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Anesthesiology Research and Practice
Volume 2009, Article ID 827290, 9 pages
http://dx.doi.org/10.1155/2009/827290
Clinical Study

Tetrahydrocannabinol (Delta 9-THC) Treatment in Chronic Central Neuropathic Pain and Fibromyalgia Patients: Results of a Multicenter Survey

1Department of Anesthesiology, Intensive Care, Emergency Medicine and Pain Therapy, Kantonsspital Lucerne, 6000 Lucerne, Switzerland
2Department of Anesthesiology, Medical Faculty Mannheim, University of Heidelberg, 68167 Mannheim, Germany
3Department of Anesthesiology and Pain Medicine, Swiss Paraplegic Center, 6207 Nottwil, Switzerland
4Department of Neuroscience, Algesiology and Pediatrics, 90419 Nuremberg, Germany

Received 20 April 2009; Revised 30 July 2009; Accepted 7 September 2009

Academic Editor: Thomas J. J. Blanck

Copyright © 2009 Janet Weber et al. This is an open access article distributed under the Creative Commons Attribution License, which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly cited.

Abstract

Central neuropathic pain is difficult to treat, but delta 9-Tetrahydrocannabinol (delta 9-THC) may be a promising therapeutic agent. We administered in 172 patients on average 7.5 mg delta 9-THC over 7 months. Of these, 48 patients prematurely withdrew due to side effects, insufficient analgesia, or expense of therapy. Thus, 124 patients were assessed retrospectively in a multicenter telephone survey. Reported changes in pain intensity, recorded on a numeric rating scale (NRS), Pain Disability Index (PDI), Medical Outcomes Short-Form (SF-12), Quality of Life Impairment by Pain (QLIP), Hospital Anxiety Depression Scale (HADS), and amount of concomitant pain medication were recorded. Psychometric parameters (PDI, SF-12, QLIP, HADS) and pain intensity improved significantly during delta 9-THC treatment. Opioid doses were reduced and patients perceived THC therapy as effective with tolerable side effects. About 25% of the patients, however, did not tolerate the treatment. Therapy success and tolerance can be assessed by a transient delta 9-THC titration and its maintained administration for several weeks. The present survey demonstrates its ameliorating potential for the treatment of chronic pain in central neuropathy and fibromyalgia. A supplemental delta 9-THC treatment as part of a broader pain management plan therefore may represent a promising coanalgesic therapeutic option.