Cesamet (nabilone) for Fibromyalgia: Does Synthetic Marijuana Work?

Synthetic Marijuana: Does It Work?

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The drug Cesamet (nabilone) is a cannabinoid, meaning that it's a synthetic form of cannabis (marijuana.) Its primary use is treating nausea and vomiting in people who are on chemotherapy for cancer.

However, it's also used to treat chronic pain, including the pain of fibromyalgia (FMS). It isn't FDA-approved for this usage, though.

Cesamet is a Schedule II controlled substance because of its risk of abuse.

That's the same level as Vicodin (hydrocodone acetaminophen).

How Cesamet Works

Cesamet works by binding with certain receptors in the brain (called canabinoid receptors) and altering the actions of some brain chemicals.

It's believed that the medicinal effects are from different chemiclas than cause the "high" associated with marijuana use.

Cesamet for Fibromyalgia

We have a growing body of evidence on Cesamet as an FMS treatment. Most, but not all, of the results are positive.

A 2016 study on cannabinoids for rheumatic disease concluded there was insufficient evidence to recommend these drugs.

However, other studies have had positive results. A 2010 study on sleep improvement for people with FMS and insomnia found that Cesamet was more effective than the common antidepressant amitriptyline.

A 2016 review of literature on pain treatment concluded that Cesamet is shown to have a small but significant effect on pain from fibromyalgia, neuropathy, cancer, and other conditions.

In most cases, researchers found, it was used in conjunction with other pain treatments rather than as a stand-alone treatment.

In earlier studies and reviews, the reported results have ranged from small to significant.

Cesamet & Abuse Potential

According to research, abuse of Cesamet is extremely rare.

However, it is possible, especially in people with a history of abusing marijuana, alcohol, or other drugs, or who have family members with this kind of history.

Make sure to let your doctor know if you're using more of your medication than is prescribed. He/she can help you deal with any issues involving abuse or dependence.

Cesamet Dosage

For pain, a typical Cesamet dosage is 0.5 mg twice per day or 1 mg twice per day. Usually, a patient starts at a lower dosage and gradually increases.

Be sure to follow your doctor's dosage recommendations closely.

Cesamet Side Effects

If you experience any of these serious side effects while taking Cesamet, call your doctor right away:

  • rapid heartbeat
  • hallucinations
  • difficulty understanding reality
  • difficulty thinking clearly

If you have the following side effects, and they're severe or don't go away, you should let your doctor know:

  • headache
  • dizziness
  • unsteady gait
  • drowsiness
  • sleep problems
  • weakness
  • dry mouth
  • changes in appetite
  • nausea
  • euphoria or feeling like you're "high"
  • trouble concentrating
  • anxiety
  • confusion
  • depression

In studies, researchers report that it was rare for people to withdraw due to side effects.

Cesamet Overdose Symptoms

Overdose is possible with Cesamet. If you experience symptoms of overdose, call poison control at 1-800-222-1222. If you're with someone who's collapsed or not breathing, call 911 immediately.

Overdose symptoms include:

  • rapid heartbeat
  • dizziness or lightheadedness
  • fainting
  • hallucinations
  • anxiety
  • changes in your thinking, mood, or behavior
  • confusion
  • slow breathing
  • coma

Is Cesamet Right for You?

You and your doctor should have a conversation about Cesamet if you think it's a medication you'd like to try.

Be sure to weight the pros and cons, review your current symptoms and medications, and make an informed decision.

Sources:

Calandre EP, Rico-Villademoros F, Slim M. Expert opinion on pharmacotherapy. 2015 Jun;16(9):1347-68. An update on pharmacotherapy for the treatment of fibromyalgia.

Fitzcharles MA, et al. Schmerz. 2016 Feb;30(1):47-61. Efficacy, tolerability and safety of cannabinoids in chronic pain associated with rheumatic diseases (fibromyalgia syndrome, back pain, osteoarthritis, rheumatoid arthritis): A systematic review of randomized controlled trials.

Sumpton JE, Moulin DE. Handbook of clinical neurology. 2014;119:513-27. Fibromyalgia.

Tsang CC, Giudice MG. Pharmacotherapy. 2016 Mar;36(3):273-86. Nabilone for the Management of Pain.

Ware MA, et al. Anesthesia and analgesia. 2010 Feb 1;110(2):604-10. The effects of nabilone on sleep in fibromyalgia: results of a randomized controlled trial.

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