Ware et al. (2010) [29] |
Adults with post-surgical or post-traumatic neuropathic pain (>4 on VAS) for ≥ 3 months. Requirements: normal liver and renal function, hematocrit > 38%, negative pregnancy test. Exclusion criteria: cancer, severe comorbidity, substance abuse, history of psychosis, suicide, pregnancy, breastfeeding. |
VAS pain scores for 9.4% THC were significantly reduced (9.4% THC = 5.4, 0% THC = 6.1, p = 0.023); 9.4% THC improved sleep quality and symptoms of anxiety and depression (p < 0.05 for both). |
Smoked cannabis improved pain, mood, and sleep quality in chronic neuropathic pain. |
Weizman et al. (2018) [32] |
27–40-year-old men with chronic lumbar radicular pain for > 6 months. Women and patients with other comorbidities were excluded. |
THC decreased ACC and sensorimotor cortex functional connectivity in right SII, left SII, and right MI, which correlated with improved pain (r = 0.68, p = 0.005; r = 0.66, p = 0.007; r = 0.8, p = 0.0003, respectively). |
THC may reduce subjective neuropathic pain by interfering with neural pathways in the ACC. |
van de Donk et al. (2019) [34] |
Adult females with fibromyalgia and NRS pain score ≥ 5. Exclusion criteria included neuropsychiatric disorders, use of opioids or benzodiazepines, substance abuse, pregnancy, breastfeeding, recent cannabis use, pain disorder other than fibromyalgia. |
No significant differences between groups for NRS pain scores or electrical pain threshold; 30% pain reduction in 18 bediol patients (p = 0.01). Bediol and bedrocan enhanced pressure threshold (p < 0.001 and p = 0.006, respectively). |
Bedrocan and bediol reduced pressure threshold, but no group significantly reduced pain NRS scores or electrical pain threshold. |
Chaves et al. (2020) [38] |
Adults with fibromyalgia with moderate-severe symptoms. Exclusion criteria included comorbidity, psychiatric illness, another disorder causing pain, pregnancy, breastfeeding, cannabis sensitivity. |
Significant decline in FIQ scores in the cannabis group (cannabis = 30.50 ± 16.18, placebo = 61.22 + 17.30, p = 0.005). |
THC oil improved the quality of life in fibromyalgia patients. |
Ware et al. (2010) [40] |
Adult fibromyalgia patients with chronic insomnia for 6 months. Exclusion criteria: cancer, use of monoamine oxidase inhibitors, neuropsychiatric illness, urinary retention, or sensitivity to study drugs. |
Nabilone was superior in sleep quality (difference = −3.25, 95% CI = −5.26 to −1.24). No significant differences on Leeds Sleep Evaluation Questionnaire, but nabilone showed more restful sleep (difference = 0.48, 95% CI = 0.01–0.95) and quicker sleep onset (difference = −0.7, 95% CI = −1.36–0.03). |
Nabilone was effective in improving sleep quality in fibromyalgia patients with chronic insomnia. |
van Amerongen et al. (2018) [44] |
Adults with progressive MS and severe pain and spasticity. Patients were excluded if they had epilepsy, recent disease worsening, or severe cardiac, renal, or hepatic disease. |
Improvement from baseline spasticity on Modified Ashworth Scale, 9-Hole Peg Test, and subjective NRS (p = 0.001, p = 0.018, and p = 0.001, respectively). No change in gait or H/M ratio from baseline. Prolonged CSP duration in MS patients (47.9 ± 6.2, p = 0.001). |
Oral THC:CBD spray was effective in reducing spasticity in MS patients. |