Nausea is both a symptom and a side effect- It results from the stimulation of specific receptors, 5-HT3 for acute (sudden) emesis and the NK1 receptor for delayed emesis as is found in chemotherapy. Both receptors have been selectively blocked with anti-emetic drugs demonstrating their role in nausea and vomiting.

CB1 receptors appear to be co-located and have an opposite effect (an anti-emetic effect) to the 5-HT3 receptors. The mere presence of cannabinoids may also interfere with the action of the 5-HT3 receptors by direct interference with calcium channels in the receptor itself independent of any CB1 receptor activity. In the presence of CB1 antagonists (which block the CB1 receptor) this anti-emetic property of cannabinoids to interfere with the 5-HT3 receptor continues.

The majority of the anti-emetic effect of cannabinoids does, however, result from agonists binding to the CB1 receptor in the gut and brain stem. There has been a series of 19 patients reported that developed cyclical vomiting with chronic use of marijuana, which resolved when use ceased and returned if restarted.

However many recent studies, including a meta-analysis of over 1300 patients using various CB1 receptor agonists has demonstrated that cannabis and related compounds are equal to slightly better than conventional anti-emetics and the euphoria and associated anti-pain, pro-appetite effects make cannabis and related endocannabinoids especially useful in chemotherapy and HIV related nausea.

 

1

Regulation of nausea and vomiting by cannabinoids (abst – 2010)

http://onlinelibrary.wiley.com/doi/10.1111/j.1476-5381.2010.01176.x/abstract;jsessionid=56CED9CE51B025C161AA2E821BEC94ED.d01t01

2

Methods evaluating cannabinoid and endocannabinoid effects on gastrointestinal functions. (abst – 2006) http://www.ncbi.nlm.nih.gov/pubmed/16506408

3

Emerging role of cannabinoids in gastrointestinal and liver diseases: basic and clinical aspects (full – 2008) http://gut.bmj.com/content/57/8/1140.full

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