Initial experiences with medicinal extracts of cannabis for chronic pain: results from 34 ‘N of 1’ studies
Abstract
Three Cannabis Based Medicinal Extracts (CBMEs) for sublingual use became available in 2000. A total of 34 'N of 1' studies were undertaken using this novel therapy for patients with chronic, mainly neuropathic, pain and associated symptoms to explore efficacy, tolerability, safety and dosages. Three CBMEs (Delta9 Tetrahydrocannabinol (THC), Cannabidiol (CBD) and a 1:1 mixture of them both) were given over a 12-week period. After an initial open-label period, the CBMEs were used in a randomised, double-blind, placebo controlled, crossover trial. Extracts which contained THC proved most effective in symptom control. Regimens for the use of the sublingual spray emerged and a wide range of dosing requirements was observed. Side-effects were common, reflecting a learning curve for both patient and study team. These were generally acceptable and little different to those seen when other psycho-active agents are used for chronic pain. These initial experiences with CBME open the way to more detailed and extensive studies.
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Δ9-THC and Sativex, but not placebo or cannabidiol, reduced the visual analogue scale rating of the two worst pain symptoms during the crossover phase.
“Δ9-THC and Sativex®, but not placebo or CBD, reduced the VAS rating of the two worst pain symptoms during the crossover phase.156”
From Cannabinoids as Pharmacotherapies for Neuropathic Pain: From the Bench to the Bedside (2009) · cites this paper as [156]
Quality of sleep was improved by all cannabinoid based medications.
“Quality of sleep was improved by all cannabinoid based medications156”
From Cannabinoids as Pharmacotherapies for Neuropathic Pain: From the Bench to the Bedside (2009) · cites this paper as [156]
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A Conversion of oral cannabidiol to delta9-tetrahydrocannabinol seems not to occur in humans
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The use of cannabis in supportive care and treatment of brain tumor
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Role of Cannabinoids in Pain Management
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POST‐SURGICAL NEUROPATHIC PAIN
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- Authors
- Notcutt, W., Price, M., Miller, R., Newport, S., Phillips, C., Simmons, S., & Sansom, C.
- Affiliations
- James Paget University Hospital (GB)
- ORCID
- Notcutt, William
- Venue
- Anaesthesia
- Publisher
- Wiley
- Published
- 2004-04-16
- Volume
- 59
- Issue
- 5
- Pages
- 440-452
- ISSN
- 0003-2409 (ISSN-L)
- 1365-2044
- OpenAlex
- W2148726807
- Cited by
- 305
- References
- 28
- Citations by year
- 2026: 10 · 2025: 12 · 2024: 10 · 2023: 17 · 2022: 24 · 2021: 19 · 2020: 23 · 2019: 14 · 2018: 14 · 2017: 11 · 2016: 7 · 2015: 10 · 2014: 9 · 2013: 4 · 2012: 8
- FWCI
- 15.71
- Type
- journal article
- Language
- en
- Open access
- closed
- Locations
- Anaesthesia (publishedVersion)
- PubMed (publishedVersion)
- Funders
- GW Pharmaceuticals
- Multiple Sclerosis Society
- 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
- chronic pain, neuropathic pain, sublingual administration, delta-9-tetrahydrocannabinol, cannabidiol, THC:CBD ratio, symptom management, dosing regimen, N-of-1 studies
- MeSH terms
- Administration, Sublingual, Adult, Aged, Cannabidiol, Chronic Disease, Depressive Disorder, Double-Blind Method, Drug Combinations, Female, Humans, Male, Middle Aged, Multiple Sclerosis, Pain, Pain Measurement, Sleep, Dronabinol, Treatment Outcome, Patient Selection, Cross-Over Studies, Analgesics, Non-Narcotic
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