Initial experiences with medicinal extracts of cannabis for chronic pain: Results from 34 ‘N of 1’ studies
2004/04/16 by William Notcutt, Mario Price, Roy Miller +4 · 28 citations
Medicine · Psychology · #Cannabis and Cannabinoid Research #Psychedelics and Drug Studies #Parkinson's Disease Mechanisms and Treatments
paper · pdf · doi:10.1111/j.1365-2044.2004.03674.x
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.
Cited by
- The Endocannabinoid System as an Emerging Target of Pharmacotherapy
- A systematic review of cannabidiol dosing in clinical populations
- Cannabis-based medicines for chronic neuropathic pain in adults
- Survey of Australians using cannabis for medical purposes. [europepmc]
- The therapeutic potential of drugs that target cannabinoid receptors or modulate the tissue levels or actions of endocannabinoids. [europepmc]
- Site-specific increases in peripheral cannabinoid receptors and their endogenous ligands in a model of neuropathic pain. [europepmc]
- The endocannabinoid system as an emerging target of pharmacotherapy. [europepmc]
- Simultaneous quantification of Delta9-tetrahydrocannabinol, 11-hydroxy-Delta9-tetrahydrocannabinol, and 11-nor-Delta9-tetrahydrocannabinol-9-carboxylic acid in human plasma using two-dimensional gas chromatography, cryofocusing, and electron impact-mass spectrometry. [europepmc]
- Simultaneous GC-EI-MS determination of Delta9-tetrahydrocannabinol, 11-hydroxy-Delta9-tetrahydrocannabinol, and 11-nor-9-carboxy-Delta9-tetrahydrocannabinol in human urine following tandem enzyme-alkaline hydrolysis. [europepmc]
- Role of the cannabinoid system in pain control and therapeutic implications for the management of acute and chronic pain episodes. [europepmc]
- Cannabinoids as pharmacotherapies for neuropathic pain: from the bench to the bedside. [europepmc]
- The analgesic potential of cannabinoids. [europepmc]
- The n-of-1 clinical trial: the ultimate strategy for individualizing medicine? [europepmc]
- The endocannabinoid system, cannabinoids, and pain. [europepmc]
- Cannabidiol in humans-the quest for therapeutic targets. [europepmc]
- Peripherally Selective Cannabinoid 1 Receptor (CB1R) Agonists for the Treatment of Neuropathic Pain. [europepmc]
- Clinical Endocannabinoid Deficiency Reconsidered: Current Research Supports the Theory in Migraine, Fibromyalgia, Irritable Bowel, and Other Treatment-Resistant Syndromes. [europepmc]
- A Conversion of Oral Cannabidiol to Delta9-Tetrahydrocannabinol Seems Not to Occur in Humans. [europepmc]
- Cannabis-based medicines for chronic neuropathic pain in adults. [europepmc]
- Patterns of medicinal cannabis use, strain analysis, and substitution effect among patients with migraine, headache, arthritis, and chronic pain in a medicinal cannabis cohort. [europepmc]
- A systematic review of cannabidiol dosing in clinical populations. [europepmc]
- Cannabinoids for the treatment of mental disorders and symptoms of mental disorders: a systematic review and meta-analysis. [europepmc]
- Cannabinoids in Chronic Non-Cancer Pain: A Systematic Review and Meta-Analysis. [europepmc]
- A Balanced Approach for Cannabidiol Use in Chronic Pain. [europepmc]
- Cannabidiol: pharmacology and therapeutic targets. [europepmc]
- Reasons for cannabidiol use: a cross-sectional study of CBD users, focusing on self-perceived stress, anxiety, and sleep problems. [europepmc]
- Medical cannabinoids: a pharmacology-based systematic review and meta-analysis for all relevant medical indications. [europepmc]
- Clinical Practice Guidelines for Cannabis and Cannabinoid-Based Medicines in the Management of Chronic Pain and Co-Occurring Conditions. [europepmc]
Related