Chronic Pain and Comorbid Emotional Disorders: Neural Circuitry and Neuroimmunity Pathways

International Journal of Molecular Sciences, Год журнала: 2025, Номер 26(2), С. 436 - 436

Опубликована: Янв. 7, 2025

Chronic pain is a multidimensional experience that not only involves persistent nociception but also frequently accompanied by significant emotional disorders, such as anxiety and depression, which complicate its management amplify impact. This review provides an in-depth exploration of the neurobiological mechanisms underlying comorbidity chronic disturbances. Key areas focus include dysregulation major neurotransmitter systems (serotonin, gamma-aminobutyric acid, glutamate) resulting functional remodeling critical neural circuits implicated in processing, regulation, reward. Given contribution neuroimmune to chronicity mood we further conducted investigation into role factors, including resident immune cells, infiltrating release inflammatory mediators. discusses current therapeutic strategies, encompassing pharmacological interventions, neuromodulation, integrative approaches, emphasizes necessity targeted treatments address both components. Finally, it identifies gaps understanding outlines future research directions aimed at elucidating complex interplay between thereby laying foundation for more effective holistic treatment paradigms.

Язык: Английский

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The Use of Compounds Derived from Cannabis sativa in the Treatment of Epilepsy, Painful Conditions, and Neuropsychiatric and Neurodegenerative Disorders

International Journal of Molecular Sciences, Год журнала: 2024, Номер 25(11), С. 5749 - 5749

Опубликована: Май 25, 2024

Neurological disorders present a wide range of symptoms and challenges in diagnosis treatment. Cannabis sativa, with its diverse chemical composition, offers potential therapeutic benefits due to anticonvulsive, analgesic, anti-inflammatory, neuroprotective properties. Beyond cannabinoids, cannabis contains terpenes polyphenols, which synergistically enhance pharmacological effects. Various administration routes, including vaporization, oral ingestion, sublingual, rectal, provide flexibility treatment delivery. This review shows the efficacy managing neurological such as epilepsy, neurodegenerative diseases, neurodevelopmental disorders, psychiatric painful pathologies. Drawing from surveys, patient studies, clinical trials, it highlights alleviating symptoms, slowing disease progression, improving overall quality life for patients. Understanding mechanisms can open up possibilities using this plant individual needs.

Язык: Английский

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Is Fibromyalgia a Fashionable Diagnosis or a Medical Mystery?

Cureus, Год журнала: 2023, Номер unknown

Опубликована: Сен. 7, 2023

Despite its prevalence, there is no clear-cut diagnostic path or treatment paradigm for fibromyalgia; this can lead to a multiplicity of symptoms and comorbid conditions that complicate care. "Overlapping symptoms" describe occur concomitantly with fibromyalgia include migraine, irritable bowel syndrome, obesity, pelvic pain syndromes. A variety pharmacologic nonpharmacologic treatments are available fibromyalgia, but best personalized an individual recognizes potential comorbidities. Opioids not the recommended front-line treatment, cannabinoids hold promise limitations options, such as aerobic resistance exercise cognitive behavior therapy, play very important often underestimated role. Amitriptyline appears be safe effective in treating six main domains: pain, disturbed sleep, fatigue, affective symptoms, functional limitations, impaired cognition ("fibro fog"). Very low-dose naltrexone (2.5-4.5 mg) may offer analgesic anti-inflammatory benefits patients, further studies needed. Fibromyalgia devastating debilitating condition clinicians challenged diagnosis well. Further research well compassionate approaches offering care those required.

Язык: Английский

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Biphasic effects of cannabis and cannabinoid therapy on pain severity, anxiety, and sleep disturbance: a scoping review

Pain Medicine, Год журнала: 2024, Номер 25(6), С. 387 - 399

Опубликована: Янв. 24, 2024

Abstract Introduction Cannabinoids are being used by patients to help with chronic pain management and address the 2 primary comorbidities of anxiety sleep disturbance. It is necessary understand biphasic effects cannabinoids improve treatment this symptom triad. Methods A scoping review was conducted identify whether on severity, anxiolysis, disturbance have been reported. The search included Embase, Biosis, Medline databases clinical literature published between 1970 2021. inclusion criteria were (1) adults more than 18 years age, (2) data or discussion dose associated U-shaped linear responses, (3) measurements and/or Data extracted independent reviewers (with a third reviewer as tiebreaker) subjected thematic analysis. Results After database study eligibility assessment, 44 publications met final for review. Eighteen that specifically provided information response in synthesis: 9 related outcomes, 7 measuring anxiety, reporting effects. Conclusions This reports pain, sleep, anxiety. Dose–response relationships present, but we found gaps current regard humans. There lack prospective research humans exploring specific relationship.

Язык: Английский

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Oral cannabidiol (CBD) as add-on to paracetamol for painful chronic osteoarthritis of the knee: a randomized, double-blind, placebo-controlled clinical trial

The Lancet Regional Health - Europe, Год журнала: 2023, Номер 35, С. 100777 - 100777

