Login Register Cart 0
Generic placeholder image

Current Pharmaceutical Biotechnology

Editor-in-Chief

ISSN (Print): 1389-2010
ISSN (Online): 1873-4316

Back
Journal Home About Journal Editorial Board Journal Insight Current Issue Volumes/Issues
Subscribe
Research Article

The Effectiveness of Topical Cannabidiol Oil in Symptomatic Relief of Peripheral Neuropathy of the Lower Extremities

Author(s): Dixon H. Xu, Benjamin D. Cullen*, Meng Tang and Yujiang Fang

Volume 21, Issue 5, 2020

Page: [390 - 402] Pages: 13

DOI: 10.2174/1389201020666191202111534

Price: $65

Abstract

Background: Peripheral neuropathy can significantly impact the quality of life for those who are affected, as therapies from the current treatment algorithm often fail to deliver adequate symptom relief. There has, however, been an increasing body of evidence for the use of cannabinoids in the treatment of chronic, noncancer pain. The efficacy of a topically delivered cannabidiol (CBD) oil in the management of neuropathic pain was examined in this four-week, randomized and placebocontrolled trial.

Methods: In total, 29 patients with symptomatic peripheral neuropathy were recruited and enrolled. 15 patients were randomized to the CBD group with the treatment product containing 250 mg CBD/3 fl. oz, and 14 patients were randomized to the placebo group. After four weeks, the placebo group was allowed to crossover into the treatment group. The Neuropathic Pain Scale (NPS) was administered biweekly to assess the mean change from baseline to the end of the treatment period.

Results: The study population included 62.1% males and 37.9% females with a mean age of 68 years. There was a statistically significant reduction in intense pain, sharp pain, cold and itchy sensations in the CBD group when compared to the placebo group. No adverse events were reported in this study.

Conclusion: Our findings demonstrate that the transdermal application of CBD oil can achieve significant improvement in pain and other disturbing sensations in patients with peripheral neuropathy. The treatment product was well tolerated and may provide a more effective alternative compared to other current therapies in the treatment of peripheral neuropathy.

Keywords: CBD, diabetic neuropathy, review, cannabis sativa, hemp, nerve pain.

