The role of cannabis in treatment‐resistant fibromyalgia women

Abstract

Fibromyalgia is a pain-focused syndrome involving diffuse chronic myalgia, somatization, sleep disturbances, and cognitive and functional impairments affecting approximately 3% of the general population, mostly following trauma, motor vehicle accidents, acute febrile disease, or mental illness stress. 1 Women are affected two times more than men. 2 Although extensively investigated, anatomic or pathophysiological causes for fibromyalgia are still obscure. [2][3][4] Fibromyalgia treatment includes non pharmacological, 5-9 pharmacological, or combined strategies. Non pharmacological treatment includes education, 10 cognitive therapies, [11][12][13][14][15] and passive versus active physical therapies. [16][17][18][19][20] Passive treatment modalities may include massages, acupuncture, 21 and additional alternative medicine treatments, 8,13,[22][23][24] while active physical therapies

Cannabis for the Treatment of Fibromyalgia: A Systematic Review

“…After duplicates were removed, we identified 1203 articles. After screening and assessing for eligibility, nine studies involving 564 participants were included in the systematic review [ 11 , 12 , 13 , 14 , 15 , 16 , 17 , 18 , 19 ]. ( Figure 2 ).…”

“…Of the four randomized controlled trials, two studies used a parallel design [ 18 , 19 ] and two used a crossover design [ 16 , 17 ]. Of the five observational studies, one used a crossover design [ 12 ], one used a cross-sectional design [ 11 ], and three used a prospective or retrospective design [ 13 , 14 , 15 ]. Of the eight longitudinal studies, five were short-term in duration (4 to 10 weeks), while three were intermediate-term studies (one was 16 weeks, two were 24 weeks).…”

“…Two studies focused on inhaled cannabis, with one using either smoked or vaporized cannabis [ 12 ] and the other having participants inhale it through a balloon [ 17 ]. One study selected the route of cannabis administration based on patient preferences [ 15 ]. Of the four randomized controlled trials, three compared to placebos [ 17 , 18 , 19 ], while one compared to amitriptyline [ 16 ].…”

“…This was attributed to their selection of a non-exposed cohort from a different source, and to their dependence on written self-reports to confirm exposure. All studies demonstrated moderate-to-high risk of bias pertaining to outcomes, owing to a high percentage of patients lost to follow-up [ 13 , 14 ], insufficient follow-up of cohorts [ 11 , 15 ], or inadequate assessment of outcomes [ 11 ]. Figure 1 shows the C-ROB assessment of the four included RCTs.…”

Cannabis for treating fibromyalgia

“…Fibromyalgia is a common painful condition, which can be very hard to treat with standard therapies. Hershkovich et al 1 performed a prospective study that included women with fibromyalgia. The authors enrolled 30 women and measured World Health Organization Quality of Life Bref questionnaire (WhoQoL‐bref) and pain scores before treatment with cannabis and 12 months after treatment.…”