Dronabinol for Neuropathic Pain in Palliative Care.

Abstract

Neuropathic pain, characterized by dysfunction in the somatosensory system, is prevalent among palliative care patients, often resulting from conditions such as cancer, neurodegenerative diseases, and diabetes. Effective management of neuropathic pain is crucial for enhancing patient comfort and quality of life. This review explores the efficacy of dronabinol, a synthetic delta-9-tetrahydrocannabinol (THC), in managing neuropathic pain in palliative care. A comprehensive review of neuropathic pain mechanisms, treatment options, and the role of the endocannabinoid system was conducted. Clinical evidence supporting use of dronabinol for neuropathic pain was analyzed, including its pharmacological action, safety profile, and potential advantages over traditional analgesics. Dronabinol modulates pain pathways through CB1/CB2 receptor activation, reducing nociceptive transmission and neuroinflammation. Clinical studies indicate that dronabinol provides modest analgesic effects, improves associated symptoms such as nausea and sleep disturbances, and exhibits opioid-sparing potential. Dronabinol may represent a potential therapeutic option for neuropathic pain in palliative care. Its reported multimodal effects, generally favorable safety profile, and possible role in reducing opioid requirements should be considered potential advantages; however, these findings are supported by limited and heterogeneous evidence. Further research is needed to better define optimal dosing, assess long-term safety, and compare its efficacy with established treatments for neuropathic pain.