NDLI: The effects of nabilone on sleep in fibromyalgia: results of a randomized controlled trial.

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The effects of nabilone on sleep in fibromyalgia: results of a randomized controlled trial.

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The effects of nabilone on sleep in fibromyalgia: results of a randomized controlled trial.

Content Provider	World Health Organization (WHO)-Global Index Medicus
Author	Ware, Mark A. Fitzcharles, Mary-Ann Joseph, Lawrence Shir, Yoram
Description	Country affiliation: Canada Author Affiliation: Ware MA ( Pain Clinic, McGill University Health Centre, Montreal, Quebec, Canada. mark.ware@muhc.mcgill.c)
Abstract	BACKGROUND: Sleep disorders affect many patients with chronic pain conditions. Cannabis has been reported by several patient populations to help sleep. We evaluated the safety and efficacy of nabilone, a synthetic cannabinoid, on sleep disturbance in fibromyalgia (FM), a disease characterized by widespread chronic pain and insomnia. METHODS: We conducted a randomized, double-blind, active-control, equivalency crossover trial to compare nabilone (0.5-1.0 mg before bedtime) to amitriptyline (10-20 mg before bedtime) in patients with FM with chronic insomnia. Subjects received each drug for 2 wk with a 2-wk washout period. The primary outcome was sleep quality, measured by the Insomnia Severity Index and the Leeds Sleep Evaluation Questionnaire. Secondary outcomes included pain, mood, quality of life, and adverse events (AEs). RESULTS: Thirty-one subjects were enrolled and 29 completed the trial (26 women, mean age 49.5 yr). Although sleep was improved by both amitriptyline and nabilone, nabilone was superior to amitriptyline (Insomnia Severity Index difference = 3.2; 95% confidence interval = 1.2-5.3). Nabilone was marginally better on the restfulness (Leeds Sleep Evaluation Questionnaire difference = 0.5 [0.0-1.0]) but not on wakefulness (difference = 0.3 [-0.2 to 0.8]). No effects on pain, mood, or quality of life were observed. AEs were mostly mild to moderate and were more frequent with nabilone. The most common AEs for nabilone were dizziness, nausea, and dry mouth. CONCLUSIONS: Nabilone is effective in improving sleep in patients with FM and is well tolerated. Low-dose nabilone given once daily at bedtime may be considered as an alternative to amitriptyline. Longer trials are needed to determine the duration of effect and to characterize long-term safety.
File Format	HTM / HTML
ISSN	00032999
Issue Number	2
Volume Number	110
e-ISSN	15267598
Journal	Anesthesia & Analgesia
Language	English
Publisher	Lippincott Williams & Wilkins
Publisher Date	2010-02-01
Publisher Place	United States
Access Restriction	One Nation One Subscription (ONOS)
Subject Keyword	Discipline Anesthesiology Anti-anxiety Agents Therapeutic Use Dronabinol Analogs & Derivatives Fibromyalgia Complications Sleep Initiation And Maintenance Disorders Drug Therapy Adult Aged Amitriptyline Adverse Effects Antidepressive Agents Cross-over Studies Double-blind Method Female Humans Male Middle Aged Pain Measurement Patient Satisfaction Sleep Etiology Journal Article Randomized Controlled Trial Research Support, Non-u.s. Gov't
Content Type	Text
Resource Type	Article
Subject	Anesthesiology and Pain Medicine

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