Dronabinol increases pain threshold in patients with functional chest pain: a pilot double-blind placebo-controlled trial

Diseases of the Esophagus : Official Journal of the International Society for Diseases of the Esophagus
Z MalikRon Schey

Abstract

Noncardiac chest pain is associated with poor quality of life and high care expenditure. The majority of noncardiac chest pain is either gastresophageal reflux disease related or due to esophageal motility disorders, and the rest are considered functional chest pain (FCP) due to central and peripheral hypersensitivity. Current treatment of FCP improves 40-50% of patients. Cannabinoid receptors 1 (CB1) and 2 (CB2) modulate release of neurotransmitters; CB1 is located in the esophageal epithelium and reduces excitatory enteric transmission and potentially could reduce esophageal hypersensitivity. We performed a prospective study to evaluate its effects on pain threshold, frequency, and intensity in FCP. Subjects with FCP received dronabinol (5 mg, twice daily; n = 7; average age, 44 years; mean body mass index, 26.7) or placebo (n = 6; average age, 42 years; mean body mass index, 25.9) for 28 days (4 weeks). Chest pain, general health, and anxiety/depression questionnaires were assessed at baseline and at 4 weeks. Subjects underwent an esophageal balloon distention test prior to treatment and on last day of the study. Dronabinol increased pain thresholds significantly (3.0 vs. 1.0; P = 0.03) and reduced pain intensity and odynoph...Continue Reading

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Citations

Oct 5, 2016·Current Treatment Options in Gastroenterology·Zachary Wilmer Reichenbach, Ron Schey
Oct 7, 2016·Current Treatment Options in Gastroenterology·Jose M Remes-Troche
Oct 8, 2019·Journal of Neurogastroenterology and Motility·Ronnie FassJose Tawil
Jan 16, 2020·Medicina·Bogdan Ionel TambaTeodora Alexa-Stratulat
Jan 12, 2021·Frontiers in Psychiatry·Amir GarakaniDan V Iosifescu

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