Are oral cannabinoids safe and effective in refractory neuropathic pain?
Abstract
Although cannabinoids have anti-hyperalgesic effects in animal models of nerve injury, there are currently very few prospective trials of the efficacy of cannabinoids in neuropathic pain in humans. This open label prospective study investigated the safety, tolerability and analgesic benefit of oral Delta-9-tetrahydrocannabinol (THC) titrated to a maximal dosage of 25 mg/day in 8 consecutive patients with chronic refractory neuropathic pain. Spontaneous ongoing and paroxysmal pain, allodynia and paresthesias were assessed. The sensory and affective components of pain using the McGill pain questionnaire, quality of life, mood, anxiety and functionality were also evaluated. Seven patients suffered from side effects necessitating premature arrest of the drug in 5 of them. THC (mean dosage: 16.6+/-6.5 mg/day) did not induce any significant effects on ongoing and paroxysmal pain, allodynia, quality of life, anxiety/depression scores and functional impact of pain. These results do not support an overall benefit of THC in pain and quality of life in patients with refractory neuropathic pain.
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The mean dose was 16.6 ± 6.5 mg oral dronabinol in one study and 15 ± 6 mg in the other study.
“The mean dose was 16.6 ± 6.5 mg oral dronabinol in one study164 and 15 ± 6 mg in the other study.165”
From Cannabinoids as Pharmacotherapies for Neuropathic Pain: From the Bench to the Bedside (2009) · cites this paper as [164]
The authors are aware of only two clinical studies that have failed to report efficacy of cannabinoids, relative to placebo, for treatment of mixed neuropathic pain.
“We are aware of only two clinical studies that have failed to report efficacy of cannabinoids, relative to placebo, for treatment of mixed neuropathic pain.164, 165”
From Cannabinoids as Pharmacotherapies for Neuropathic Pain: From the Bench to the Bedside (2009) · cites this paper as [164]
One study reported side-effects that were more prominent in older patients and did not correlate with analgesia.
“One study reported side-effects that were more prominent in older patients and did not correlate with analgesia.164”
From Cannabinoids as Pharmacotherapies for Neuropathic Pain: From the Bench to the Bedside (2009) · cites this paper as [164]
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References 27 · Cited by 74
- Authors
- Attal, N., Brasseur, L., Guirimand, D., Clermond‐Gnamien, S., Atlami, S., & Bouhassira, D.
- Affiliations
- Inserm (FR)
- Hôpital Ambroise-Paré (FR)
- Corresponding author
- Bouhassira, D.
- Venue
- European Journal of Pain
- Publisher
- Wiley
- Published
- 2004-04
- Volume
- 8
- Issue
- 2
- Pages
- 173-177
- ISSN
- 1090-3801 (ISSN-L)
- 1532-2149
- OpenAlex
- W2064803709
- Cited by
- 74
- References
- 27
- Citations by year
- 2026: 3 · 2022: 2 · 2021: 4 · 2020: 1 · 2019: 4 · 2018: 1 · 2017: 2 · 2016: 4 · 2015: 6 · 2014: 3 · 2013: 2 · 2012: 8
- FWCI
- 3.43
- Type
- journal article
- Language
- en
- Open access
- closed
- Locations
- European Journal of Pain (publishedVersion)
- PubMed (publishedVersion)
- Topics
- Health Sciences › Medicine › Pharmacology › Cannabis and Cannabinoid Research
- Health Sciences › Medicine › Physiology › Pain Mechanisms and Treatments
- Health Sciences › Medicine › Anesthesiology and Pain Medicine › Pain Management and Opioid Use
- Keywords
- delta-9-tetrahydrocannabinol, refractory neuropathic pain, chronic neuropathic pain, analgesic efficacy, drug safety and tolerability, allodynia, paresthesia, quality of life, mood and anxiety, McGill Pain Questionnaire
- MeSH terms
- Administration, Oral, Adult, Aged, Dose-Response Relationship, Drug, Female, Humans, Male, Middle Aged, Neuralgia, Pain Measurement, Intractable Pain, Pilot Projects, Dronabinol, Treatment Outcome, Analgesics, Non-Narcotic
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