Abstract
Objective: To report the effects of Cannabidiol (CBD) on pain and other symptoms in patients with fibromyalgia. Literature review: CBD is a phytocannabinoid used in the treatment of various conditions, including fibromyalgia. It interacts with the endocannabinoid system through CB1 and CB2 receptors and modulates the activity of other ligands and receptors. These, when activated by CBD, become desensitized, which ultimately reduces the perception of pain. CBD also interacts with other systems, affecting the inflammatory response. Patients with fibromyalgia report widespread intense pain, which can also be influenced by metacognitions. CBD, as an alternative treatment for this condition, can modulate pain perception and reduce depressive symptoms in these patients, improving their quality of life and offering other long-term benefits. Final considerations: The therapeutic potential of CBD in treating fibromyalgia is evidenced by its ability to interact with the endocannabinoid system and other molecular mechanisms in the human brain, inhibiting pain symptoms. Thus, CBD emerges as a safe alternative with few side effects for treating fibromyalgia, encouraging the optimization of its use in this patient profile.
References
ALVAREZ MC, et al. Exploring the relationship between fibromyalgia-related fatigue, physical activity, and quality of life. Int J Environ Res Public Health, 2022; 19(8): 4870.
ARNOLD LM, et al. Gabapentin in the treatment of fibromyalgia: a randomized, double-blind, placebo-controlled, multicenter trial. Arthritis Rheum. 2007; 56(4): 1336-44.
ASSIS MR, et al. Treatment data from the Brazilian fibromyalgia registry (EpiFibro). Adv Rheumatol, 2020; 60(1): 9.
BARROS S, et al. Manejo Clínico da Fibromialgia: Terapias Farmacológicas e Não Farmacológicas para Alívio dos Sintomas. Braz. J. Implantol. Health Sci. 2023; 5(5): 5665-80.
BERARDI G, et al. Dor localizada e fadiga durante a recuperação de exercícios de resistência submáxima em pessoas com fibromialgia. Fisioterapia, 2023; 103(6).
BERGER AA, et al. Cannabis and cannabidiol (CBD) for the treatment of fibromyalgia. Best Pract Res Clin Anaesthesiol, 2020; 34(3): 617-631.
BOEHNKE KF, et al. Cannabidiol use for fibromyalgia: prevalence of use and perceptions of effectiveness in a large online survey. J Pain, 2021; 22(5): 556-566.
BOEHNKE KF, et al. Substituting cannabidiol for opioids and pain medications among individuals with fibromyalgia: a large online survey. J Pain, 2021; 22(11): 1418-1428.
CHAVES C, et al. Ingestion of a THC-rich cannabis oil in people with fibromyalgia: a randomized, double-blind, placebo-controlled clinical trial. Pain Med, 2020; 21(10): 2212-2218.
CRISTANCHO MM, et al. Chronic Pain Management in General and Hospital Practice. Singapura: Springer, 2020.
DONK T, et al. An experimental randomized study on the analgesic effects of pharmaceutical-grade cannabis in chronic pain patients with fibromyalgia. Pain, 2019; 160(4): 860-869.
FRIEDRICH JV, et al. Fibromialgia: importância do conhecimento da doença e seus tratamentos. Fag Journal Of Health, 2020; 2(2): 307-314.
GALVEZ-SÁNCHEZ CM e PASO GARD. Diagnostic criteria for fibromyalgia: critical review and future perspectives. J. Clin. Med, 2020; 9(4): 1219.
GIORGI V, et al. Adding medical cannabis to standard analgesic treatment for fibromyalgia: a prospective observational study. Clin Exp Rheumatol, 2020; 38(123): 53-59.
HÄUSER W, et al. Non‐pharmacological interventions for fibromyalgia (fibromyalgia syndrome) in adults: an overview of Cochrane Reviews. The Cochrane Database of Systematic Reviews, 2022; 1.
JOHN AWS, et al. Fibromyalgia: A clinical update. Nurse Pract, 2022; 47(4): 20-30.
LEDERMAN S, et al. Efficacy and Safety of Sublingual Cyclobenzaprine for the Treatment of Fibromyalgia: Results From a Randomized, Double‐Blind, Placebo‐Controlled Trial. Arthritis Care Res (Hoboken), 2023; 75(11): 2359-2368.
MERANTE D e PATEL S. Fibromyalgia: an urgent need for harmonized, global, and patient-centric regulatory guidance for developing medications for the treatment of pain and associated symptoms. Pain Med, 2019; 2074-2077.
MIGLIORINI F, et al. Pharmacological management of fibromyalgia: a Bayesian network meta-analysis. Expert Rev. Clin. Pharmacol, 2022; 15(2): 205-214.
NAYA N, et al. Molecular and cellular mechanisms of action of cannabidiol. Molecules, 2023; 28(16): 5980.
OŻAROWSKI M, et al. Cannabidiol in neurological and neoplastic diseases: Latest developments on the molecular mechanism of action. Int J Mol Sci, 2021; 22(9): 4294.
QIN Z, et al. Analysis of the analgesic effects of tricyclic antidepressants on neuropathic pain, diabetic neuropathic pain, and fibromyalgia in rat models. Saudi J. Biol. Sci, 2020; 27(9): 2485-2490.
ROSSI A, et al. Fluoxetine: a review on evidence-based medicine. Ann Gen Hosp Psychiatry, 2004; 123(1): 2.
SIMÃO VP, et al. The clinical use of cannabinoids for pain. World Journal of Advanced Research and Reviews, 2024; 21(03): 1295–1302.
SOCIEDADE BRASILEIRA DE REUMATOLOGIA. Fibromialgia. 2022. In: Site eletrônico – Sociedade Brasileira de Fibromialgia. Brasília. Disponível em: https ://www.reumatologia.org.br/doencas-reumaticas/fibromialgia-e-doencas-articulares-inflamatorias/. Acesso em: 02 jul. 2024.
SOUZA JB e PERISSINOTTI DMN. The prevalence of fibromyalgia in Brazil–a population-based study with secondary data of the study on chronic pain prevalence in Brazil. BrJP, 2018; 345-348.
TENTI M, et al. The relationship between metacognition, anger, and pain intensity among fibromyalgia patients: A serial mediation model. Psychol Health Med, 2024; 29(4): 791-808.
ÚBEDA-D’OCASAR E, et al. Pain intensity and sensory perception of tender points in female patients with fibromyalgia: A pilot study. Int J Environ Res Public Health, 2021; 18(4): 1461.
WANG X, et al. An overview on synthetic and biological activities of cannabidiol (CBD) and its derivatives. Bioorg Chem, 2023; 140: 106810.
WOLFE F e JOHANNES J. Rasker. The evolution of fibromyalgia, its concepts, and criteria. Cureus, 2021; 13(11): 20010.
YASSIN M, et al. Efeito da adição de cannabis medicinal ao tratamento analgésico em pacientes com dor lombar relacionada à fibromialgia: um estudo observacional cruzado de centro único. Clin Exp Rheumatol, 2019; 37(116): 13-20.