Опубликована: Ноя. 10, 2023

Painful knee osteoarthritis (KOA) is common, pharmacological treatment, however, often hampered by limited tolerability. Cannabidiol, which preclinically showed anti-inflammatory, analgesic activity, could supplement established analgesics, but robust clinical trials are lacking. The aim of our study was to investigate the effects oral high-dose CBD administered over 8 weeks on pain, function and patient global assessment as an add-on continued paracetamol in chronic symptomatic KOA.Prospective, randomized, placebo-controlled, double-blind, parallel-group study. Single center, Outpatient Clinic, Department Special Anaesthesia Pain Therapy at Medical University Vienna, Austria. Eligibility criteria included: age: 18-98 years; painful KOA; score ≥5 pain subscale Western Ontario McMasters Universities Osteoarthritis (WOMAC) Index; KOA confirmed imaging. Participants were dosage 3 g/d randomly assigned web-based software 1:1 cannabidiol 600 mg/d (n = 43) or placebo 43). Study period: weeks. Primary outcome: Change WOMAC scores (0 no 10 worst possible pain) from baseline week treatment. Trial Registration: ClinicalTrials.gov Identifier: NCT04607603. completed.The trial conducted October 1, 2020 March 29, 2022. 159 patients screened, 86 randomized. Among participants (mean age, 62.8 [SD 20.3] 60 females [69.8%]), 58 (67.4%) completed trial. Mean 6.0 ± 1.1. Analysis: Intention-to-treat principal. reduction 2.5 (95% CI: 1.8-3.3) group 2.4 1.7-3.2) with significant difference (p 0.80). Adverse events significantly more frequent (cannabidiol: 135 [56%]; placebo: 105 [44%]) 0.008). Rise above liver aminotransferases gamma-glutamyltransferase common 15) than 5) 0.02).In patients, had additional effect compared adding paracetamol. Our results do not support use KOA.Trigal Pharma GmbH.

Язык: Английский

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A survey of cost, access and outcomes for cannabinoid‐based medicinal product use by Australians with endometriosis

Australian and New Zealand Journal of Obstetrics and Gynaecology, Год журнала: 2024, Номер 64(4), С. 411 - 415

Опубликована: Фев. 28, 2024

People with endometriosis use cannabis to manage their symptoms. This study aimed identify costs, modes of administration, product composition, and self‐reported effectiveness for those accessing medicinal in Australia. There were 192 survey responses analysed. Most (63.5%) used a ‘cannabis clinic’ doctor, incurring an initial consultation cost $100–$200+ (10.2% Medicare bulk‐billed) median cannabinoid medicine costs $300AUD per month. Cost was major barrier access, necessitating reducing dosage (76.1%) and/or consuming illicit (42.9%), despite prescription. (77%) medical consumers two or more products, delta‐9‐tetrahydrocannabinol predominant oil flower products most frequently prescribed.

Язык: Английский

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Exploring the therapeutic potential of cannabinoids in cancer by modulating signaling pathways and addressing clinical challenges

Discover Oncology, Год журнала: 2024, Номер 15(1)

Опубликована: Сен. 27, 2024

Язык: Английский

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The Complex Interplay of Prescription Drug Monitoring Programs, Regulated Medical Cannabis, and Chronic Pain Healthcare Visits

Journal of General Internal Medicine, Год журнала: 2025, Номер unknown

Опубликована: Янв. 2, 2025

Язык: Английский

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Reducing medical cannabis use risk among Veterans: A descriptive study

Harm Reduction Journal, Год журнала: 2025, Номер 22(1)

Опубликована: Янв. 15, 2025

Canadian Veterans experiencing chronic pain report concerns about accessing accurate information on the risks associated with medical cannabis (MC) use. The Lower Risk Cannabis Use Guidelines (LRCUG) were developed to equip individuals who use recreationally safer-use strategies. Many of harm reduction recommendations for recreational are relevant and important considerations MC primary objective our study was assess Veterans' awareness interest in LRCUG, engagement potential higher-risk behaviours. Armed Forces living (N = 582) recruited online through Chronic Pain Centre Excellence Veterans. Participants completed measures on: (never, past, current use), sources knowledge, mental health, receiving LRCUG. Chi-Square post-hoc analyses characterized sample assessed demographic differences based status Engagement behaviours aligned LRCUG recommendations, detailed descriptively. currently more likely be unemployed (z 3.62, p < .01), released as a Non-Commissioned Officer -3.83, unable work due disability -3.43, .01) than do not Less 30% aware greater among (n 356). that contradicted ranged from ~ 9% 85%. Approximately experienced co-morbid health concerns, yet their purposes (LRCUG recommendation #7). Additionally, almost 85% engaged daily #5). majority two or (60.2%; #12). Almost half all received healthcare provider internet. Our suggests importance safer guidelines tailored Development lower-risk can support prescribing practitioners needed better-informed decisions, patients' needs circumstances.

Язык: Английский

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Feasibility pilot of a novel coaching intervention to optimize cannabis use for chronic pain management among Veterans

Journal of Cannabis Research, Год журнала: 2025, Номер 7(1)

Опубликована: Янв. 25, 2025

Abstract Introduction Chronic pain is common among Veterans, some of whom use cannabis for pain. We conducted a feasibility pilot study novel coaching intervention to help Veterans optimize medical products management (NCT06320470). Methods The drew from scientific literature, consultation with experts, Veteran input via Community Advisory Board, and tenets motivational interviewing. Participants were chronic who endorsed current or interest in using management. received up 4 individual sessions videoconference, spaced approximately 2 weeks apart. assessed (adherence, satisfaction, acceptability) preliminary effects on symptoms 14 after baseline. primary outcome was the Patient Global Impression Change (PGIC), exploratory outcomes included domains Patient-Reported Outcomes Measurement Information System (PROMIS)-29. Results Of 22 enrolled participants, 17 attended sessions, 3 sessions. Among those completed end surveys (16/21), 87.5% very completely satisfied 81.3% rated as extremely helpful. All participants reported improvement PGIC, 63% reporting much improvement. statistically significant decreased intensity (7.1/10 vs. 5.7/10) interference (T-score 66.3 61.8), increased social satisfaction 41.4 44.3). noted helpful factors, including co-developing personalized plan, discussing questions/concerns, trying different approaches cannabis-based treatment. Conclusions In this clinically improvements symptoms. Our results support evaluating larger, efficacy trial.

Язык: Английский

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