A double-blind trial of delta 9-tetrahydrocannabinol in primary anorexia nervosa. Blood Levels of the Endocannabinoid Anandamide are Increased in Anorexia Nervosa and in Binge-Eating Disorder, but not in Bulimia Nervosa Dronabinol in severe, enduring anorexia nervosa: a randomized controlled trial. Effect of dronabinol therapy on physical activity in anorexia nervosa: a randomised, controlled trial Comparison of orally administered cannabis extract and delta-9-tetrahydrocannabinol in treating patients with cancer-related anorexia-cachexia syndrome: a multicenter, phase III, randomized, double-blind, placebo-controlled clinical trial from the Cannabis-In-Cachexia-Study-Group. Effects of dronabinol on anorexia and disturbed behavior in patients with Alzheimer's disease. Changes in IGF-I, urinary free cortisol and adipokines during dronabinol therapy in anorexia nervosa: Results from a randomised, controlled trial. Atypical Antipsychotics as Augmentation Therapy in Anorexia Nervosa Dronabinol as a treatment for anorexia associated with weight loss in patients with AIDS. Cannabis abuse and the course of recent onset schizophrenic disorders Neuroleptics in the short-term treatment of anorexia nervosa. A double-blind placebo-controlled study with sulpiride. Course of cannabis use and clinical outcome in patients with non-affective psychosis: a 3-year follow-up study. A preliminary controlled study to determine whether whole-plant cannabis extracts can improve intractable neurogenic symptoms Salience network and olanzapine in schizophrenia: implications for treatment in anorexia nervosa. How effective and safe is medical cannabis as a treatment of mental disorders? A systematic review Increased Dopamine D2/D3 Receptor Binding After Recovery from Anorexia Nervosa Measured by Positron Emission Tomography and [11C]Raclopride Effects of the Cannabinoid-1 Receptor Antagonist Rimonabant on Psychiatric Symptoms in Overweight People With Schizophrenia: A Randomized, Double-Blind, Pilot Study
Δ9-Tetrahydrocannabinol ( Δ9-THC ) , the most prominent psychoactive cannabinoid in Cannabis sativa L. ( marijuana ) , has been reported to have properties of appetite stimulation , promotion of weight gain , and antiemetic efficacy in selected patient population s. In this 4-week , double-blind , crossover study , 11 female patients with primary anorexia nervosa ( PAN ) were evaluated on Δ9-THC and on an active placebo , diazepam . All patients participated in a st and ardized behavior modification treatment program . The following data were obtained : ( 1 ) daily weight , ( 2 ) daily caloric intake , and ( 3 ) weekly psychiatric assessment s. The two groups were comparable on all measures at baseline except for two items on the behavioral rating scales . The only significant differences found between the changes over time on Δ9-THC versus diazepam were more pathology on Δ9-THC for somatization , interpersonal sensitivity , and sleep disturbance . Three patients experienced severe dysphoric reactions consisting of paranoid ideation and feelings of loss of control during Δ9-THC administration . One week after the study ended , each subject was given the highest dose level of Δ8-THC achieved in the study , and periodic blood sample s were obtained coincident with self-rated “ subjective high ” assessment s and pulse measurements . Quantitative analyses of these sample s indicated peak times of 1 to 5 hours postdose for Δ9- THC and for its primary active metabolite , 11-hydroxy-THC , which generally coincided with peak times for “ subjective high ” and pulse rate . The results of this clinical investigation suggest that Δ9-THC is not efficacious , in short-term administration , in the treatment of primary anorexia nervosa and is associated with significant psychic disturbance in some PAN patients The endocannabinoid system , consisting of two cannabinoid receptors ( CB1 and CB2 ) and the endogenous lig and s an and amide ( arachidonoylethanolamide ( AEA ) ) and 2-arachidonoylglycerol ( 2-AG ) , has been shown to control food intake in both animals and humans , modulating either rewarding or quantitative aspects of the eating behavior . Moreover , hypothalamic endocannabinoids seem to be part of neural circuitry involved in the modulating effects of leptin on energy homeostasis . Therefore , alterations of the endocannabinoid system could be involved in the pathophysiology of eating disorders , where a deranged leptin signalling has been also reported . In order to verify this hypothesis , we measured plasma levels of AEA , 2-AG , and leptin  in 15 women with anorexia nervosa ( AN ) , 12 women with bulimia nervosa ( BN ) , 11 women with binge-eating disorder ( BED ) , and 15 healthy women .  