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Abstract
Dronabinol effects on weight in patients with HIV infection
Weight loss is a major characteristic of symptomatic HIV infection and appears to be a prognostic factor in death from AIDS. Anecdotally, smoking marijuana has been noted to cause appetite stimulation in uninfected subjects. In addition, some AIDS patients who smoke marijuana have noted improved appetite and weight stabilization or gain. In controlled studies in normal volunteers and cancer patients, dronabinol has been noted to cause weight gain and increase appetite. We therefore treated 12 symptomatic HIV-infected patients with dronabinol in an attempt to improve appetite and control weight loss.
Patients were treated with dronabinol (Marinol, Roxane Laboratories, Columbus, Ohio, USA) at a starting dose of 2.5 mg orally three times daily. Doses, which were adjusted to minimize side-effects while stimulating appetite, ranged from 2.5 mg twice daily to 5 mg four times daily. Most patients were continuing treatment at the time of this analysis; the median duration of treatment was >= 12 weeks (range, > 4 to >20 weeks).
All patients tolerated therapy well. They were able to adjust the medication dose to avoid unwanted THC side-effects, such as sedation and persistent euphoria. No patient discontinued therapy because of side-effects. Seven of the patients gained weight while on therapy and two others lost less than they had prior to therapy. Both patients who had previously received megestrol gained weight on dronabinol. The patient concurrently on megestrol lost weight, but slightly less rapidly than before starting dronabinol. While no formal measurements of body composition were performed, there was no clinical evidence that weight gain was due to fluid retention.
Source: Clinical Studies and Case Reports
Dronabinol effects on weight in patients with HIV infection
Weight loss is a major characteristic of symptomatic HIV infection and appears to be a prognostic factor in death from AIDS. Anecdotally, smoking marijuana has been noted to cause appetite stimulation in uninfected subjects. In addition, some AIDS patients who smoke marijuana have noted improved appetite and weight stabilization or gain. In controlled studies in normal volunteers and cancer patients, dronabinol has been noted to cause weight gain and increase appetite. We therefore treated 12 symptomatic HIV-infected patients with dronabinol in an attempt to improve appetite and control weight loss.
Patients were treated with dronabinol (Marinol, Roxane Laboratories, Columbus, Ohio, USA) at a starting dose of 2.5 mg orally three times daily. Doses, which were adjusted to minimize side-effects while stimulating appetite, ranged from 2.5 mg twice daily to 5 mg four times daily. Most patients were continuing treatment at the time of this analysis; the median duration of treatment was >= 12 weeks (range, > 4 to >20 weeks).
All patients tolerated therapy well. They were able to adjust the medication dose to avoid unwanted THC side-effects, such as sedation and persistent euphoria. No patient discontinued therapy because of side-effects. Seven of the patients gained weight while on therapy and two others lost less than they had prior to therapy. Both patients who had previously received megestrol gained weight on dronabinol. The patient concurrently on megestrol lost weight, but slightly less rapidly than before starting dronabinol. While no formal measurements of body composition were performed, there was no clinical evidence that weight gain was due to fluid retention.
Source: Clinical Studies and Case Reports
