(207) Managing chronic pain with low dose of nabilone

Abstract

Our aim is to report changes in the severity of pain, sleep quality, daily activities and mental status with low dose of nabilone in sufferers from motor vehicle accident (MVA’s). Six patients with chronic pain, 37 to 80 years old were retrospectively analysed. All patients were receiving nightly dose of nabilone 0.5 mg. The outcome measures; Brief Pain Inventory (BPI), the Edmonton Symptoms Assessment Scale (ESAS) with diagram and patients’ log, the Sleep Questionnaire (SQ) and the Mini-Mental Status Exam (MMSE) were assessed pre-treatment and six months following the intervention. Final data are presented as average percentage changes from baseline. The ESAS individual item and summary scores showed good internal consistency and correlated appropriately with results obtained from BPI, SQ and MMSE. The overall improvements were as follows: ESAS numeric scale 21%; BPI 19.6% in pain scale with 26% decrease interference of pain in daily activities and SQ 33%. However, the MMSE results have decreased by only 1% from baseline (28%) revealing no cognitive impairment. These data demonstrated that a low dose of nabilone reduces clinical pain and fatigue/malaise in MVA patients despite increased in their general daily activities, work tolerance and socialization. The degree of pain and time to return to work following intervention has been evident. Improvement of sleep was consistent with fewer awakenings and more refreshing mornings. Patients were less anxious and irritable. Their appetite increased with BMI normalization. Their prescription and OTC medications were reduced. During the follow-up period, patients neither reported cognitive impairment nor adverse events. Nabilone did not cause daytime sleepiness or impaired alertness. Also, patients did not request an increase in nabilone dose or any other “drug seeking” behaviours. No drop-outs were reported.