Cannabis Use in Fibromyalgia

Fibromyalgia is a chronic disorder characterized by widespread pain and tenderness, often accompanied by fatigue, memory problems, and sleep disturbances. Therapy includes both nonpharmacological (education, cognitive behavioral therapy, and exercise) and pharmacological treatment (including medicines as pregabalin, duloxetine, milnacipran, amitriptyline, serotonin selective reuptake inhibitors, and cyclobenzaprine). A number of surveys have reported that cannabis products are frequently used in patients with fibromyalgia. Results showed that most of the patients who tried medical marijuana found it to be effective or very effective for the therapy of some symptoms of this condition. Significant relief of pain and stiffness has been reported after cannabis self-administration. The efficacy and tolerability of oral nabilone for the treatment of pain and sleep difficulty have been established in some noncontrolled studies and two randomized-controlled clinical trials. Nabilone significantly reduced pain and improved quality of life in comparison to placebo. Nabilone was more effective than amitriptyline in improving sleep in fibromyalgia. More studies are needed to evaluate the efficacy and safety of cannabinoids in fibromyalgia.