An experimental randomized study on the analgesic effects of pharmaceutical-grade cannabis in chronic pain patients with fibromyalgia

Donk, Tine van de; Niesters, Marieke; Kowal, Mikael A.; Olofsen, Erik; Dahan, Albert; Velzen, Monique van

doi:10.1097/j.pain.0000000000001464

Cited by 173 publications

(194 citation statements)

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“…3 A randomized controlled trial (RCT) in the Netherlands that involved women with fibromyalgia who were treated with pharmaceutical-grade inhaled cannabis in various concentrations of Δ9-tetrahydrocannabinol (THC) and cannabidiol (CBD) found that none of the treatments had an effect greater than placebo on spontaneous pain, and reduced pain scores were significantly correlated with the extent of drug high. 5 Furthermore, CBD increased plasma concentrations of THC but reduced THC's analgesic effects, which emphasizes the complexity of THC-CBD interactions and the possible role of psychotropic mechanisms on symptom relief.…”

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confidence: 99%

“…It is possible that medical cannabis does not meaningfully affect the medical condition other than through subtle psychoactive effects that bring comfort. 5 Patients who want to try cannabis as a treatment often seek medical advice about dosages, choice of specific products and method of administration. 7 Other than broad recommendations that cannabis should not be smoked and to use products with low THC and high CBD levels, no regulatory or medical body has provided specific guidance.…”

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confidence: 99%

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Medical cannabis: strengthening evidence in the face of hype and public pressure

Fitzcharles

Shir

Haüser

2019

CMAJ

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confidence: 99%

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confidence: 99%

Medical cannabis: strengthening evidence in the face of hype and public pressure

Fitzcharles

Shir

Haüser

2019

CMAJ

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“…van de Donk et al conducted a randomized, placebocontrolled trial exploring the analgesic effect of different cannabis varieties (with different THC:CBD contents) on fibromyalgia patients. ey found that THC-containing products increased the pain threshold, whereas CBD-containing products increased plasma-THC levels but diminished THC analgesic effect [75]. is study demonstrated the complex effect of cannabinoids and the endocannabinoid system on chronic pain.…”

Section: Cannabinoidsmentioning

confidence: 67%

Current and Emerging Pharmacotherapy for Fibromyalgia

Tzadok

Ablin

2020

Pain Research and Management

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Introduction. Fibromyalgia syndrome (FMS) is a pain disorder with an estimated prevalence of 1–5%. It is associated with a variety of somatic and psychological disorders. Its exact pathogenesis is still unclear but is involved with neural oversensitization and decreased conditioned pain modulation (CPM), combined with cognitive dysfunction, memory impairment, and altered information processing. Connectivity between brain areas involved in pain processing, alertness, and cognition is increased in the syndrome, making its pharmacologic therapy complex. Only three drugs, pregabalin, duloxetine, and milnacipran are currently FDA-approved for FM treatment, but many other agents have been tested over the years, with varying efficacy. Areas Covered. The purpose of this review is to summarize current clinical experience with different pharmacologic treatments used for fibromyalgia and introduce future perspectives in developing therapies. Expert Opinion. Future insights into the fields of cannabinoid and opioid research, as well as an integrative approach towards the incorporation of genetics and functional imaging combined with additional fields of research relevant towards the study of complex CNS disorders, are likely to lead to new developments of novel tailor-made treatments for FMS patients.

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“…Since the beginning of the 21st century, different countries, such as the United States, Canada, Austria, Finland, Germany, Portugal, and Spain, and just recently Iran, have authorized and regulated medical cannabis for its therapeutic effects. Some of the synthetic, extract, or natural forms of cannabinoids available on the world market or under research and clinical trials include Marinol ® , Cesamet™, Sativex ® , Epidiolex ® , Bedrocan ® , Bedrobinol ® , Bediol ® , Bedica ® , Bedrolite ® [ 167 , 168 ] Namisol ® and Syndros ® (Dronabinol ® oral solution), Epidiolex ® , and Arvisol ® ( Table 2 ). Medical cannabis can be used in a number of different ways, for example, as pills, tablets, capsules, soft gel, dissolved in an oil solution (olive, sesame, coconut, or hempseed oil), tea, or by inhaling it after vaporization.…”

Section: Medicinal Properties Of Cannabinoidsmentioning

confidence: 99%

It Is Our Turn to Get Cannabis High: Put Cannabinoids in Food and Health Baskets

et al. 2020

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Cannabis is an annual plant with a long history of use as food, feed, fiber, oil, medicine, and narcotics. Despite realizing its true value, it has not yet found its true place. Cannabis has had a long history with many ups and downs, and now it is our turn to promote it. Cannabis contains approximately 600 identified and many yet unidentified potentially useful compounds. Cannabinoids, phenolic compounds, terpenoids, and alkaloids are some of the secondary metabolites present in cannabis. However, among a plethora of unique chemical compounds found in this plant, the most important ones are phytocannabinoids (PCs). Over hundreds of 21-22-carbon compounds exclusively produce in cannabis glandular hairs through either polyketide and or deoxyxylulose phosphate/methylerythritol phosphate (DOXP/MEP) pathways. Trans-Δ9-tetrahydrocannabinol (Δ9-THC) and cannabidiol (CBD) are those that first come to mind while talking about cannabis. Nevertheless, despite the low concentration, cannabinol (CBN), cannabigerol (CBG), cannabichromene (CBC), tetrahydrocannabivarin (THCV), cannabidivarin (CBDV), cannabinodiol (CBND), and cannabinidiol (CBDL) may have potentially some medical effects. PCs and endocannabinoids (ECs) mediate their effects mainly through CB1 and CB2 receptors. Despite all concerns regarding cannabis, nobody can ignore the use of cannabinoids as promising tonic, analgesic, antipyretic, antiemetic, anti-inflammatory, anti-epileptic, anticancer agents, which are effective for pain relief, depression, anxiety, sleep disorders, nausea and vomiting, multiple sclerosis, cardiovascular disorders, and appetite stimulation. The scientific community and public society have now increasingly accepted cannabis specifically hemp as much more than a recreational drug. There are growing demands for cannabinoids, mainly CBD, with many diverse therapeutic and nutritional properties in veterinary or human medicine. The main objective of this review article is to historically summarize findings concerning cannabinoids, mainly THC and CBD, towards putting these valuable compounds into food, feed and health baskets and current and future trends in the consumption of products derived from cannabis.

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An experimental randomized study on the analgesic effects of pharmaceutical-grade cannabis in chronic pain patients with fibromyalgia

Abstract: Supplemental Digital Content is Available in the Text.This experimental highly controlled trial in 20 patients with fibromyalgia shows that the cannabinoid THC, but not CBD, is effective in the treatment of fibromyalgia pain.

Cited by 173 publications

References 30 publications

Medical cannabis: strengthening evidence in the face of hype and public pressure

Medical cannabis: strengthening evidence in the face of hype and public pressure

Current and Emerging Pharmacotherapy for Fibromyalgia

It Is Our Turn to Get Cannabis High: Put Cannabinoids in Food and Health Baskets

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