“The benefit of treatment with cannabinoids for a number of medical indications has been shown in controlled trials in which predominantly standardized and/or synthetic cannabinoid preparations were used. The use of such preparations may therefore be reasonable for patients in whom conventional treatment does not achieve adequate relief of symptoms such as spasticity, pain, nausea, vomiting, or loss of appetite”
In principle, physicians of any discipline without additional qualifications can prescribe dronabinol (prepacked or individually mixed), nabilone, and the cannabis extract, even beyond the licensed indications (off-label), to any individual patient. The most frequent off-label uses of cannabis-based medications are as follows:
- In palliative medicine, to increase appetite and alleviate nausea
- To treat chronic pain (often together with opiates)
- To treat spasticity of causes other than MS (e.g., in paraplegic patients)
- To treat tics in patients with Tourette syndrome.
Off-label treatment with cannabinoid medications is difficult in everyday clinical practice, however, because statutory health insurers usually refuse to assume the costs. To avoid possible subsequent recourse claims, the question of assumption of costs should therefore be clarified with the relevant insurer before writing a prescription. A private prescription, where the patient will bear the costs, can be issued at any time.
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