Plasma levels of AEA result ed significantly enhanced in both anorexic and BED women , but not in bulimic patients . No significant change occurred in the plasma levels of 2-AG in all the patients ' groups . Moreover , circulating AEA levels were significantly and inversely correlated with plasma leptin concentrations in both healthy controls and anorexic women . These findings show for the first time a derangement in the production of the endogenous cannabinoid AEA in drug-free symptomatic women with AN or with BED . Although the pathophysiological significance of this alteration awaits further studies to be clarified , it suggests a possible involvement of AEA in the mediation of the rewarding aspects of the aberrant eating behaviors occurring in AN and BED OBJECTIVE The evidence for pharmacological treatment of severe , longst and ing anorexia nervosa ( AN ) is sparse and the few controlled pharmacologic studies have focused on a narrow range of drugs . The aim of the present study was to investigate the effects of treatment with a synthetic cannabinoid agonist on body weight and eating disorder-related psychopathological personality traits in women with severe , enduring AN . METHOD This add-on , prospect i ve , r and omized , double blind , controlled crossover study was conducted between 2008 and 2011 at a specialized care center for eating disorders . Twenty-five women over 18 years with AN of at least 5 years duration were r and omized to treatment with either dronabinol-placebo or placebo-dronabinol .  In addition to the st and ardized baseline therapeutic regime , the participants received dronabinol , 2.5 mg twice daily for 4 weeks and matching placebo for 4 weeks , separated by a 4-week wash-out period . Primary outcome was the mean change in body weight . Secondary outcome was score changes on the Eating Disorder Inventory-2 ( EDI-2 ) . Data were analyzed for the 24 patients who completed the trial . RESULTS During dronabinol treatment , participants gained 0.73 kg ( t = 2.86 , df = 22 , p < 0.01 ) above placebo without significant psychotropic adverse events . Dronabinol significantly predicted weight gain in a multiple linear regression including EDI-2 body dissatisfaction score and leptin . EDI-2 subscale scores showed no significant changes over time . DISCUSSION Dronabinol therapy was well tolerated . During four weeks of exposure it induced a small but significant weight gain in the absence of severe adverse events Purpose The level of physical activity is inappropriately high in up to 80 % of the patients suffering of anorexia nervosa ( AN ) , as a result of conscious efforts to lose weight , affect regulation and biological adaptive changes to starvation induced by hypothermia and neuroendocrine mechanisms . The purpose s of this paper were to ( 1 ) assess the effect of dronabinol — a synthetic cannabinoid agonist — on physical activity in patients with chronic and stable AN , and to ( 2 ) unravel the role of leptin and cortisol in this process . Methods This prospect i ve , r and omised , double-blind , crossover study was conducted at a specialised care centre for eating disorders . Twenty-four adult women with AN of at least 5-year duration received either the dronabinol-placebo or placebo-dronabinol sequence .  Physical activity was monitored during the fourth week of each intervention . Body weight , leptin and urinary free cortisol excretion were measured repeatedly during the trial . Changes in behavioural dimensions related to AN were assessed by Eating Disorder Inventory-2 . Results The total duration of physical activity did not change , while its average intensity increased by 20 % ( P = 0.01 ) during dronabinol therapy , result ing in an increased energy expenditure with 68.2 kcal/day ( P = 0.01 ) above placebo . Conclusions This r and omised , double-blind study revealed that cannabinoid agonist treatment was associated with a modest increase in physical activity in adult women with severe and longst and ing AN . Additionally , we detected a strong relationship between the circulating levels of leptin and physical activity in these chronically undernourished patients PURPOSE To compare the effects of cannabis extract ( CE ) , delta-9-tetrahydrocannabinol ( THC ) , and placebo ( PL ) on appetite and quality of life ( QOL ) in patients with cancer-related anorexia-cachexia syndrome ( CACS ) . PATIENTS AND METHODS Adult patients with advanced cancer , CACS , weight loss ( > or = 5 % over 6 months ) , and Eastern Cooperative Oncology Group ( ECOG ) performance status ( PS ) < or = 2 were r and omly assigned ( 2:2:1 ) to receive CE ( st and ardized for 2.5 mg THC and 1 mg cannabidiol ) or THC ( 2.5 mg ) or PL orally , twice daily for 6 weeks . Appetite , mood , and nausea were monitored daily with a visual analog scale ( VAS ) ; QOL was assessed with the European Organisation for Research and Treatment of Cancer Quality of Life Question naire C30 ( composite score : questions 29 and 30 ) . Cannabinoid-related toxicity was assessed every 2 weeks . RESULTS Of 289 patients screened , 243 were r and omly assigned and 164 ( CE , 66 of 95 patients ; THC , 65 of 100 patients ; and PL , 33 of 48 patients ) completed treatment . At baseline , groups were comparable for age ( mean , 61 years ) , sex ( 54 % men ) , weight loss ( 32 % > or = 10 % ) , PS ( 13 % ECOG = 2 ) , antineoplastic treatment ( 50 % ) , appetite ( mean VAS score , 31/100 mm ) , and QOL ( mean score , 30/100 ) . Intent-to-treat analysis showed no significant differences between the three arms for appetite , QOL , or cannabinoid-related toxicity . Increased appetite was reported by 73 % , 58 % , and 69 % of patients receiving CE , THC , or PL , respectively . An independent data review board recommended termination of recruitment because of insufficient differences between study arms . CONCLUSION CE at the oral dose administered was well tolerated by these patients with CACS . No differences in patients ' appetite or QOL were found either between CE , THC , and PL or between CE and THC at the dosages investigated A placebo-controlled crossover design , with each treatment period lasting 6 weeks , was used to investigate effects of dronabinol in 15 patients with a diagnosis of probable Alzhemer 's disease who were refusing food . Eleven patients completed both study periods ; one patient who died of a heart attack 2 weeks before the end of the study was also included in the analysis . The study was terminated in 3 patients : one developed a gr and mal seizure and 2 developed serious intercurrent infections . Body weight of study subjects increased more during the dronabinol treatment than during the placebo periods . Dronabinol treatment decreased severity of disturbed behavior and this effect persisted during the placebo period in patients who received dronabinol first . Adverse reactions observed more commonly during the dronabinol treatment than during placebo periods included euphoria , somnolence and tiredness , but did not require discontinuation of therapy . These results indicate that dronabinol is a promising novel therapeutic agent which may be useful not only for treatment of anorexia but also to improve disturbed behavior in patients with Alzheimer 's disease OBJECTIVE Anorexia nervosa ( AN ) is characterised by complex neuroendocrine disturbances due to severe underweight , physical hyperactivity and purging behaviour . Cannabinoid agonists are used to palliate cachexia of various causes , but their interactions with the hormonal systems that are involved in energy metabolism have not been previously described in humans . Therefore we found it of interest to assess interactions between the synthetic cannabinoid agonist dronabinol and insulin-like growth factor I ( IGF-I ) , urinary free cortisol ( UFC ) and adipokines in patients with chronic AN . DESIGN This was a prospect i ve , double-blind r and omised crossover study , conducted at a specialised care centre for eating disorders . The results are based on twenty-four adult women with chronic AN , who completed the study . The participants received dronabinol ( oral capsules , 5 mg daily ) and matching placebo over four weeks , separated by a four-week washout period . Bioactive IGF was determined by a cell-based bioassay , whereas total IGF-I , IGFBP-2 and -3 and the two adipokines leptin and adiponectines were measured by immunoassays . The UFC excretion was determined by mass spectrometry . RESULTS As previously reported , dronabinol treatment caused a small , yet significant increase in BMI as compared to placebo ( + 0.23 kg/m(2 ) ; P = 0.04 ) . This modest weight gain predicted a corresponding increase in bioactive IGF-I , while the amount of daily energy expenditure due to physical activity had a comparable but opposite effect . Nevertheless , neither IGF-I , bioactive IGF nor the IGFBPs levels changed significantly during dronabinol intervention as compared to placebo . Adiponectin also remained unaffected by the weight gain , whereas plasma leptin showed a transient increase at three weeks ( P < 0.05 ) . UFC levels were decreased during dronabinol intervention . CONCLUSION Our results showed that low-dosage therapy with the synthetic cannabinoid agonist dronabinol affected neither the concentration nor the activity of the circulating IGF-system in women with severe and chronic AN . However , our results suggest that such treatment may alleviate the increased hypothalamic-pituitary-adrenal axis activity seen in these patients Anorexia nervosa ( AN ) is a life-threatening and difficult to treat mental illness with the highest mortality rates of any psychiatric disorder . We aim ed to garner preliminary data on the real-world use of olanzapine and aripiprazole as augmentation agents of Selective Serotonin Reuptake Inhibitors ( SSRIs ) in adult in patients affected by AN . We retrospectively evaluated the clinical charts of patients who were hospitalized between 2012 and 2014 . Patients were evaluated upon admission and discharge . We investigated eating symptomatology , and both general and eating psychopathology using : Hamilton Rating Scale for Anxiety , Hamilton Rating Scale for Depression , and Yale-Brown-Cornell Eating Disorders Scale .  