An umbrella review of meta-analyses of randomized controlled trials and observational studies has assessed the risks and benefits of cannabis use. The review found that cannabis-based medicines increased adverse events related to the central nervous system, psychological effects, and vision in people with mixed conditions. Cannabidiol was found to be effective in reducing seizures but increased pneumonia and gastrointestinal adverse events. Cannabis-based medicines or cannabinoids were found to reduce chronic pain but increased psychological distress. The review also highlighted the harmful effects of cannabis use during adolescence and early adulthood, in people with mental health disorders, during pregnancy, and while driving. Overall, the review supports the avoidance of cannabis in certain populations and highlights the need for caution in its use.
A systematic review and individual participant data meta-analysis of randomized controlled trials (RCTs) assessing mindfulness-based programs (MBPs) for mental health promotion found that MBPs reduced average psychological distress between 1 and 6 months post-intervention with a small to moderate effect size. The study also explored whether baseline distress, gender, age, education, and dispositional mindfulness modified the effect of MBPs on distress, but no clear indications of modification were found. The results suggest that group-based teacher-led MBPs generally reduce psychological distress among volunteering community adults, but more research is needed to identify sources of variability in outcomes at an individual level.
Patients with long COVID-19 had lower levels of vitamin D than other COVID-19 survivors, particularly those with brain fog, according to a retrospective, case-matched study. The study suggests that vitamin D levels should be evaluated in COVID-19 patients after hospital discharge and that vitamin D supplementation could represent a possible preventive strategy in reducing the burden of COVID-19 sequelae. However, further randomized controlled trials are needed to establish the optimal timing and dosage of supplementation.
A systematic review and network meta-analysis of 98 randomized controlled trials involving 15,134 participants found that the comparative effectiveness and safety of analgesic medicines for acute non-specific low back pain are uncertain. Low or very low confidence was noted in evidence for reduced pain intensity after treatment with tolperisone, aceclofenac plus tizanidine, pregabalin, and 14 other medicines compared with placebo. Increased adverse events had moderate to very low confidence with tramadol, paracetamol plus sustained release tramadol, baclofen, and paracetamol plus tramadol compared with placebo. Until higher quality randomized controlled trials of head-to-head comparisons are published, clinicians and patients are recommended to take a cautious approach to manage acute non-specific low back pain with analgesic medicines.
