624 Benefits of an Add‐on Treatment With the Synthetic Cannabinomimetic Nabilone on Patients With Chronic Pain‐a Randomized Controlled Trial

Pinsger, Martin; Schimetta, Wolfgang; Volc, Dieter; Hiermann, E.; Riederer, Franz; Pölz, Werner

doi:10.1016/s1090-3801(06)60627-7

Cited by 32 publications

(48 citation statements)

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“…However, the authors noted that a small number of subjects responded well to nabilone and side-effects were generally mild and in the expected range 166. Benefits of an add-on treatment with nabilone have nonetheless been noted in patients with chronic therapy-resistant pain (observed in causal relationship with a pathological status of the skeletal and locomotor system) 167. Oral dronanbinol produced significant pain relief versus placebo when combined with opioid therapy in both a double-blind, placebo-controlled crossover phase and a subsequent open-label extension 168.…”

Section: Cannabinoid Modulation Of Neuropathic Pain In Clinical Studiesmentioning

confidence: 99%

Cannabinoids as Pharmacotherapies for Neuropathic Pain: From the Bench to the Bedside

2009

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Summary:Neuropathic pain is a debilitating form of chronic pain resulting from nerve injury, disease states, or toxic insults. Neuropathic pain is often refractory to conventional pharmacotherapies, necessitating validation of novel analgesics. Cannabinoids, drugs that share the same target as ⌬ 9 -tetrahydrocannabinol (⌬ 9 -THC), the psychoactive ingredient in cannabis, have the potential to address this unmet need. Here, we review studies evaluating cannabinoids for neuropathic pain management in the clinical and preclinical literature. Neuropathic pain associated with nerve injury, diabetes, chemotherapeutic treatment, human immunodeficiency virus, multiple sclerosis, and herpes zoster infection is considered. In animals, cannabinoids attenuate neuropathic nociception produced by traumatic nerve injury, disease, and toxic insults. Effects of mixed cannabinoid CB 1 /CB 2 agonists, CB 2 selective agonists, and modulators of the endocannabinoid system (i.e., inhibitors of transport or degradation) are compared. Effects of genetic disruption of cannabinoid receptors or enzymes controlling endocannabinoid degradation on neuropathic nociception are described. Specific forms of allodynia and hyperalgesia modulated by cannabinoids are also considered. In humans, effects of smoked marijuana, synthetic ⌬ 9 -THC analogs (e.g., Marinol, Cesamet) and medicinal cannabis preparations containing both ⌬ 9 -THC and cannabidiol (e.g., Sativex, Cannador) in neuropathic pain states are reviewed. Clinical studies largely affirm that neuropathic pain patients derive benefits from cannabinoid treatment. Subjective (i.e., rating scales) and objective (i.e., stimulusevoked) measures of pain and quality of life are considered. Finally, limitations of cannabinoid pharmacotherapies are discussed together with directions for future research.

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Section: Cannabinoid Modulation Of Neuropathic Pain In Clinical Studiesmentioning

confidence: 99%

Cannabinoids as Pharmacotherapies for Neuropathic Pain: From the Bench to the Bedside

2009

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“…Furthermore, Pinsger et al 4 found that among 30 patients with spinal pain taking conventional treatments, the pain intensity ratings and quality of life scores both improved during cannabinoid use (compared with crossover to placebo) and when allowed to blindly switch to their preferred drug at the end of the crossover, more than 85% favoured nabilone.…”

Section: Discussionmentioning

confidence: 99%

The use of cannabinoids in chronic pain

Reynolds

Osborn

2013

BMJ Case Reports

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SUMMARYWe present the case of a 56-year-old man who developed chronic pain following the excision of a facial cancer that was poorly controlled despite multiple analgesic medications. Following the starting of nabilone (a synthetic cannabinoid) his pain control was greatly improved and this had a huge impact on his quality of life. We also managed to significantly reduce his doses of opioid analgesia and ketamine. We review the current literature regarding the medicinal use of cannabinoids, with an emphasis on chronic pain, in an attempt to clarify their role and how to select patients who may benefit from this treatment. BACKGROUND

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“…Berman et al (Berman et al, 2004) found that Sativex and GW-2000-02 (a cannabis extract containing mostly THC; GW Pharmaceuticals) reduced pain from brachial plexus avulsion for patients with pain refractory to other analgesics, while Sativex has shown further promise in treating allodynia in neuropathic pain syndromes of varying origin (Nurmikko et al, 2007). Pinsger et al (Pinsger et al, 2006), and Berlach et al (Berlach et al, 2006) have both tested whether nabilone can control chronic pain, and found a statistically significant decrease in pain, with side effects generally mild. Ajulemic acid, a synthetic analogue of an active metabolite of THC, was found to reduce neuropathic pain in a study by Kaarst et al (Karst et al, 2003).…”

Section: Neuropathic Painmentioning

confidence: 99%