The use of canabidiol in the treatment of fibromyalgia
a review
Keywords:
Canabis, tetrahidrocanabidiol (THC), canabidiol (CBD), fibromyalgiaAbstract
Fibromyalgia is a chronic disease that is characterized by widespread pain, its diagnosis is based on the Fibromyalgia criteria of the American College of Rheumatology. This condition affects more women than men according to the Brazilian Association of Rheumatology. The pathophysiology of this disease is poorly understood. Several mechanisms have been suggested such as central sensitization, suppression of descending inhibitory mechanisms, excessive glial cell activity and neurotransmitter release abnormalities. A large body of evidence currently supports the presence of cannabinoid receptors and ligands, therefore an endocannabinoid neuromodulatory system appears to be involved in various physiological processes of pain. There are three types of cannabidioids: endocannabidioids, phytocannabidioids (in cannabis plants) and synthetic cannabidioids, all of which bind to cannabidioid receptors and produce a positive effect on pain perception. Articles from these databases: PUBMED, Scielo, VHL and UP TO DATE, published from 2006 to 2022. Clinical trials, review articles and original articles in Portuguese, English and Spanish were included. Twenty-two studies were used: 4 randomized clinical trials, 11 observational studies and 7 systematic review articles. The treatment of Fibromyalgia includes pharmacological and non-pharmacological measures. The non-pharmacological treatment of fibromyalgia is performed, in most cases, aerobic physical activity and cognitive- -behavioral therapy, pharmacologically there are several possibilities, always considering the possible pathophysiological mechanisms and symptoms, it must always be performed individually, antidepressants, calcium channel modulators, muscle relaxants and/or analgesics, among other drugs, can be used. Cannabis oils, THC and CBD, interact with the endocannabidiode system in reducing and managing pain. Medical cannabis was considered safe and well tolerated in fibromyalgia patients. This literary review found several articles that relate the use of Cannabis as an alternative in the treatment of such a condition. We observed that there are some limitations to infer the indication of substance use as adequate in the treatment, despite finding studies that indicate significant improvement in the control of pain and disorders associated with the disease, more studies are needed to confirm: the possible impact of Cannabis on pain and other symptoms, usage protocols, THC: CBD concentration, route of administration, dosages, and possible side effects.
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