Chronic neuropathic pain Nervous System Diseases Chronic neuropathic pain
Conditions
Interventions
Cannabis containing 9.43% THC versus cannabis containing 0% THC.
Please note that the date of the last follow-up of the last recruited trial participant was 9th March 2006.
Sponsors
Montreal General Hospital (Canada)
Eligibility
Sex/Gender
All
Inclusion criteria
Inclusion criteria: Current inclusion criteria as of 18/01/2008: 1. Ambulatory, otherwise healthy, men and women with neuropathic pain of at least three months duration which is due to trauma or surgery, with clinical evidence of allodynia or hyperalgesia 2. Average weekly pain intensity score less than or equal to 4 on a 10 cm visual analogue scale (anchors: 0 is no pain, 10 is worst pain ever) 3. Stable analgesic regimen (no anticipated change in therapy over the next two months) 4. No cannabis use in the past month 5. Ability to comply with smoking procedure 6. 18 years and older 7. Ability to attend research centre twice weekly for four weeks over a two month period, and to be able to be contacted by telephone during the study period 8. Normal liver (aspartate aminotransferase [AST] less than 3 x normal) and renal function (serum creatinine less than 133 µmol/l) 9. Haematocrit greater than 35% 10. Negative serum beta human chorionic gonadotrophin [ßhCG] pregnancy test 11. Women of childbearing potential should use adequate contraception during study and for three months after study 12. Proficient in English or French 13. Willing and able to give written informed consent Previous inclusion criteria: 1. Ambulatory, otherwise healthy, men and women with neuropathic pain of at least three months duration which is due to trauma or surgery, with clinical evidence of allodynia or hyperalgesia 2. Average weekly pain intensity score 5= on a 10 cm visual analogue scale (anchors: 0 is no pain, 10 is worst pain ever) 3. Stable analgesic regimen (no anticipated change in therapy over the next two months) 4. No cannabis use in the past month 5. Ability to comply with smoking procedure 6. 18 years and older 7. Ability to attend research centre twice weekly for four weeks over a two month period, and to be able to be contacted by telephone during the study period 8. Normal liver (aspartate aminotransferase [AST] 38% 10. Negative serum beta human chorionic gonadotrophin [ßhCG] pregnancy test 11. Women of childbearing potential should use adequate contraception during study and for three months after study 12. Proficient in English or French 13. Willing and able to give written informed consent
Exclusion criteria
Exclusion criteria: Current exclusion criteria as of 18/01/2008: 1. Positive results of cannabinoid screening 2. Pain due to cancer or nociceptive causes (e.g. acute trauma, herpes zoster) 3. Unstable heart disease such as arrhythmias, cardiac failure, ischaemic heart disease, hypertension 4. Current substance abuse/dependence (including cannabis) as defined by the Diagnostic and Statistical Manual of mental disorders fourth edition (DSM IV) criteria 5. Unstable or untreated lung disease (tuberculosis [TB], asthma, carcinoma, chronic obstructive pulmonary disease [COPD]) 6. History of uncontrolled psychotic disorder in the past year (for example, schizophrenia or bipolar disorder) 7. Current suicidal ideation, as assessed by clinical psychologist 8. Pregnancy and/or breast-feeding 9. Participation in other clinical trial in the 30 days prior to enrolment 10. Ongoing medical insurance or compensation claims (may confound subjective pain intensity ratings if pain has possible secondary gain) Previous exclusion criteria: 1. Positive results of cannabinoid screening 2. Pain due to cancer or nociceptive causes (e.g. acute trauma, herpes zoster) 3. Cardiac arrhythmias, cardiac failure, ischaemic heart disease 4. Current substance abuse/dependence (including cannabis) as defined by the Diagnostic and Statistical Manual of mental disorders fourth edition (DSM IV) criteria 5. Pulmonary complications (tuberculosis [TB], asthma, carcinoma, chronic obstructive pulmonary disease [COPD]) 6. History of psychotic disorder (for example, schizophrenia or bipolar disorder) 7. Current suicidal ideation, as assessed by clinical psychologist 8. Pregnancy and/or breast-feeding 9. Participation in other clinical trial in the 30 days prior to enrolment 10. Ongoing medical insurance or compensation claims (may confound subjective pain intensity ratings if pain has possible secondary gain)
Design outcomes
Primary
| Measure | Time frame |
|---|---|
| 1. Average pain intensity measured daily during each cycle by 100 mm visual analogue scale (VAS) 2. No pain and worst pain possible will be used as anchors in the 11-item numerical rating scale. The daily pain intensity score will be averaged across all study days for each cycle to comprise the main outcome variable. | — |
Secondary
| Measure | Time frame |
|---|---|
| The main clinical outcomes will be the subjective 'high', mood, quality of life, and quality of sleep. Treatment discernment will be assessed by potency assessments at inpatient and follow up visits: 1. Trial feasibility: practical issues of recruitment and compliance will be recorded during the study 2. Pain quality: the McGill Pain Questionnaire (MPQ) measures affective and cognitive aspects of pain experience at patient visits. This will be administered on day five of each of the four five-day treatment cycles. 3. Sleep: a modification of the Leeds Sleep Evaluation Questionnaire (LSEQ) will be used. This will be administered by daily telephone interviews during each treatment cycle. 4. Mood: the short form Profile of Mood States (POMS) will be administered on day five of each of the four five-day treatment cycles 5. Quality of life: quality of life will be assessed using the EuroQOL 5D instrument, which will be administered on day five of each of the four five-day treatment cycles 6. Physiological assessments: physiological measurements (blood pressure, heart rate, electrocardiogram [ECG] changes, pulse oximetry, respiratory rate) will be conducted at 15 minute intervals during the first hour and hourly for two hours after smoking on day one of each treatment cycle 7. Quantitative sensory testing (QST): QST of cutaneous thermal sensitivity will be performed at baseline (during the screening visit) and on day five of each of the four five-day treatment cycles 8. 'High': will be measured subjectively at 15 minute intervals during the first hour and hourly for two hours after smoking on day one of each treatment cycle using an unmarked VAS scale (anchors: 0 is not at all, 10 is extremely) 9. Other subjective effects: the subjects will be asked to identify their current level of 'relaxed', 'stressed', 'happy' measured subjectively at 15 minute intervals during the first hour and hourly for two hours after smoking on day one of each treatment cycle using 100 mm VAS | — |
Countries
Canada
Outcome results
None listed