Does the cannabinoid dronabinol reduce central pain in multiple sclerosis? Randomised double blind placebo controlled crossover trial

  title={Does the cannabinoid dronabinol reduce central pain in multiple sclerosis? Randomised double blind placebo controlled crossover trial},
  author={Kristina Bacher Svendsen and Troels Staehelin Jensen and Flemming Winther Bach},
  journal={BMJ : British Medical Journal},
Abstract Objective To evaluate the effect of the oral synthetic δ-9-tetrahydrocannabinol dronabinol on central neuropathic pain in patients with multiple sclerosis. Design Randomised double blind placebo controlled crossovertrial. Setting Outpatient clinic, University Hospital of Aarhus, Denmark. Participants 24 patients aged between 23 and 55 years with multiple sclerosis and central pain. Intervention Orally administered dronabinol at a maximum doseof 10 mg daily or corresponding placebo for… 

What is a crossover trial?

  • P. Sedgwick
  • Medicine, Psychology
    BMJ : British Medical Journal
  • 2014
The researchers reported that dronabinol had a significant analgesic effect on central pain in patients with multiple sclerosis, although the effects were modest they were clinically relevant.

Dronabinol Is a Safe Long-Term Treatment Option for Neuropathic Pain Patients

The trial results demonstrate that dronabinol is a safe long-term treatment option and a positive benefit-risk ratio and no signs of drug abuse and only one possible case of dependency occurred.

Randomized, controlled trial of cannabis-based medicine in central pain in multiple sclerosis

CBM was generally well tolerated, although more patients on CBM than placebo reported dizziness, dry mouth, and somnolence, and Cognitive side effects were limited to long-term memory storage.

A randomized, placebo‐controlled trial of levetiracetam in central pain in multiple sclerosis

This study found no effect of the anticonvulsant levetiracetam in non‐selected patients with central pain in multiple sclerosis, but an effect in subgroups with specific pain symptoms was indicated.

A randomized placebo-controlled trial of duloxetine for central pain in multiple sclerosis.

This study suggests that duloxetine has a direct pain-relieving effect in MS, and among patients who completed 6 weeks of treatment, there were significant reductions in average and worst daily pain scores with dulOxetine compared to placebo.

Efficacy of dronabinol as an adjuvant treatment for chronic pain patients on opioid therapy.

Smoked Medicinal Cannabis for Neuropathic Pain in HIV: A Randomized, Crossover Clinical Trial

Smoked cannabis was generally well tolerated and effective when added to concomitant analgesic therapy in patients with medically refractory pain due to HIV DSPN.

Psychopathological and Cognitive Effects of Therapeutic Cannabinoids in Multiple Sclerosis: A Double-Blind, Placebo Controlled, Crossover Study

Cannabinoid treatment did not induce psychopathology and did not impair cognition in cannabis-naïve patients with MS, but the positive correlation between blood levels of &Dgr;-9-tetrahydrocannabinol and psychopathological scores suggests that at dosages higher than those used in therapeutic settings, interpersonal sensitivity, aggressiveness, and paranoiac features might arise.

Smoked cannabis for chronic neuropathic pain: a randomized controlled trial

A single inhalation of 25 mg of 9.4% tetrahydrocannabinol herbal cannabis three times daily for five days reduced the intensity of pain, improved sleep and was well tolerated, and no differences in mood or quality of life were found.



Analgesic effect of the synthetic cannabinoid CT-3 on chronic neuropathic pain: a randomized controlled trial.

In this preliminary study, CT-3 was effective in reducing chronic neuropathic pain compared with placebo and no major adverse effects were observed.

Controlled-release oxycodone for pain in diabetic neuropathy

In this 6-week trial, CR oxycodone was effective for the treatment of moderate to severe pain due to diabetic neuropathy and the most common adverse events were opioid related.

Lack of analgesic efficacy of oral delta-9-tetrahydrocannabinol in postoperative pain.

This study demonstrates no evidence of an analgesic effect of orally administered delta-9-THC 5 mg in postoperative pain in humans.

[The therapeutic use of D9-tetrahydrocannabinol (dronabinol) in refractory neuropathic pain].

The present study did not reveal any significant efficacy of THC in a small cohort of patients with chronic refractory neuropathic pain, but underlined the unfavorable side effect profile of the drug.

Pain relief with oral cannabinoids in familial Mediterranean fever

This is the first United Kingdom report of the controlled use of a standardised pharmaceutical preparation of cannabinoids in capsular form and a highly significant reduction in additional analgesic requirements was achieved.

A preliminary controlled study to determine whether whole-plant cannabis extracts can improve intractable neurogenic symptoms

Cannabis medicinal extracts can improve neurogenic symptoms unresponsive to standard treatments, and unwanted effects are predictable and generally well tolerated.

Are cannabinoids an effective and safe treatment option in the management of pain? A qualitative systematic review

Cannabinoids are no more effective than codeine in controlling pain and have depressant effects on the central nervous system that limit their use, and in acute postoperative pain they should not be used.

Evaluation of Intramuscular Levonantradol and Placebo in Acute Postoperative Pain

Administration of a single intramuscular dose of 1.5, 2.0, or 3.0 mg levonantradol or placebo to 56 patients with moderate to severe postoperative or trauma pain showed significant analgesic effects as compared to placebo, however, no significant dose response was observed.