←Nausea

Study register · detail RCT (randomisiert, doppelblind, Crossover) · Nausea · 1981

Comparative trial of the antiemetic effects of THC and haloperidol.

Neidhart et al. ·Journal of Clinical Pharmacology Impact 1.8

Mixed GRADE Moderate 56 citations

Samplen = 52 Pat.

Durationtwo treatment cycles

ControlHaloperidol, oral

EndpointNumber of vomiting events

Blindingdoppelblind

DesignRCT (randomisiert, doppelblind, Crossover)

Cannabinoidthc

Routeoral

Key finding

THC and haloperidol were equally effective in controlling nausea and vomiting, but the side effects of THC were less well tolerated than those of haloperidol.

Summary

n=52 cancer patients under strongly emetogenic chemotherapy (cisplatin/nitrogen mustard/doxorubicin), THC vs. haloperidol (randomised, double-blind, crossover); both agents equally effective for nausea and vomiting: ~10% complete control of emesis, approx. one third <5 emesis episodes; patients who did not respond to one antiemetic had good control with the other in ~50% of cases. THC toxicity less well tolerated than haloperidol, though mostly no severe side effects.

PopulationCancer patients under emetogenic chemotherapy (cisplatin, nitrogen mustard or doxorubicin), n=52

InterventionDelta-9-tetrahydrocannabinol (THC), oral, crossover

ControlHaloperidol, oral

OutcomeTHC and haloperidol equally effective with regard to number of vomiting events, patient assessment of efficacy and preference; approx. 10% complete control, approx. 1/3 <5 episodes

Confidence in the evidence

Moderate

The third of four GRADE levels, the effect estimate is probably reliable.

Downgraded for

Imprecision

Quality profile

Sample size ★★★★★

Blinding Double-blind

Effect size Mixed

Citations / year ★★★★★

Authors

Neidhart JA, Gagen MM, Wilson HE, Young DC

DOI 10.1002/j.1552-4604.1981.tb02571.x↗

Design: RCT (randomisiert, doppelblind, Crossover)

Abstract

A prospective, randomized and double-blinded trial of the comparative effects of delta-9-tetrahydrocannabinol (THC) and haloperidol (H) was begun in February 1980. Patients were randomized to initially receive either THC or haloperidol with cross-over to the other agent after two courses. All patients evaluated efficacy and toxicity of each agent and those patients completing the study expressed a preference for either THC or haloperidol. All patients are receiving chemotherapeutic agents known to induce severe vomiting (cis-platinum, nitrogen mustard, or doxorubicin) or have a history or retching with chemotherapy. Fifty-two patients are evaluable as of October, 1980. THC and haloperidol were equally effective in controlling nausea and vomiting as judged by number of vomiting episodes, patient evaluation of efficacy, and patient preference. About 10% of patients had complete control of vomiting and a third had less than five episodes. Patients failing one of the antiemetics had good control with the other about half the time. Toxicities from THC were less well tolerated than those from haloperidol, but most patients had no serious side effects. Nonoverlapping toxicities and efficacy raise the possibility that a combination of the agents might be worthwhile.

The impediment to action advances action. — Marcus Aurelius