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.