Abstract
We assessed the efficacy of dronabinol (Marinol capsules; Solvay Pharmaceuticals,
Brussels, Belgium), a synthetic Δ9-THC (tetrahydrocannabinol), in 30 patients taking opioids for chronic pain to determine
its potential analgesic effects as an adjuvant treatment. 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 capsules over the course of three, 8-hour visits. Baseline self-report
measures, hourly ratings of pain intensity, pain relief, pain bothersomeness, treatment
satisfaction, mood, side effects, and blood serum levels were obtained. Phase II was
an extended open-label titrated trial of dronabinol as add-on medication to patients
on stable doses of opioids. Results of the Phase I study showed that patients who
received dronabinol experienced decreased pain intensity and increased satisfaction
compared with placebo. No differences in benefit were found between the 20 mg and
10 mg doses. In the Phase II trial, titrated dronabinol contributed to significant
relief of pain, reduced pain bothersomeness, and increased satisfaction compared with
baseline. The incidence of side effects was dose-related. Overall, the use of dronabinol
was found to result in additional analgesia among patients taking opioids for chronic
noncancer pain.
Perspective
This study examines the effect of adding a cannabinoid to the regimen of patients
with chronic pain who report significant pain despite taking stable doses of opioids.
The results of our preliminary study suggest that dronabinol, a synthetic THC, may
have an additive effect on pain relief.
Key words
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Article Info
Publication History
Published online: December 14, 2007
Accepted:
October 26,
2007
Received in revised form:
October 16,
2007
Received:
August 20,
2007
Footnotes
Supported in part by an investigator-initiated grant from Solvay Pharmaceuticals, Inc.
Identification
Copyright
© 2008 American Pain Society. Published by Elsevier Inc. All rights reserved.
