Clinical Studies and Case Reports

On this site you will find clinical studies with cannabis or single cannabinoids in different diseases and case reports on the use of cannabis by patients.
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TitleComparison of analgesic effects and patient tolerability of nabilone and dihydrocodeine for chronic neuropathic pain: randomised, crossover, double blind study.
Author(s)Frank B, Serpell MG, Hughes J, Matthews JN, Kapur D.
Journal, Volume, IssueBMJ. 2008 Jan 26;336(7637):199-201.
Major outcome(s)Nabilone as effective as hydrocodeine in treating neuropatic pain

OBJECTIVE: To compare the analgesic efficacy and side effects of the synthetic cannabinoid nabilone with those of the weak opioid dihydrocodeine for chronic neuropathic pain. DESIGN: Randomised, double blind, crossover trial of 14 weeks' duration comparing dihydrocodeine and nabilone. SETTING: Outpatient units of three hospitals in the United Kingdom. PARTICIPANTS: 96 patients with chronic neuropathic pain, aged 23-84 years. MAIN OUTCOME MEASURES: The primary outcome was difference between nabilone and dihydrocodeine in pain, as measured by the mean visual analogue score computed over the last 2 weeks of each treatment period. Secondary outcomes were changes in mood, quality of life, sleep, and psychometric function. Side effects were measured by a questionnaire. INTERVENTION: Patients received a maximum daily dose of 240 mg dihydrocodeine or 2 mg nabilone at the end of each escalating treatment period of 6 weeks. Treatment periods were separated by a 2 week washout period. Results Mean baseline visual analogue score was 69.6 mm (range 29.4-95.2) on a 0-100 mm scale. 73 patients were included in the available case analysis and 64 patients in the per protocol analysis. The mean score was 6.0 mm longer for nabilone than for dihydrocodeine (95% confidence interval 1.4 to 10.5) in the available case analysis and 5.6 mm (10.3 to 0.8) in the per protocol analysis. Side effects were more frequent with nabilone. CONCLUSION: Dihydrocodeine provided better pain relief than the synthetic cannabinoid nabilone and had slightly fewer side effects, although no major adverse events occurred for either drug.

Dose(s)2 mg
Duration (days)48
Participants96 patients with chronic neuropatic pain
DesignControlled study
Type of publicationMedical journal
Address of author(s)Pain Management Unit, Royal Victoria Infirmary, Newcastle upon Tyne NE1 4LP.
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