Journal of pain & palliative care pharmacotherapy
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J Pain Palliat Care Pharmacother · Oct 2024
ReviewThe Effectiveness of Tramadol in Pain Relief in Chronic Diseases: A Review Based on Clinical Trials.
Tramadol is a synthetic opioid with a central effect from the aminocyclohexanol group, which has two main mechanisms of action, including as a weak agonist of opioid receptors and as a norepinephrine and serotonin reuptake inhibitor. The present study presents a review based on clinical trials designed in 2023. In July 2023, six international databases, including Medline/PubMed, ProQuest, Scopus, EMBASE, Google Scholar, and ISI (Web of Science), were searched and 58 articles were included in the study. ⋯ It should be noted that there is not enough evidence to support the long-term effectiveness of tramadol, but this argument also extends to nonopioid and other types of opioid analgesics, and the lack of long-term trials is due to regulatory and ethical issues. Although opioids can cause addiction when used for a long time, tramadol has a reasonable safety profile. According to the patient's condition and the clinical judgment of the medical professional, tramadol can be prescribed for patients, but the consequences of its use must be considered and a personalized treatment algorithm should be selected if the benefits outweigh the risks of the drug.
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J Pain Palliat Care Pharmacother · Oct 2024
Changes in Pain and Mental Health Symptoms Associated with Prescribed Medicinal Cannabis Use: A One-Year Longitudinal Study.
Chronic pain and mental health issues like depression and anxiety significantly contribute to disease burden in Western countries. While cannabinoids are suggested to have analgesic, anxiolytic and antidepressant properties, evidence, especially for long-term use, is inconclusive. This 12-month observational study evaluated the effects of prescribed medicinal cannabis for 96 patients suffering from pain, as well as sleep disturbances, depression and anxiety. ⋯ Adverse effects were common but mostly mild or moderate, most commonly dry mouth and sleepiness. These results show that prescribed medicinal cannabis treatment is associated with improvements in chronic pain and mental health symptoms, such as depression, anxiety and stress. However, findings also suggest reduced effectiveness with longer-term use, emphasizing the need for additional research.
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J Pain Palliat Care Pharmacother · Oct 2024
Comparison of Cannabis-Based Medicinal Product Formulations for Fibromyalgia: A Cohort Study.
This cohort study aims to assess the outcomes of fibromyalgia patients enrolled in the UK Medical Cannabis Registry prescribed a homogenous selection of cannabis-based medicinal products (CBMPs). A cohort study of fibromyalgia patients treated with oils (Adven®, Curaleaf International, UK), dried flower (Adven®, Curaleaf International, UK) or both CBMPs was performed. Primary outcomes were changes from baseline at 1, 3, 6 and 12 months in validated patient-reported outcome measures. ⋯ Improvements were observed across all primary outcomes with no differences observed across different formulations of CBMPs. Adverse events were reported by one-quarter of participants and were more likely to reported by cannabis naïve patients. This present work through focusing on a homogeneous group of CBMPs can help inform randomized controlled trials after observing signals of improvement associated with a specific cultivar of CBMPs.
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J Pain Palliat Care Pharmacother · Oct 2024
Topical Formulation of Tramadol 5% in the Management of Osteoarthritis of the Knee: A Double-Blind, Randomized, Prospective, Placebo-Controlled Clinical Trial.
The goal of the present study was to evaluate the efficacy of topical tramadol in the management of knee osteoarthritis pain. Sixty patients with moderate to severe pain of knee osteoarthritis were enrolled. Patients were randomized to receive tramadol 5% or placebo along with oral diclofenac 100 mg/day. ⋯ At the end of follow-up period, VAS decreased by 21% (from 7.2 ± 2.1 to 5.7 ± 2.4, p-value < 0.05) and WOMAC score decreased by 23% (from 49.6 ± 17.4 to 38.4 ± 18.1, p-value < 0.05) in intervention group. Topical tramadol was significantly effective in reducing the intensity of pain and osteoarthritis symptoms in comparison to placebo considering VAS (5.7 ± 2.4 vs. 8.0 ± 2.9, p-value = 0.001) and WOMAC score (38.4 ± 18.1 vs. 46.0 ± 18.6, p-value = 0.007). Topical tramadol 5% appears to be effective in moderate to severe knee osteoarthritis pain.