Low dose treatment with the synthetic cannabinoid Nabilone significantly reduces spasticity-related pain -: A double-blind placebo-controlled cross-over trial
Low dose treatment with the synthetic cannabinoid Nabilone significantly reduces spasticity-related pain -: A double-blind placebo-controlled cross-over trial
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DOI：
10.1007/s00415-006-0218-8
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发表时间：
2006-10-01
影响因子：
6
通讯作者：
Poewe, Werner
中科院分区：
文献类型：
--
作者：
Wissel, Joerg;Haydn, Tanja;Poewe, Werner
约30%的慢性上运动神经元综合征(UMNS)患者患有与痉挛相关的致残性疼痛，常规治疗无法完全纠正。据报道，Delta9-四氢大麻酚(Delta(9)-THC)在多发性硬化症(MS)患者的疼痛治疗中具有额外的益处。出现了一个问题，即潜在的精神副作用较低的合成大麻素是否也会有效。为了评价小剂量合成大麻素纳贝酮(每天1毫克)治疗痉挛相关疼痛的安全性和有效性，进行了一项安慰剂对照双盲交叉试验。13名纳入患者中有11名完成了研究。11点盒子测试显示，纳比隆治疗后疼痛明显减轻(p<；0.05)，而痉挛、运动功能和日常生活能力没有变化。5例患者报告副作用：1例中度短暂性肢体无力(纳比隆阶段，退出)，3例轻度嗜睡(2例纳比隆，1例安慰剂)，1例轻度吞咽困难(安慰剂)。一名患者因多发性硬化症的急性复发(纳比隆阶段，退出)而被排除在研究之外。纳比隆每天1毫克被证明是治疗慢性UMNS和痉挛相关疼痛的安全和容易应用的选择，否则无法控制。
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.