The Adverse effects of medicinal phytocannabinoids in adults: an updated overview

Abstract

Phytocannabinoids, compounds from Cannabis sativa, have stood out for their therapeutic potential in conditions such as chronic pain, multiple sclerosis and epilepsy. Despite the benefits, it is essential to understand the adverse effects of these compounds, both isolated and in complete extracts, to maximize therapeutic benefits. This review aims to synthesize evidence on the adverse effects of phytocannabinoids in adults, guiding clinical practice and future research.

Following guidelines from the Joanna Briggs Institute and Cochrane Collaboration, a systematic review was conducted, with searches in the PubMed, Web of Science and Embase databases. Systematic reviews of clinical studies that evaluated adverse effects of the use of oral phytocannabinoids in adults were included. Data extraction was carried out in Microsoft Excel, covering information on reported adverse effects and the methodological quality of the studies. This review was registered on the Prospero platform CRD42024555180.

474 articles were retrieved, of which 8 were included in the final synthesis. The most common adverse effects were observed in the central nervous system (45%), gastrointestinal system (40%), and respiratory system (15%). Diarrhea, nausea, headache and sedation were frequently reported, with 96% of effects considered mild. Comparing complete extracts and isolated CBD, it was observed that the former were associated with adverse effects such as dyspnea, while CBD did not present such effects.

It is concluded that the adverse effects of phytocannabinoids, although common, are generally mild, reinforcing their safety in the treatment of various pathologies. There is a need for more studies to fully understand the effects of complete extracts, which can improve clinical and research decisions.