Journal ArticleDOI
Cannabis in painful HIV-associated sensory neuropathy A randomized placebo-controlled trial
Donald I. Abrams,C. A. Jay,Starley B. Shade,H. Vizoso,Haatem Reda,S. Press,Margaret Kelly,Michael C. Rowbotham,Karin L. Petersen +8 more
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TLDR
Smoked cannabis was well tolerated and effectively relieved chronic neuropathic pain from HIV-associated sensory neuropathy and an experimental pain model as discussed by the authors, which is comparable to oral drugs used for chronic pain.Abstract:
Objective: To determine the effect of smoked cannabis on the neuropathic pain of HIV-associated sensory neuropathy and an experimental pain model. Methods: Prospective randomized placebo-controlled trial conducted in the inpatient General Clinical Research Center between May 2003 and May 2005 involving adults with painful HIV- associated sensory neuropathy. Patients were randomly assigned to smoke either cannabis (3.56% tetrahydrocannabinol) or identical placebo cigarettes with the cannabinoids extracted three times daily for 5 days. Primary outcome measures included ratings of chronic pain and the percentage achieving 30% reduction in pain intensity. Acute analgesic and anti-hyperalgesic effects of smoked cannabis were assessed using a cutaneous heat stimulation procedure and the heat/capsaicin sensitization model. Results: Fifty patients completed the entire trial. Smoked cannabis reduced daily pain by 34% (median reduction; IQR 71, 16) vs 17% (IQR 29, 8) with placebo (p 0.03). Greater than 30% reduction in pain was reported by 52% in the cannabis group and by 24% in the placebo group (p 0.04). The first cannabis cigarette reduced chronic pain by a median of 72% vs 15% with placebo (p 0.001). Cannabis reduced experimentally induced hyperalgesia to both brush and von Frey hair stimuli (p 0.05) but appeared to have little effect on the painfulness of noxious heat stimulation. No serious adverse events were reported. Conclusion: Smoked cannabis was well tolerated and effectively relieved chronic neuropathic pain from HIV-associated sensory neuropathy. The findings are comparable to oral drugs used for chronic neuropathic pain.read more
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Journal ArticleDOI
Cannabinoids for Medical Use: A Systematic Review and Meta-analysis.
Penny Whiting,Penny Whiting,Robert Wolff,Sohan Deshpande,Marcello Di Nisio,Steven Duffy,Adrian V. Hernandez,Adrian V. Hernandez,J. Christiaan Keurentjes,Shona H. Lang,Kate Misso,Steve Ryder,Simone Schmidlkofer,Marie Westwood,Jos Kleijnen +14 more
TL;DR: There was moderate- quality evidence to support the use of cannabinoids for the treatment of chronic pain and spasticity and low-quality evidence suggesting that cannabinoids were associated with improvements in nausea and vomiting due to chemotherapy, weight gain in HIV infection, sleep disorders, and Tourette syndrome.
Journal ArticleDOI
EFNS guidelines on the pharmacological treatment of neuropathic pain: 2010 revision
Nadine Attal,Giorgio Cruccu,Ralf Baron,Maija Haanpää,Per Hansson,Troels S. Jensen,Turo Nurmikko +6 more
TL;DR: The second European Federation of Neurological Societies Task Force as discussed by the authors aimed at updating the existing evidence about the pharmacological treatment of neuropathic pain since 2005, and identified studies using the Cochrane Database and Medline.
EFNS guidelines on the pharmacological treatment of neuropathic pain: 2009 revision
TL;DR: This second European Federation of Neurological Societies Task Force aimed at updating the existing evidence about the pharmacological treatment of neuropathic pain since 2005.
Journal ArticleDOI
The evidence for pharmacological treatment of neuropathic pain
TL;DR: Large‐scale drug trials that aim to identify possible subgroups of patients who are likely to respond to specific drugs are needed to test the hypothesis that a mechanism‐based classification may help improve treatment of the individual patients.
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The Health Effects of Cannabis and Cannabinoids: The Current State of Evidence and Recommendations for Research
TL;DR: Despite increased cannabis use and a changing state-level policy landscape, conclusive evidence regarding the shortand long-term health effects—both harms and benefits—of cannabis use remains elusive.
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