Table 1.

Summary of acute and long-term clinical side-effects of cannabinoid-based drugs.

Symptoms	Type of effect+	Type of drug
		Synthetic Cannabinoids	Cannabis
Neuropsychiatric	Acute	Severe psychotic symptoms including; agitation (28), aggression, catatonia, paranoia, auditory and visual hallucinations, perceptual alterations, and persistent psychosis episode (10, 14, 29).	Perceptual alterations including; hallucinations and distortion of spatial perception are typical effects (7, 30). Paranoia, aggressiveness, and prolonged psychosis were observed in vulnerable users and are dose-related (1, 2, 7).
	Long-term	Chronic use may increase the risk for developing psychotic disorders (15, 27, 31).	An increased risk of psychotic disorders in vulnerable individuals and naïve users (2, 25, 27, 32).
Affect	Acute	Negative mood, panic attacks, manic behavior (13), depression (16), and suicidal ideation (10, 33).	Anxiety and panic attacks; especially in naïve users (1).
	Long-term	Depression (16), irritability and persistent anxiety (29, 33).	An increased risk for developing anxiety (34, 35), and mood disorders (1, 36, 37).
Cognitive	Acute	Severe cognitive impairments including; memory alteration, attention difficulties, and amnesia (13, 33).	Wide range of dose-related cognitive deficits including; attention, working-memory, cognitive inhibition, and psychomotor function (38–41).
	Long-term	Executive function deficits of working memory and attention (16)	Impairments of set-shifting, verbal learning, attention, short-term memory and psychomotor functions (39, 42).
Cardiovascular	Acute	Tachycardia, hypertension, myocardial infraction, arrhythmias, chest pain, and palpitations (13, 43).	An increase of cardiovascular activity, increase heart rate, and decrease blood pressure (44, 40).
	Long-term	Prolong use may increase risk of cardiovascular disease (44, 45).	An increased risk of cardiovascular disease after prolong use (1, 44, 46).
Neurologic	Acute	Dizziness, somnolence, seizures, hypertonicity, hyperflexion, hyperextension, sensation changes, and fasciculations (10, 14, 29).	Dizziness, somnolence, and muscle tension (38, 40).
	Long-term	Preliminary evidence for structural and functional central nervous system alterations (47, 48).	Structural and functional abnormalities in a range of brain areas including the hippocampus and amygdala (49, 50).
Gastrointestinal	Acute	Nausea, emesis, and appetite change (10, 14, 20, 29).	Hyperemesis, and increase appetite (1, 7, 20).
	Long-term	Severe weight-loss after prolong use (10, 13).	Low body weight among regular users (51).
Other	Acute	Acute kidney injury, abdominal pain, miosis, mydriasis, xerostomia, hyperthermia, fatigue, rhabdomyolysis, cough (11, 13, 43), deficits of driving ability (52, 53, 54).	Bronchodilation (55), impairments of driving ability (1, 7).
	Long-term	Kidney diseases, insomnia, nightmares, dependency, tolerance, and withdrawal (11, 13, 43).	An increased risk of obstructive lung disease including lung-cancer (1, 7, 55), an increased risk of cancers of the oral cavity, pharynx and esophagus (56), cannabis addiction, tolerance, and withdrawal (1, 7).

⁺Acute effect denotes 0–6 h after last drug use; Long-term effects denotes 3 weeks or longer after last drug use.