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Initial experiences with medicinal extracts of cannabis for chronic pain: results from 34 'N of 1' studies.
No direction reported
Samplen = 34
Summary
Early exploratory investigation (34 'N-of-1' trials, predominantly neuropathic chronic pain) with sublingual cannabis extracts (THC, CBD, 1:1) over 12 weeks, randomised after an open-label phase, double-blind, placebo-controlled in a crossover design. THC-containing extracts showed the best symptom control across a broad dose range. Side effects were frequent but mostly acceptable and comparable to other psychotropic drugs. Caveat: very small, heterogeneous pilot data without quantitative effect sizes, only indicative for later studies.
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★★★★★
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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.
The impediment to action advances action.