Clinical Note Are oral cannabinoids safe and effective in refractory neuropathic pain? N. Attal a, b, L. Brasseur a, b, D. Guirimand a, b, S. Clermond-Gnamien c, S. Atlami c and D. Bouhassira , , a, b a INSERM E-332, Centre d'Evaluation et de Traitement de la Douleur, Hôpital Ambroise Paré, AP-HP, 92100, Boulogne-Billancourt, France b Université Versaille-Saint-Quentin, Versailles, France c Service de Pharmacie, Hôpital Ambroise Paré, AP-HP, 92100, Boulogne-Billancourt, France Abstract Although cannabinoids have anti-hyperalgesic effects in animal models of nerve injury, there are currently very few prospective trials of the efficacy of cannabinoids in neuropathic pain in humans. This open label prospective study investigated the safety, tolerability and analgesic benefit of oral -9-tetrahydrocannabinol (THC) titrated to a maximal dosage of 25 mg/day in 8 consecutive patients with chronic refractory neuropathic pain. Spontaneous ongoing and paroxysmal pain, allodynia and paresthesias were assessed. The sensory and affective components of pain using the McGill pain questionnaire, quality of life, mood, anxiety and functionality were also evaluated. Seven patients suffered from side effects necessitating premature arrest of the drug in 5 of them. THC (mean dosage: 16.6 ± 6.5 mg/day) did not induce any significant effects on ongoing and paroxysmal pain, allodynia, quality of life, anxiety/depression scores and functional impact of pain. These results do not support an overall benefit of THC in pain and quality of life in patients with refractory neuropathic pain. European Journal of Pain Volume 8, Issue 2 , April 2004, Pages 173-177 doi:10.1016/S1090-3801(03)00084-3 Ann's NOTE: Interestingly we first heard about this study via the IACM Bulletin (International Association for Cannabis as Medicine). Here is how they reviewed the study: Science: Neuropathic pain An open study with eight patients suffering from severe neuropathic pain that was refractory to all other therapies was conducted in France. Patients suffered from spinal cord injury, poststroke pain and peripheral nerve injury. They received up to 25 mg THC daily for 4 months. The dose was increased every week by 5 mg starting with 2 x 2.5 mg. Mean achieved dose was 16.6 mg (range 7.5-25 mg). In seven patients there was no relevant decrease in pain intensity. In one patient spontaneous pain decreased by 60 percent. At 4 weeks there was a tendency to a reduction in number of painful attacks from 9.8 daily before the treatment to 3.2 daily, but this effect disappeared after 2 months. (Source: Attal N, et al. Eur J Pain 2004;8:173–177) It is possible that the study varies from the abstract, that has been known to happen. But we cannot access the original paper at this time. 4/8/04 Remember we are NOT Doctors and have NO medical training. This site is like an Encylopedia - there are many pages, many links on many topics. Support our work with any size DONATION - see left side of any page - for how to donate. You can help raise awareness of CAM.