The charts of 75 patients were included in this study . The sample result ed equally distributed among those receiving SSRIs and either aripiprazole or olanzapine in addition to SSRIs . Notwithst and ing a few baseline clinical differences , upon discharge all groups were significantly improved on all measures . Interestingly , aripiprazole showed the greatest effectiveness in reducing eating-related preoccupations and rituals with a large effect size . The body of evidence on medication management in AN is in dismal condition . Augmentation therapy is a well-established approach to a variety of mental disorders and it is often used in every-day clinical practice with patients affected by AN as well . Nevertheless , to date very little data is available on this topic . Results from our sample yielded promising results on the effectiveness of aripiprazole augmentation in reducing eating-related obsessions and compulsions . R and omized controlled trials are warranted to confirm these encouraging findings The effects of dronabinol on appetite and weight were evaluated in 139 patients with AIDS-related anorexia and > or = 2.3 kg weight loss in a multi-institutional study . Patients were r and omized to receive 2.5 mg dronabinol twice daily or placebo . Patients rated appetite , mood , and nausea by using a 100-mm visual analogue scale 3 days weekly . Efficacy was evaluable in 88 patients . Dronabinol was associated with increased appetite above baseline ( 38 % vs 8 % for placebo , P = 0.015 ) , improvement in mood ( 10 % vs -2 % , P = 0.06 ) , and decreased nausea ( 20 % vs 7 % ; P = 0.05 ) . Weight was stable in dronabinol patients , while placebo recipients had a mean loss of 0.4 kg ( P = 0.14 ) . Of the dronabinol patients , 22 % gained > or = 2 kg , compared with 10.5 % of placebo recipients ( P = 0.11 ) . Side effects were mostly mild to moderate in severity ( euphoria , dizziness , thinking abnormalities ) ; there was no difference in discontinued therapy between dronabinol ( 8.3 % ) and placebo ( 4.5 % ) recipients . Dronabinol was found to be safe and effective for anorexia associated with weight loss in patients with AIDS OBJECTIVE We sought to examine the relation between cannabis abuse and the symptomatic course of recent-onset schizophrenia and related disorders . DESIGN A prospect i ve cohort study over a year using monthly Brief Psychiatric Rating Scale assessment s. PARTICIPANTS  Cannabis-abusing patients ( n = 24 ) were compared with nonabusers ( n = 69 ) . Eleven patients were mild and 13 were heavy cannabis-abusing patients . RESULTS Significantly more and earlier psychotic relapses occurred in the cannabis-abusing group ( P = .03 ) . This association became stronger when mild and heavy cannabis abuse were distinguished ( P = .002 ) . No confounding effect of other variables , eg , other street drugs , was found . In all but one patient , cannabis abuse preceded the onset of the first psychotic symptoms for at least 1 year . CONCLUSIONS Cannabis abuse and particularly heavy abuse can be considered a stressor eliciting relapse in patients with schizophrenia and related disorders and possibly a premorbid precipitant There is a remarkable lack of controlled investigations about the usefulness of psychotropic drugs in anorexia nervosa despite the popular use of neuroleptics in these patients . Inspired by a previous study using pimozide , a double-blind placebo-controlled cross-over study with sulpiride was carried out in 18 female anorexia nervosa in patients . No direct effect of sulpiride has been established with regard to behavioural and attitudinal characteristics as measured by behaviour observation scales as well as by two self-report question naires ( Eating Attitudes Test , Body Attitudes Test ) . Regarding daily weight gain , sulpiride was on the whole superior to placebo , especially in the first treatment period of three weeks . In the cross-over analysis , however , this effect did not reach statistical significance BACKGROUND Prospect i ve studies on the relationship between course of cannabis use and clinical outcome in patients with non-affective psychotic disorders are inconclusive . The current study examined whether ( 1 ) persistent , recently started , discontinued and non-cannabis-using patients with a psychotic disorder differed with regard to illness outcome at 3-year follow-up , and ( 2 ) whether timing of cannabis discontinuation was associated with course of clinical outcome . METHOD This 3-year follow-up study was part of a multi-center study in the Netherl and s and Belgium ( Genetic Risk and Outcome of Psychosis ; GROUP ) . We used