While there is increasing evidence that whole-plant medicine may be more effective for many patients than synthetic cannabinoid due to the 'entourage effect' of various plant constituents working in concert, clinical research into synthetic cannabinoids can also be very helpful in understanding the therapeutic effect of cannabis.
Nabilone is a synthetic cannabinoid that was approved for use by Health Canada in 1982 for the treatment of chemotherapy-induced nausea. Over the years, several randomized controlled studies have shown cannabinoids, including nabilone, to be effective in the treatment of chronic pain.(3,4). More recently, in an open study of 47 patients, Fraser (5) found nabilone to be of benefit in the treatment of nightmares in posttraumatic stress disorder (PTSD). Fraser also noted in this study that nabilone increased sleep time and was not associated with the development of tolerance.
Aside from reducing the risks of undesired drug interactions that often happens when multiple medications are used at the same time, nabilone also reduces treatment costs and improves the likelihood that patients will regularly take their prescribed medication, resulting in improved health outcomes. Little evidence has been found anywhere for nabilone abuse, including in Canada where it has been available for over 30 years. (2)
Medical marijuana patients consistently report that nabilone has a therapeutic effect on the body rather than a "high" effect on the mind.
Sleep Improvements, Nightmare Reduction
As you can see in the graph below, average sleep time for the 104 male inmate patients increased by over 40%, from 5 hours to just over 7 hours per night and the number of nightmares per night were dramatically reduced, by more than 80%, from just over five to less than one per night, on average, with nabilone treatment.
Potential Brain Healing
Jiang et al (6) found in research with laboratory rats that cannabinoids promote hippocampal neurogenesis (development of new nerve cells in a region of the brain) and have anxiolytic (a drug used to reduce anxiety) and antidepressant effects. Given that individuals with PTSD are known to have smaller hippocampal regions in their brains than people who do not suffer from PTSD, this study by Jiang and colleagues, suggests a potential therapeutic role for cannabinoids in the treatment of PTSD.
Chronic Pain Relief
Of the 68 men who took nabilone for chronic pain, 61 of them (89.6%) reported an improvement in their pain, typically within the first 1 to 2 weeks of treatment, and this was largely maintained for the balance of the trial. The improvement reported was seen regardless of whether the pain was of neuropathic (chronic pain resulting from injury to the brain, spinal cord or nerves), musculoskeletal, or other origin.
In this study, adverse effects from nabilone were for the most part “minor and easy to manage, and when they did occur, tended to occur early within the first month of treatment". Adverse effects were also relatively more common in individuals who had never used cannabis and occurred at relatively low doses.
Limitations To This Study
This study has several limitations that prevent drawing firm conclusions due to the retrospective design of the study and the lack of control group. Sleep, nightmares, and pain measures were less than ideal as they were entirely based on patient self-reporting. On the other hand, since the therapeutic benefits for the number of hours of sleep, nightmares, and pain were typically dramatic and occurred within just 1 to 2 weeks of starting on the nabilone drug and maintained throughout the trial period, does strongly suggest that the nabilone was largely responsible for these therapeutic benefits.
If you have used nabilone, please contact us with details about your experiences so that we can share this information with others to potentially help them too. Thank you!
(1) Cameron, C, Watson D, Robinson, J. A Synthetic Cannabinoid in a Correctional Population for Posttraumatic Stress Disorder–Related Insomnia and Use of Nightmares, Chronic Pain, Harm Reduction, and Other Indications, A Retrospective Evaluation, J Clin Psychopharmacol. Oct 2014; 34(5): 559–564, PMCID: PMC4165471,
(2) MA, St Armand E. The abuse potential of the synthetic cannabinoid nabilone. Addiction. 2010; 105 (3): 494– 503
(3) Lynch ME, Campbell F. Cannabinoids for treatment of chronic non-cancer pain: a systematic review of randomized trials. Br J Clin Pharmacol. 2011; 72 (5): 735– 744 [PMC free article] [PubMed]
(4) Burns TL, Ineck JR. Cannabinoid analgesia as a potential new therapeutic option in the treatment of chronic pain. Ann Pharmacother. 2006; 40 (2): 251– 260 [PubMed]
(5) Fraser GA. The use of a synthetic cannabinoid in the management of treatment-resistant nightmares in posttraumatic stress disorder (PTSD). CNS Neurosci Ther. 2009; 15 (1): 84– 88 [PubMed]
(6) Jiang W, Zhang Y, Xiao L, et al. Cannabinoids promote embryonic and adult hippocampal neurogenesis and produce anxiolytic and antidepressant-like effect. J Clin Invest. 2005; 115 (11): 3104– 3116 [PMC free article][PubMed]