Manejo farmacológico del dolor neuropático mediante el uso de cannabinoides. Revisión bibliográfica

Abstract

Background: Neuropathic pain is characterized by damage to the somatosensory neural axes. It usually presents as chronic; less than 50% of patients achieve significant pain relief with recommended drugs. Medical cannabis is legal in several countries worldwide. Multiple studies have shown a reasonable efficacy rate for pain relief; however, its use is still controversial. General objective: To describe the pharmacological treatment of neuropathic pain using cannabinoids. Methodology: A narrative bibliographic review was conducted, identifying articles in English and Spanish published in the last ten years from databases such as PubMed, Science Direct, and Scopus. Inclusion and exclusion criteria were limited, obtaining a total of 47 studies. Results: Inhaled cannabinoids improve neuropathic pain by approximately 30%. The lowest dose of tetrahydrocannabinol was 0.5mg, which did not significantly change pain scales. The maximum dose was 28mg, with significant changes in pain scales. The most common adverse events are somnolence, "feeling stoned," cough, nausea, and euphoria, directly related to the dose used. Conclusion: Using of cannabinoids as a pharmacological treatment requires substantial evidence of safety in long-term use. It may be recommended to use this principle as a rescue in exacerbated episodes as long as the regulatory laws of the country or state permit its use.