mixed-model analyses to investigate the association between pattern of cannabis use and symptoms , global functioning and psychotic relapse . RESULTS In our sample of 678 patients , we found persistent users to have more positive and general symptoms , worse global functioning and more psychotic relapses compared with non-users and discontinued users [ Positive and Negative Syndrome Scale ( PANSS ) positive , p < 0.001 ; PANSS general , p < 0.001 ; Global Assessment of Functioning ( GAF ) symptoms , p = 0.017 ; GAF disability , p < 0.001 ; relapses , p = 0.038 ] . Patients who started using cannabis after study onset were characterized by worse functioning at baseline and showed an increase in general symptoms ( including depression and anxiety ) at the 3-year follow-up ( p = 0.005 ) . Timing of cannabis discontinuation was not associated with clinical outcome . CONCLUSIONS These findings suggest that cannabis use in patients with a psychotic disorder has a long-lasting negative effect on illness outcome , particularly when persistent . Treatment should focus on discouraging cannabis use Objectives : To determine whether plant-derived cannabis medicinal extracts ( CME ) can alleviate neurogenic symptoms unresponsive to st and ard treatment , and to quantify adverse effects . Design : A consecutive series of double-blind , r and omized , placebo-controlled single-patient cross-over trials with two-week treatment periods . Setting : Patients attended as out patients , but took the CME at home . Subjects : Twenty-four patients with multiple sclerosis ( 18 ) , spinal cord injury ( 4 ) , brachial plexus damage ( 1 ) , and limb amputation due to neurofibromatosis ( 1 ) . Intervention : Whole-plant extracts of delta-9-tetrahydrocannabinol ( THC ) , cannabidiol ( CBD ) , 1:1 CBD : THC , or matched placebo were self-administered by sublingual spray at doses determined by titration against symptom relief or unwanted effects within the range of 2.5–120 mg/24 hours . Measures used : Patients recorded symptom , well-being and intoxication scores on a daily basis using visual analogue scales . At the end of each two-week period an observer rated severity and frequency of symptoms on numerical rating scales , administered st and ard measures of disability ( Barthel Index ) , mood and cognition , and recorded adverse events . Results : Pain relief associated with both THC and CBD was significantly superior to placebo . Impaired bladder control , muscle spasms and spasticity were improved by CME in some patients with these symptoms . Three patients had transient hypotension and intoxication with rapid initial dosing of THC-containing CME . Conclusions : Cannabis medicinal extracts can improve neurogenic symptoms unresponsive to st and ard treatments . Unwanted effects are predictable and generally well tolerated . Larger scale studies are warranted to confirm these findings UNLABELLED The salience network ( SN ) , a set of brain regions composed of the anterior fronto-insular cortex ( aFI ) and the anterior cingulate cortex ( ACC ) , is usually involved in interoception , self-regulating , and action selection . Accumulating evidence indicates that dysfunctions in this network are associated with various pathophysiological deficits in both schizophrenia and eating disorders , stemming mainly from dysfunctional information processing of internal or external stimuli . In addition , the metabolic side effects of some antipsychotics ( APs ) , as well as their pharmacological mechanisms of action , also suggest a link between the functional and neurophysiological changes in the brain in both schizophrenia and in eating disorders . Nevertheless , there is still a knowledge gap in explicitly and directly linking the metabolic side effects associated with AP treatment with the dysfunction in SN associated with processing of food-related information in schizophrenia . Here we provide neuroimaging evidence for such a link , by presenting data on a group of schizophrenia patients who followed 16 weeks of olanzapine treatment and undertook a passive viewing task while their brain activity was recorded . In response to food-related dynamic stimuli ( video clips ) , we observed a decreased activity in SN ( aFI and ACC ) after the treatment , which also correlated with ghrelin plasma concentration and a measure of dietary restraint . Taken together with past findings regarding the role of SN in both schizophrenia and eating disorders , our results suggest that enhancing the reactivity in the SN has the potential to be a treatment strategy in people with anorexia nervosa . CLINICAL TRIAL REGISTRATION NUMBER NCT 00290121 We conducted a review of systematic review s ( SRs ) and r and omized-controlled trials ( RCTs ) to analyze efficacy and safety of cannabis-based medication in patients with mental disorders . Five data bases were systematic ally search ed ( 2006—August 