Quality of Life

Anorexia can affect up to 90 % of people with advanced cancer. It is a complex symptom associated with changes in taste, lack of hunger at mealtimes and lack of food enjoyment. Associated weight loss is part of the physical decline that occurs as cancer worsens. Weight loss can also occur from cachexia, the increased metabolism of energy due to raised inflammatory cytokines, liver metastases and other factors seen in several advanced cancers. Independent of anorexia, although frequently associated (where it is referred to as the cachexia-anorexia syndrome), it accounts for a significant amount of morbidity and deaths in people with cancer. In particular, quality of life for the patient and the family is significantly affected with this syndrome as it causes anxiety and distress. Therefore, it is important that research into therapies is undertaken, particularly focusing on an understanding of the pharmacokinetic properties of compounds in this cachexic population. Cannabinoids are one such group of therapies that have received a large amount of media focus recently. However, there appears to be a lack on rigorous pharmacokinetic data of these complex and varied compounds in the cachexic population. Similarly, there is a lack of pharmacokinetic data in any population group for the non- tetrahydrocannabinol (THC) and cannabidiol (CBD) cannabinoids (often due to the lack of analytical standards for quantification). This review will thus examine the pharmacokinetics of major cannabinoids i.e. THC and CBD in a cancer population. Overall, based on the current literature, evidence for the use of cannabinoids for the treatment of cancer-related cachexia-anorexia syndrome remains equivocal. A high-quality, rigorous, phase I/II study to elicit pharmacokinetic dose-concentration and concentration-response data, with a clinically acceptable mode of delivery to reduce intrapatient variability and enable more consistent bioavailability is needed in this population.

Topics: Anorexia; Cachexia; Cannabidiol; Dronabinol; Humans; Neoplasms; Quality of Life

Topics: Adolescent; Adult; Aged; Anorexia; Canada; Cannabidiol; Dronabinol; Female; Humans; Male; Mental Disorders; Middle Aged; Mobile Applications; Pain; Palliative Care; Patient Portals; Patient Satisfaction; Retrospective Studies; Sleep Initiation and Maintenance Disorders