« Previous Next »
Graphical Abstract

[1]
Palmieri, B.; Laurino, C.; Vadalà, M. Short-Term Efficacy of CBD-enriched hemp oil in girls with dysautonomic syndrome after human papillomavirus vaccination. Isr. Med. Assoc. J., 2017, 19(2), 79-84.
[PMID: 28457055]
[2]
Bruni, N.; Della Pepa, C.; Oliaro-Bosso, S.; Pessione, E.; Gastaldi, D.; Dosio, F. Cannabinoid. Molecules, 2018, 23(10)E2478
[http://dx.doi.org/10.3390/molecules23102478] [PMID: 30262735]
[3]
Dogrul, A.; Gul, H.; Akar, A.; Yildiz, O.; Bilgin, F.; Guzeldemir, E. Topical cannabinoid antinociception: synergy with spinal sites. Pain, 2003, 105(1-2), 11-16.
[http://dx.doi.org/10.1016/S0304-3959(03)00068-X] [PMID: 14499415]
[4]
Modesto-Lowe, V.; Bojka, R.; Alvarado, C. Cannabis for peripheral neuropathy: The good, the bad, and the unknown. Cleve. Clin. J. Med., 2018, 85(12), 943-949.
[http://dx.doi.org/10.3949/ccjm.85a.17115] [PMID: 30526755]
[5]
Campos, A.C.; Fogaça, M.V.; Scarante, F.F.; Joca, S.R.L.; Sales, A.J.; Gomes, F.V.; Sonego, A.B.; Rodrigues, N.S.; Galve-Roperh, I.; Guimarães, F.S. Plastic and neuroprotective mechanisms involved in the therapeutic effects of cannabidiol in psychiatric disorders. Front. Pharmacol., 2017, 8, 269.
[http://dx.doi.org/10.3389/fphar.2017.00269] [PMID: 28588483]
[6]
Stockings, E.; Campbell, G.; Hall, W.D.; Nielsen, S.; Zagic, D.; Rahman, R.; Murnion, B.; Farrell, M.; Weier, M.; Degenhardt, L. Cannabis and cannabinoids for the treatment of people with chronic noncancer pain conditions: a systematic review and meta-analysis of controlled and observational studies. Pain, 2018, 159(10), 1932-1954.
[http://dx.doi.org/10.1097/j.pain.0000000000001293] [PMID: 29847469]
[7]
Grotenhermen, F.; Müller-Vahl, K. The therapeutic potential of cannabis and cannabinoids. Dtsch. Arztebl. Int., 2012, 109(29-30), 495-501.
[http://dx.doi.org/10.3238/arztebl.2012.0495] [PMID: 23008748]
[8]
Hampson, R.E.; Deadwyler, S.A. Cannabinoids reveal the necessity of hippocampal neural encoding for short-term memory in rats. J. Neurosci., 2000, 20(23), 8932-8942.
[http://dx.doi.org/10.1523/JNEUROSCI.20-23-08932.2000] [PMID: 11102504]
[9]
Huestis, M.A.; Gorelick, D.A.; Heishman, S.J.; Preston, K.L.; Nelson, R.A.; Moolchan, E.T.; Frank, R.A. Blockade of effects of smoked marijuana by the CB1-selective cannabinoid receptor antagonist SR141716. Arch. Gen. Psychiatry, 2001, 58(4), 322-328.
[http://dx.doi.org/10.1001/archpsyc.58.4.322] [PMID: 11296091]
[10]
Munro, S.; Thomas, K.L.; Abu-Shaar, M. Molecular characterization of a peripheral receptor for cannabinoids. Nature, 1993, 365(6441), 61-65.
[http://dx.doi.org/10.1038/365061a0] [PMID: 7689702]
[11]
Mallet, P.E.; Beninger, R.J. The cannabinoid CB1 receptor antagonist SR141716A attenuates the memory impairment produced by delta9-tetrahydrocannabinol or anandamide. Psychopharmacology, (Berl.), 1998, 140(1), 11-19.
[http://dx.doi.org/10.1007/s002130050733] [PMID: 9862397]
[12]
Toth, C.C.; Jedrzejewski, N.M.; Ellis, C.L.; Frey, W.H., II Cannabinoid-mediated modulation of neuropathic pain and microglial accumulation in a model of murine type I diabetic peripheral neuropathic pain. Mol. Pain, 2010, 6, 16.
[http://dx.doi.org/10.1186/1744-8069-6-16] [PMID: 20236533]
[13]
Callaghan, B.C.; Price, R.S.; Feldman, E.L. Distal symmetric polyneuropathy: A review. JAMA, 2015, 314(20), 2172-2181.
[http://dx.doi.org/10.1001/jama.2015.13611] [PMID: 26599185]
[14]
Finnerup, N.B.; Haroutounian, S.; Kamerman, P.; Baron, R.; Bennett, D.L.H.; Bouhassira, D.; Cruccu, G.; Freeman, R.; Hansson, P.; Nurmikko, T.; Raja, S.N.; Rice, A.S.; Serra, J.; Smith, B.H.; Treede, R.D.; Jensen, T.S. Neuropathic pain: an updated grading system for research and clinical practice. Pain, 2016, 157(8), 1599-1606.
[http://dx.doi.org/10.1097/j.pain.0000000000000492] [PMID: 27115670]
[15]
Mold, J.W.; Vesely, S.K.; Keyl, B.A.; Schenk, J.B.; Roberts, M. The prevalence, predictors, and consequences of peripheral sensory neuropathy in older patients. J. Am. Board Fam. Pract., 2004, 17(5), 309-318.
[http://dx.doi.org/10.3122/jabfm.17.5.309] [PMID: 15355943]
[16]
Zeng, L.; Alongkronrusmee, D.; van Rijn, R.M. An integrated perspective on diabetic, alcoholic, and drug-induced neuropathy, etiology, and treatment in the US. J. Pain Res., 2017, 10, 219-228.
[http://dx.doi.org/10.2147/JPR.S125987] [PMID: 28176937]
[17]