2018 ) ; 4 SRs ( of 11 RCTs ) and 14 RCTs ( 1629 participants ) were included . Diagnoses were : dementia , cannabis and opioid dependence , psychoses/schizophrenia , general social anxiety , posttraumatic stress disorder , anorexia nervosa , attention-deficit hyperactivity disorder , and Tourette`s disorder . Outcome variables were too heterogeneous to conduct a meta- analysis . A narrative synthesis method was applied . The study quality was assessed using the risk-of-bias tool and SIGN-checklists . THC- and CBD-based medicines , given as adjunct to pharmaco- and psychotherapy , were associated with improvements of several symptoms of mental disorders , but not with remission . Side effects occurred , but severe adverse effects were mentioned in single cases only . In order to provide reliable treatment recommendations , more and larger RCTs with follow-up assessment s , consistent outcome measures and active comparisons are needed BACKGROUND Several lines of evidence support the possibility that disturbances of dopamine ( DA ) function could contribute to alterations of weight , feeding , motor activity , and reward in anorexia nervosa ( AN ) . METHODS To assess possibly trait-related disturbances but avoid confounding effects of malnutrition , 10 women who were recovered from AN ( REC AN ) were compared with 12 healthy control women ( CW ) .  Positron emission tomography with [(11)C]raclopride was used to assess DA D2/D3 receptor binding . RESULTS The women who were recovered from AN had significantly higher [(11)C]raclopride binding potential in the antero-ventral striatum than CW . For REC AN , [(11)C]raclopride binding potential was positively related to harm avoidance in the dorsal cau date and dorsal putamen . CONCLUSIONS These data lend support for the possibility that decreased intrasynaptic DA concentration or increased D2/D3 receptor density or affinity is associated with AN and might contribute to the characteristic harm avoidance or increased physical activity found in AN . Most intriguing is the possibility that individuals with AN might have a DA related disturbance of reward mechanisms contributing to altered hedonics of feeding behavior and their ascetic , anhedonic temperament Weight gain is a major adverse effect of several second-generation antipsychotic medications . Rimonabant is a cannabinoid-1 receptor antagonist that promotes weight loss in the general population . We conducted a 16-week , double-blind , placebo-controlled study of rimonabant ( 20 mg/d ) in people with schizophrenia or schizoaffective disorder , based on the Diagnostic and Statistical Manual of Mental Disorders , Fourth Edition criteria , who were clinical ly stable on second-generation antipsychotics . Participants had a body mass index of 27 kg/m2 or higher with hyperlipidemia or body mass index of 30 kg/m2 or higher , and no current substance abuse/dependence ( except nicotine ) , more than weekly cannabis use , or recent depressive symptoms/suicidality . An exercise and dietary counseling group was offered weekly . Target enrollment was 60 ; the trial was terminated early because of withdrawal of rimonabant from the European market . Fifteen participants were r and omized ( 7 rimonabant  , 8 placebo ) ; 5 completed in each group . Rimonabant was associated with a greater reduction in Brief Psychiatric Rating Scale total score  versus placebo ( mean ± SE difference , −1.9 ± 0.8 , P = 0.02 ) , driven by differences in the Brief Psychiatric Rating Scale anxiety/depression ( −1.4 ± 0.35 , P = 0.0004 ) and hostility ( −0.7 ± 0.3 , P = 0.02 ) factors . Group differences were not significant for the Calgary Depression Scale total score ( P = 0.24 ) , Scale for the Assessment of Negative Symptoms total score ( P = 0.13 ) , weight , blood pressure , or fasting lipids or glucose . Rimonabant was well tolerated with no significant adverse events . No significant weight loss , metabolic effects , or adverse psychiatric effects were associated with the cannabinoid-1 receptor antagonist rimonabant in this small sample of people with schizophrenia . The endocannabinoid system remains a promising target for pharmacotherapy of schizophrenia and obesity
The only properly design ed , low bias and highly powered study found a weight increasing effect  of dronabinol in AN , while the other , using Δ9-THC at a high dose , found no effect and where the dose may have counteracted the weight gaining effects due to adverse events .
Anorexia nervosa ( AN ) is a psychiatric disorder with a high mortality and unknown etiology , and effective treatment is lacking .
For decades , cannabis has been known to cause physical effects on the human body , including increasing appetite , which may be beneficial in the treatment of AN .
To systematic ally review the literature for evidence of an effect of cannabinoids on ( 1 ) weight gain , and ( 2 ) other outcomes , in AN .