High-dose cannabidiol offers relief in patients with chronic neuropathic pain

In the treatment of patients with chronic neuropathic pain, high-dose cannabidiol (CBD) helps reduce pain intensity and is well-tolerated, according to a crossover study.

The study included 38 adults (mean age 54.9 years, 82 percent male) with spinal cord injury who had had neuropathic pain for at least 3 months. These participants received CBD and placebo, with each treatment administered orally over 6 weeks and separated by a 4-week washout period. CBD treatment was titrated up to 800 mg/day over 2 weeks.

The primary endpoint of change in self-reported pain intensity was assessed using the visual analogue scale.

At baseline, five participants (13.2 percent) had cardiovascular disease, and 16 (42.1 percent) had a history of depression. The mean number of pain medications was 2.4. Common analgesics/antispasmodics used were gabapentinoids (76.3 percent), paracetamol (36.8 percent), baclofen (36.8 percent), tricyclic antidepressants (34.2 percent), and opioids (29 percent). Common nonanalgesic medications included solifenacin (21.1 percent), docusate sodium (15.8 percent), oxybutynin (13.2 percent), and pantoprazole (13.2 percent).

Self-reported pain intensity was significantly lower during CBD treatment vs placebo treatment (mean difference, −0.54; p<0.001).

Adverse events occurred in 68.4 percent of participants during CBD treatment and in 52.6 percent during placebo treatment. These events were mostly minor.

The findings support further research into high-dose CBD for chronic neuropathic pain.