Prescribing Patterns, Safety and Effects of Suk Sai-Yad Thai Traditional Medicine Formula on Patients’ Quality of Life
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Abstract
Suk Sai-Yad formula is a Thai traditional medicine (TTM) formula containing cannabis recorded in the Royal Scripture of King Narai’s Traditional Medicine. This formula containing 15.38% of cannabis leaves is recommended by the Department of Thai Traditional and Alternative Medicine and the Thai Traditional Medicinal Council for the treatment of patients with insomnia and loss of appetite. In the past, although cannabis was used as an ingredient in TTM remedies for a long time, when cannabis was classified as a schedule 5 narcotic under Thailand’s Narcotics Act B.E. 2522 (1979), medical use of cannabis-containing TTM preparations became illegal. Moreover, research and scientific evidence on its efficacy, safety, and patterns of use was also limited. This study aimed to determine prescribing patterns, adverse events, and quality of life of patients receiving Suk Sai-Yad formula. Therefore, a retrospective cohort study using a patient record review was conducted on patients visiting the Medical Cannabis Clinic at the Thai Traditional and Integrated Medicine Hospital for at least two visits from October 2019 to December 2020 and having follow-up treatment every month. A total of 138 patients (61.59% males and mean age 56.81 ± 15.51 years) participated in the study. The formula was prescribed for insomnia (87.68%), headache (7.97%), and other indications (4.35%) including loss of appetite, numbness and Parkinson’s disease. The initial doses were 0.5–2.0 g/day and the most prescribed initial dosage regimen was 1 g once a day (52.90%). Common maintenance doses prescribed were 2.0 g/day (44.18%) and 1.0 g/day (40.70%). Fifteen patients discontinued medication because of drug ineffectiveness. Researchers observed 31 adverse events in 23 patients, namely gastrointestinal irritation (7.97%), dizziness/headache (5.79%), dry mouth and dry throat (4.34%). Sixteen patients (11.59%) discontinued medication because of adverse effects. The quality of life measured using the EQ-5D-5L self-assessed questionnaire indicated that the average utility was 0.95 ± 0.11 at treatment initiation and 0.98 ± 0.05 (P < .001) after 3-month treatment. In conclusion, it was found that despite a few non-serious adverse effects, Suk Sai-Yad formula is a safe and effective alternative medication that can improve the quality of life for patients with insomnia.
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