Abstract
Cannabinoids analgesia is expressed in the brain, in the spinal cord and on the peripheral levels. In the analgesic effect of the cannabinoids the both receptors CB 1 and CB 2 are in volved.
Cannabinoids are not primary transmitters, but modulate their activity at different synapses. Their effect of cannabinoids is on inflamatory and in particular on neuropathic pain.
It concerns the traumatic neuropathy, neuropathy in herpes zoster, diabetic neuropathy, HIV neuropathy and neuropathic pain during chemotherapy. It also influence pain in multiple sclerosis.
The disadvantage of long-term cannabinoids use is the ability to induce psychosis and schizophrenia. Cannabinoids are very psychoactive and sometimes this effect is more important than analgesic effect.
Cannabinoids is not completely effective in acute pain. We must recognised the fact that cannabinoids release substance P in the spinal cord, and inhibit the release of GABA and opioids on primary afferent terminals.
This can explain their pronociceptive effect. Synthetic cannabinoids is Nabilon (Canada, USA and Great Britain) in Mexico is Cesamed.
Nabilon is used as adjuvant therapy for chronic pain and even fibromyalgia. It is very good for pain control in central spasticity and helps even in nightmares.
It is possible to conclude that cannabinoids represent a very good adjuvant therapy for chronic pain conditions with a significant psychological effect.