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Analgesic and antihyperalgesic effects of nabilone on experimental heat pain.

Abstract

OBJECTIVE

In this study, we explored the analgesic and antihyperalgesic properties of a synthetic cannabinoid (nabilone) on experimental heat pain in men and women, as well as its effects on descending pain inhibitory systems.

RESEARCH DESIGN AND METHODS

A double-blind, placebo controlled, crossover study of nabilone single doses of 0.5 and 1 mg was conducted. Excitatory systems were elicited using a temporal summation test (tonic heat pain evoked by a Peltier thermode) administered before and after activation of descending inhibitory control (triggered using a counter-irritation procedure). These tests were given before and after drug treatment. Primary outcome measures included average heat pain, temporal summation of heat pain, and drug-induced changes in the strength of descending analgesia. Possible adverse reactions were monitored throughout treatment. Seven men (mean age = 22.5 years, SD = +/- 1.5) and 10 women (mean age = 23.2 years, SD = +/- 2.8) completed this study.

RESULTS

Nabilone (1 mg and 0.5 mg) did not reduce the global pain intensity experienced during tonic heat pain (all values of p > 0.18). It also failed to potentiate the strength of descending inhibitory responses (all values of p > 43). Nevertheless, at the highest dose (1 mg), and only for women, nabilone significantly (p = 0.003) dampened the temporal summation experienced during the last portion of the tonic heat pulse test (i.e., the period of time during which temporal summation is greatest). This antihyperalgesic effect was not observed for men (at either 0.5 mg or 1 mg dose), suggesting that the antihyperalgesic properties of cannabinoids are greater for women than for men. Adverse reactions encountered were generally mild and did not provoke the cessation of testing.

CONCLUSIONS

Nabilone failed to produce analgesic effects and it did not interact with descending pain inhibitory systems. However, we found that a single 1 mg dose of nabilone reduced temporal summation for women but not men. Although a titration regime and a larger sample of subjects might have provided more robust effects, these preliminary results suggest that nabilone appears effective at relieving hyperalgesic responses in women. Possible neurobiological mechanisms and clinical implications are further discussed.

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  • Authors+Show Affiliations

    ,

    Université de Sherbrooke, Faculté de Médecine, Sherbrooke, Québec, Canada.

    , ,

    Source

    Current medical research and opinion 24:4 2008 Apr pg 1017-24

    MeSH

    Adolescent
    Adult
    Analgesics
    Anti-Anxiety Agents
    Cannabinoids
    Cross-Over Studies
    Double-Blind Method
    Dronabinol
    Female
    Hot Temperature
    Humans
    Hyperalgesia
    Male
    Pain

    Pub Type(s)

    Clinical Trial
    Journal Article
    Randomized Controlled Trial
    Research Support, Non-U.S. Gov't

    Language

    eng

    PubMed ID

    18302810

    Citation

    Redmond, William John, et al. "Analgesic and Antihyperalgesic Effects of Nabilone On Experimental Heat Pain." Current Medical Research and Opinion, vol. 24, no. 4, 2008, pp. 1017-24.
    Redmond WJ, Goffaux P, Potvin S, et al. Analgesic and antihyperalgesic effects of nabilone on experimental heat pain. Curr Med Res Opin. 2008;24(4):1017-24.
    Redmond, W. J., Goffaux, P., Potvin, S., & Marchand, S. (2008). Analgesic and antihyperalgesic effects of nabilone on experimental heat pain. Current Medical Research and Opinion, 24(4), pp. 1017-24. doi:10.1185/030079908X280635.
    Redmond WJ, et al. Analgesic and Antihyperalgesic Effects of Nabilone On Experimental Heat Pain. Curr Med Res Opin. 2008;24(4):1017-24. PubMed PMID: 18302810.
    * Article titles in AMA citation format should be in sentence-case
    TY - JOUR T1 - Analgesic and antihyperalgesic effects of nabilone on experimental heat pain. AU - Redmond,William John, AU - Goffaux,Philippe, AU - Potvin,Stéphane, AU - Marchand,Serge, Y1 - 2008/02/22/ PY - 2008/2/28/pubmed PY - 2008/6/14/medline PY - 2008/2/28/entrez SP - 1017 EP - 24 JF - Current medical research and opinion JO - Curr Med Res Opin VL - 24 IS - 4 N2 - OBJECTIVE: In this study, we explored the analgesic and antihyperalgesic properties of a synthetic cannabinoid (nabilone) on experimental heat pain in men and women, as well as its effects on descending pain inhibitory systems. RESEARCH DESIGN AND METHODS: A double-blind, placebo controlled, crossover study of nabilone single doses of 0.5 and 1 mg was conducted. Excitatory systems were elicited using a temporal summation test (tonic heat pain evoked by a Peltier thermode) administered before and after activation of descending inhibitory control (triggered using a counter-irritation procedure). These tests were given before and after drug treatment. Primary outcome measures included average heat pain, temporal summation of heat pain, and drug-induced changes in the strength of descending analgesia. Possible adverse reactions were monitored throughout treatment. Seven men (mean age = 22.5 years, SD = +/- 1.5) and 10 women (mean age = 23.2 years, SD = +/- 2.8) completed this study. RESULTS: Nabilone (1 mg and 0.5 mg) did not reduce the global pain intensity experienced during tonic heat pain (all values of p > 0.18). It also failed to potentiate the strength of descending inhibitory responses (all values of p > 43). Nevertheless, at the highest dose (1 mg), and only for women, nabilone significantly (p = 0.003) dampened the temporal summation experienced during the last portion of the tonic heat pulse test (i.e., the period of time during which temporal summation is greatest). This antihyperalgesic effect was not observed for men (at either 0.5 mg or 1 mg dose), suggesting that the antihyperalgesic properties of cannabinoids are greater for women than for men. Adverse reactions encountered were generally mild and did not provoke the cessation of testing. CONCLUSIONS: Nabilone failed to produce analgesic effects and it did not interact with descending pain inhibitory systems. However, we found that a single 1 mg dose of nabilone reduced temporal summation for women but not men. Although a titration regime and a larger sample of subjects might have provided more robust effects, these preliminary results suggest that nabilone appears effective at relieving hyperalgesic responses in women. Possible neurobiological mechanisms and clinical implications are further discussed. SN - 1473-4877 UR - https://www.unboundmedicine.com/medline/citation/18302810/Analgesic_and_antihyperalgesic_effects_of_nabilone_on_experimental_heat_pain_ L2 - http://www.tandfonline.com/doi/full/10.1185/030079908X280635 DB - PRIME DP - Unbound Medicine ER -