title: Low dose treatment with the synthetic cannabinoid Nabilone significantly reduces spasticity-related pain : a double-blind placebo-controlled cross-over trial.
abstract: About 30% of patients with chronic upper motor neuron syndrome (UMNS) suffer from disabling spasticity-related pain not sufficiently correctable by conventional treatment. Delta9-tetrahydrocannabinol (Delta(9)-THC) was reported to add benefit in the treatment of pain in patients with multiple sclerosis (MS). The question arose whether synthetic cannabinoids with lower potential for psychotropic side effects could be effective as well. To evaluate the safety and efficacy of low dose treatment with the synthetic cannabinoid Nabilone (1 mg per day) on spasticity-related pain a placebo-controlled double-blind crossover trial was performed.11 out of 13 included patients completed the study. The 11-Point-Box-Test showed a significant decrease of pain under Nabilone (p < 0.05), while spasticity, motor function and activities of daily living did not change. 5 patients reported side effects: one moderate transient weakness of the lower limbs (Nabilone phase, drop out), three mild drowsiness (two Nabilone, one placebo) and one mild dysphagia (placebo). One patient was excluded from the study due to an acute relapse of multiple sclerosis (Nabilone phase, drop out). Nabilone 1 mg per day proved to be a safe and easily applicable option in the care of patients with chronic UMNS and spasticity-related pain otherwise not controllable.
authors.affiliation: Department of Neurology, University of Innsbruck, Anichstrasse 35, 6020, Innsbruck, Austria. wissel@rehaklinik-beelitz.de
authors.forename: Jörg
authors.initials: J
authors.lastname: Wissel
authors.forename: Tanja
authors.initials: T
authors.lastname: Haydn
authors.forename: Jörg
authors.initials: J
authors.lastname: Müller
authors.forename: Christian
authors.initials: C
authors.lastname: Brenneis
authors.forename: Thomas
authors.initials: T
authors.lastname: Berger
authors.forename: Werner
authors.initials: W
authors.lastname: Poewe
authors.forename: Ludwig D
authors.initials: LD
authors.lastname: Schelosky
mesh_terms: D000203:Activities of Daily Living; D000293:Adolescent; D000328:Adult; D018592:Cross-Over Studies; D004311:Double-Blind Method; D013759:Dronabinol / Q000008:administration & dosage / Q000009:adverse effects / Q000031:analogs & derivatives* / Q000627:therapeutic use; D005260:Female; D006801:Humans; D008297:Male; D008875:Middle Aged; D016472:Motor Neuron Disease / Q000150:complications; D009128:Muscle Spasticity / Q000150:complications*; D010146:Pain / Q000188:drug therapy* / Q000209:etiology*; D010147:Pain Measurement / Q000187:drug effects; D012008:Recurrence
chemical_list: C011941:nabilone; D013759:Dronabinol