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

@article{Narang2008EfficacyOD,
  title={Efficacy of dronabinol as an adjuvant treatment for chronic pain patients on opioid therapy.},
  author={S. Narang and D. Gibson and A. Wasan and E. Ross and E. Michna and S. Nedeljkovic and R. Jamison},
  journal={The journal of pain : official journal of the American Pain Society},
  year={2008},
  volume={9 3},
  pages={
          254-64
        }
}
UNLABELLED We assessed the efficacy of dronabinol (Marinol capsules; Solvay Pharmaceuticals, Brussels, Belgium), a synthetic Delta(9)-THC (tetrahydrocannabinol), in 30 patients taking opioids for chronic pain to determine its potential analgesic effects as an adjuvant treatment. [...] Key Method Phase I of this 2-phase study was a randomized, single-dose, double-blinded, placebo-controlled, crossover trial in which subjects were randomly administered either 10 mg or 20 mg of dronabinol or identical placebo…Expand

Paper Mentions

The Subjective Psychoactive Effects of Oral Dronabinol Studied in a Randomized, Controlled Crossover Clinical Trial for Pain
TLDR
In pain patients, oral dronabinol has similar psychoactive effects to smoking marijuana, and this risk must be considered in any decision to prescribe cannabinoid medications for pain. Expand
Single dose delta-9-tetrahydrocannabinol in chronic pancreatitis patients: analgesic efficacy, pharmacokinetics and tolerability.
TLDR
A single dose of Δ9-THC was not efficacious in reducing chronic pain resulting from CP, but was well tolerated with only mild or moderate AEs. Expand
Dronabinol and chronic pain: importance of mechanistic considerations
TLDR
A mechanism-based approach beyond measurement of subjective pain relief is suggested to evaluate the therapeutic potential of dronabinol in chronic pain management, and development of objective mechanistic diagnostic biomarkers reflecting altered sensory and cognitive processing in the brain is essential to evaluate dRONabinol induced analgesia. Expand
Cannabinoid modulation of opioid analgesia and subjective drug effects in healthy humans
TLDR
It is suggested that dronabinol may not be an effective or appropriate opioid adjuvant; it could potentially increase opioid dose requirements, while increasing psychoactive opioid effects. Expand
Tetrahydrocannabinol (Delta 9-THC) Treatment in Chronic Central Neuropathic Pain and Fibromyalgia Patients: Results of a Multicenter Survey
TLDR
Delta 9-THC treatment as part of a broader pain management plan therefore may represent a promising coanalgesic therapeutic option for the treatment of chronic pain in central neuropathy and fibromyalgia. Expand
Cannabinoid–Opioid Interaction in Chronic Pain
TLDR
It is concluded that vaporized cannabis augments the analgesic effects of opioids without significantly altering plasma opioid levels, and may allow for opioid treatment at lower doses with fewer side effects. Expand
Impact of co-administration of oxycodone and smoked cannabis on analgesia and abuse liability
TLDR
Cannabis enhances the analgesic effects of sub-threshold oxycodone, suggesting synergy, without increases in cannabis’s abuse liability, which supports future research into the therapeutic use of opioid-cannabinoid combinations for pain. Expand
Cannabinoids for treatment of chronic non-cancer pain; a systematic review of randomized trials.
TLDR
There is evidence that cannabinoids are safe and modestly effective in neuropathic pain with preliminary evidence of efficacy in fibromyalgia and rheumatoid arthritis and the context of the need for additional treatments for chronic pain is reviewed. Expand
Role of Cannabinoids in the Treatment of Pain and (Painful) Spasticity
TLDR
Patients with unsatisfactory response to other methods of pain therapy and who were characterized by failed stress adaptation particularly benefited from treatment with cannabinoids, but none of the attempts to overcome the disadvantage of the narrow therapeutic index have resulted in a major breakthrough. Expand
Targeting Opioid-Induced Hyperalgesia in Clinical Treatment: Neurobiological Considerations
TLDR
It is suggested that this paradoxical state of increased nociception results from acute and long-term exposure to opioids, and appears to develop in a substantial subset of patients using opioids, be considered an additional target of clinical treatment for chronic pain. Expand
...
1
2
3
4
5
...

References

SHOWING 1-10 OF 77 REFERENCES
Lack of analgesic efficacy of oral delta-9-tetrahydrocannabinol in postoperative pain.
TLDR
This study demonstrates no evidence of an analgesic effect of orally administered delta-9-THC 5 mg in postoperative pain in humans. Expand
A Multicenter Dose-escalation Study of the Analgesic and Adverse Effects of an Oral Cannabis Extract (Cannador) for Postoperative Pain Management
TLDR
These significant dose-related improvements in rescue analgesia requirements in the 10 mg and 15 mg groups provide a number needed to treat that is equivalent to many routinely used analgesics without frequent adverse effects. Expand
Lack of analgesic efficacy of oral δ-9-tetrahydrocannabinol in postoperative pain
TLDR
This study demonstrates no evidence of an analgesic effect of orally administered &dgr;‐9‐THC 5 mg in postoperative pain in humans. Expand
Does the cannabinoid dronabinol reduce central pain in multiple sclerosis? Randomised double blind placebo controlled crossover trial
TLDR
Dronabinol has a modest but clinically relevantanalgesic effect on central pain in patients with multiple sclerosis and on the SF-36 quality of life scale, the two items bodily pain and mental health indicated benefits from active treatment compared with placebo. Expand
Pain measurements and side effect profile of the novel cannabinoid ajulemic acid
TLDR
Overall, these study findings indicate that AJA shows pain-reducing effects on patients with chronic neuropathic pain without clinically relevant psychotropic or physical side effects. Expand
Analgesic effect of the synthetic cannabinoid CT-3 on chronic neuropathic pain: a randomized controlled trial.
TLDR
In this preliminary study, CT-3 was effective in reducing chronic neuropathic pain compared with placebo and no major adverse effects were observed. Expand
Effects of intravenous tetrahydrocannabinol on experimental and surgical pain; Psychological correlates of the analgesic response
TLDR
Pain detection thresholds were altered unpredictably with high THC doses, but analgesia as indicated by pain tolerance was less than that after diazepam and placebo, and STAI following THC presaged a poor analgesic response in this group. Expand
Opioid Therapy for Chronic Noncancer Back Pain: A Randomized Prospective Study
TLDR
The results suggest that opioid therapy has a positive effect on pain and mood but little effect on activity and sleep, and tapered‐off opioid treatment is palliative and without long‐term benefit. Expand
Long-term use of a cannabis-based medicine in the treatment of spasticity and other symptoms in multiple sclerosis
TLDR
It is concluded that long-term use of an oromucosal CBM (Sativex) maintains its effect in those patients who perceive initial benefit, and the precise nature and rate of risks with long- term use, especially epilepsy, will require larger and longer-term studies. Expand
The analgesic effect of oral delta-9-tetrahydrocannabinol (THC), morphine, and a THC-morphine combination in healthy subjects under experimental pain conditions
TLDR
The aim of this study was to measure the analgesic effect of THC, morphine, and a THC‐ Morphine combination (THC‐morphine) in humans using experimental pain models and found that THC did not significantly reduce pain. Expand
...
1
2
3
4
5
...