Abstract
Objective: The purpose of this study is to assess medical cannabis’ (MC) efficacy, reported adverse effects (AE), and dosages used in the treatment of patients with trigeminal neuralgia (TN).
Background: Few treatments currently exist for the treatment of TN, and almost half of patients become refractory to those medications with limited and often invasive recommendations for symptom control. A growing amount of evidence suggests that MC may be effective in alleviating neuropathic pain, making MC a potentially valuable treatment option for TN.
Design/Methods: A retrospective chart review of patients with TN that were treated with MC through the New York State Medical Marijuana Program was conducted in Buffalo, New York.
Results: Of 42 patients (32=female 10=male) included in the study, 81% reported improvement in their TN symptoms. AE were reported in 40%, and two discontinued because of AE. The most common side effects were fatigue, somnolence, nausea, and dizziness. Of patients who reported ≥50% improvement in TN symptoms, 69% used one product and 50% used a 1:1 ratio of tetrahydrocannabinol to cannabidiol. Of patients reporting opioid use at the beginning of MC treatment, 50% were able to reduce their opioid consumption on MC.
Conclusions: This study found that MC is well tolerated in the treatment of TN, with the 81% of patients reporting improvement and 50% of patients reducing opioid consumption with MC. The most common efficacious dosage for these patients is a 1:1 ratio of THC to CBD. These results suggest that MC is a useful part of a comprehensive pain management plan for patients with TN, but future randomized placebo controlled trials are needed.
Disclosure: Dr. Mechtler has received personal compensation for consulting, serving on a scientific advisory board, speaking, or other activities with Teva, Promius, Allergan, Avanir, andAmgen. Dr. Mechtler has received research support from DENT Family Foundation. Dr. Hart has received research support from Dent Family Foundation . Dr. Bargnes has nothing to disclose. Dr. Saikali has received personal compensation for consulting, serving on a scientific advisory board, speaking, or other activities with Allergan, Amgen, Promius, Supernus, Teva, Assertio, Avanir, Cefaly, Egalet, Gammacore, and Pernix.
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