Attal, N.; Cruccu, G.; Baron, R.; Haanpää, M.; Hansson, P.; Jensen, T.S.; Nurmikko, T. European Federation of Neurological Societies. EFNS guidelines on the pharmacological treatment of neuropathic pain: 2010 revision. Eur. J. Neurol., 2010, 17(9), 1113-e88.
[http://dx.doi.org/10.1111/j.1468-1331.2010.02999.x] [PMID: 20402746]
[18]
Akram, M.; Naqvi, S.B.; Khan, A. Design and development of insulin emulgel formulation for transdermal drug delivery and its evaluation. Pak. J. Pharm. Sci., 2013, 26(2), 323-332.
[PMID: 23455203]
[19]
Zanardo, V.; Giarrizzo, D.; Maiolo, L.; Straface, G. Efficacy of Topical Application of Emu Oil on Areola Skin Barrier in Breastfeeding Women. J. Evid. Based Complementary Altern. Med., 2016, 21(1), 10-13.
[http://dx.doi.org/10.1177/2156587215588653] [PMID: 26080458]
[20]
Bennett, M.I.; Attal, N.; Backonja, M.M.; Baron, R.; Bouhassira, D.; Freynhagen, R.; Scholz, J.; Tölle, T.R.; Wittchen, H-U.; Jensen, T.S. Using screening tools to identify neuropathic pain. Pain, 2007, 127(3), 199-203.
[http://dx.doi.org/10.1016/j.pain.2006.10.034] [PMID: 17182186]
[21]
Cruccu, G.; Truini, A. Tools for assessing neuropathic pain. PLoS Med., 2009, 6(4)e1000045
[http://dx.doi.org/10.1371/journal.pmed.1000045] [PMID: 19360134]
[22]
Galer, B.S.; Jensen, M.P. Development and preliminary validation of a pain measure specific to neuropathic pain: the Neuropathic Pain Scale. Neurology, 1997, 48(2), 332-338.
[http://dx.doi.org/10.1212/WNL.48.2.332] [PMID: 9040716]
[23]
Rog, D.J.; Nurmikko, T.J.; Friede, T.; Young, C.A. Validation and reliability of the Neuropathic Pain Scale (NPS) in multiple sclerosis. Clin. J. Pain, 2007, 23(6), 473-481.
[http://dx.doi.org/10.1097/AJP.0b013e31805d0c5d] [PMID: 17575486]
[24]
Benzon, H.T. The neuropathic pain scales. Reg. Anesth. Pain Med., 2005, 30(5), 417-421.
[http://dx.doi.org/10.1097/00115550-200509000-00001] [PMID: 16135344]
[25]
Jensen, M.P.; Friedman, M.; Bonzo, D.; Richards, P. The validity of the neuropathic pain scale for assessing diabetic neuropathic pain in a clinical trial. Clin. J. Pain, 2006, 22(1), 97-103.
[http://dx.doi.org/10.1097/01.ajp.0000173018.64741.62] [PMID: 16340598]
[26]
Borgelt, L.M.; Franson, K.L.; Nussbaum, A.M.; Wang, G.S. The pharmacologic and clinical effects of medical cannabis. Pharmacotherapy, 2013, 33(2), 195-209.
[http://dx.doi.org/10.1002/phar.1187] [PMID: 23386598]
[27]
Blake, A.; Wan, B.A.; Malek, L.; DeAngelis, C.; Diaz, P.; Lao, N.; Chow, E.; O’Hearn, S. A selective review of medical cannabis in cancer pain management. Ann. Palliat. Med., 2017, 6(Suppl. 2), S215-S222.
[http://dx.doi.org/10.21037/apm.2017.08.05] [PMID: 28866904]
[28]
Huang, W-J.; Chen, W-W.; Zhang, X. Endocannabinoid system: Role in depression, reward and pain control. Mol. Med. Rep., 2016, 14(4), 2899-2903.
[http://dx.doi.org/10.3892/mmr.2016.5585] [PMID: 27484193]
[29]
Pergolizzi, J.V., Jr; Lequang, J.A.; Taylor, R., Jr; Raffa, R.B.; Colucci, D. NEMA Research Group. The role of cannabinoids in pain control: the good, the bad, and the ugly. Minerva Anestesiol., 2018, 84(8), 955-969.
[http://dx.doi.org/10.23736/S0375-9393.18.12287-5] [PMID: 29338150]
[30]
Maida, V.; Daeninck, P.J. A user’s guide to cannabinoid therapies in oncology. Curr. Oncol., 2016, 23(6), 398-406.
[http://dx.doi.org/10.3747/co.23.3487] [PMID: 28050136]
[31]
Huestis, M.A. Pharmacokinetics and metabolism of the plant cannabinoids, delta9-tetrahydrocannabinol, cannabidiol and cannabinol. Handb. Exp. Pharmacol., 2005, (168), 657-690.
[http://dx.doi.org/10.1007/3-540-26573-2_23] [PMID: 16596792]
[32]
Serpell, M.; Ratcliffe, S.; Hovorka, J.; Schofield, M.; Taylor, L.; Lauder, H.; Ehler, E. A double-blind, randomized, placebo-controlled, parallel group study of THC/CBD spray in peripheral neuropathic pain treatment. Eur. J. Pain, 2014, 18(7), 999-1012.
[http://dx.doi.org/10.1002/j.1532-2149.2013.00445.x] [PMID: 24420962]
[33]
Paudel, K.S.; Hammell, D.C.; Agu, R.U.; Valiveti, S.; Stinchcomb, A.L. Cannabidiol bioavailability after nasal and transdermal application: effect of permeation enhancers. Drug Dev. Ind. Pharm., 2010, 36(9), 1088-1097.
[http://dx.doi.org/10.3109/03639041003657295] [PMID: 20545522]
[34]
Xu, D.H.; Cullen, B.D.; Tang, M.; Fang, Y. The Effectiveness of topical cannabidiol oil in symptomatic relief of peripheral neuropathy of the lower extremities. Synapse, 2019.
[http://dx.doi.org/10.2174/1389201020666191202111534] [PMID: 31793418]

Rights & Permissions Print Cite
Article Metrics
208
24
1
© 2024 Bentham Science Publishers | Privacy Policy