Impact of Dronabinol and Marijuana in Patients With HIV

Marijuana use for medical purposes is controversial. The oral form of dronabinol, the active ingredient in marijuana, is approved by the FDA to treat anorexia in patients with AIDS and for prophylaxis against nausea and vomiting in patients about to receive chemotherapy.

Researchers sought to assess the effects of oral dronabinol (5 and 10 mg 4 times per day) and smoked marijuana (2% and 3.9% THC 4 times per day) on appetite, mood, cognition, and sleep in 10 people with HIV. Each subject experienced all of the cannabinoid conditions plus a placebo condition.

• Both oral dronabinol (10 mg only) and smoked marijuana, versus placebo, produced intoxication and positive subjective effects (e.g., feeling mellow).
• Neither oral dronabinol nor smoked marijuana, at any concentration, impaired cognitive performance.
• Both oral dronabinol and smoked marijuana, versus placebo, increased daily caloric intake. The higher concentrations of both dronabinol and smoked marijuana also increased body weight.
• The higher concentration of marijuana improved sleep ratings.

Comments:

This study found similar effects of dronabinol and marijuana on caloric intake and weight in patients with HIV. The increases in weight were seen within 4 days of starting the dronabinol or marijuana. It is important to note that the dose of dronabinol used in this study was 8 times the standard recommendations. These findings provide support for the use of dronabinol for improving appetite and weight but at doses that caused intoxication.

David A. Fiellin, MD

Reference:

Haney M, Gunderson EW, Rabkin J, et al. Dronabinol and marijuana in HIV-positive marijuana smokers: caloric intake, mood, and sleep. J Acquir Immune Defic Syndr. 2007;45(5):545–554.