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cbd spray review

Cbd spray review

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Shake well before use. Spray directly under your tongue, and hold the oil for at least 90 seconds, until fully absorbed. We recommend starting with a total of 7 sprays per day, spread over 2-3 doses. For example, 3 sprays in the morning, 2 midday and 2 in the evening. One bottle of Full Spectrum CBD Oral Spray should last you 30 days if youre following the recommended use.

Raw Organic MCT Oil (Coconut), hemp extract, natural flavouring

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Shake well before use. Spray directly under your tongue, and hold the oil for at least 90 seconds, until fully absorbed. We recommend starting with a total of 7 sprays per day, spread over 2-3 doses. For example, 3 sprays in the morning, 2 midday and 2 in the evening. One bottle of Full Spectrum CBD Oral Spray should last you 30 days if youre following the recommended use.

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What it says on the tin

This is my savior! I stopped taking antidepressants in the spring and have had very serious (but fortunately relieving) withdrawal symptoms ever since. This brings some relief to my symptoms: very strong anxiety, muscle pain, nausea, dizziness, limb numbness, headache. I tried other CBD products, but this is the best.

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Cbd spray review

THC:CBD oromucosal spray (nabiximols), a cannabis-derived medicine approved for symptomatic relief of MS-related spasticity, has also been investigated as an add-on treatment for pain. Results of placebo-controlled clinical trials of THC:CBD oromucosal spray (nabiximols) in chronic cancer-related pain were equivocal. The analgesic efficacy of THC:CBD oromucosal spray (nabiximols) was more apparent in placebo-controlled clinical trials of chronic neuropathic pain, particularly MS-associated neuropathic pain, with some patients maintaining long-term (up to 2 years) benefit. A German Pain e-Registry analysis of patients with severe chronic pain treated in daily practice with THC:CBD oromucosal spray (nabiximols) showed best results in the neuropathic pain subgroup versus nociceptive or mixed pain subgroups. Across all reviewed studies in patients with chronic cancer-related or nonmalignant pain, no new safety concerns were identified with THC:CBD oromucosal spray (nabiximols) and there was no evidence of tolerance during extended use.

Abbreviation: NRS, numerical rating scale.

A retrospective analysis of anonymized data collected in a large German Pain e-Registry has provided insight into the real-world management of severe chronic pain with THC:CBD oromucosal spray (nabiximols). 101 Among 30,228 patients prospectively registered in the German Pain e-Registry within 2017, 800 (2.6%) had received THC:CBD oromucosal spray (nabiximols) as an add-on therapy for pain relief. Prescribing of THC:CBD spray followed a change to German regulations permitting the use of cannabinoid preparations independently of their labels or even in the absence of a label in patients with resistant chronic pain conditions who fail previous management options. The main underlying chronic pain conditions in these patients were lower back pain (234 patients; 29.3%), failed back surgery syndrome (n = 148; 18.5%) and shoulder/neck pain (n = 91; 11.4%). Pain phenotype (nociceptive, mixed, neuropathic) was evaluated using the painDETECT questionnaire (PDQ7). 102 , 103 Most patients were taking analgesic opioids (86.5% strong, 16.1% mild) at baseline.

The results of studies of THC:CBD spray (nabiximols) in patients with neuropathic pain of origins other than MS are mixed ( Table 2 ). 92 – 98

Conclusions

Randomized clinical trials of THC:CBD oromucosal spray (nabiximols) for the treatment of chronic neuropathic pain conditions are summarized in Table 2 . 87 – 90 , 92 – 98

Other phytocannabinoids containing multiple different cannabinoids (eg Bedrocan ® ) have yet to undergo clinical trial development or receive approval for a first official indication. A plant-derived medicine containing single purified CBD (cannabidiol oral solution, Epidiolex ® ) was recently approved by the US Food and Drug Administration and European Medicines Agency for treatment of the rare epileptic syndromes, Lennox–Gastaut and Dravet. 67 , 68 Dronabinol (Marinol ® , Syndros ® ) is a synthetic THC indicated for treatment of anorexia associated with weight loss in patients with AIDS, and treatment of severe refractory nausea and vomiting associated with cancer chemotherapy. 69 , 70 Nabilone (Cesamet ® , Canemes ® ) is a THC analog indicated for treatment of severe refractory nausea and vomiting associated with cancer chemotherapy. 71

The results of placebo-controlled clinical trials of THC:CBD oromucosal spray (nabiximols) in chronic cancer-related pain have been variable. Efficacy was demonstrated in two studies. In a clinical trial involving patients (n = 177) with intractable cancer-related pain, mean pain 0–10 NRS scores were significantly improved after 2 weeks’ treatment with active medication compared with placebo (change from baseline: –1.37 vs –0.69; p = 0.014). About twice as many patients treated with THC:CBD (nabiximols) than placebo (43% vs 21%) achieved a clinically meaningful ≥30% reduction from baseline in pain 0–10 NRS scores. Treatment-related adverse events were mostly mild or moderate and similar to the known safety profile of THC:CBD spray (nabiximols) in MS spasticity, namely somnolence, dizziness and nausea. 83 A subsequent open-label extension study involving 39 patients who had received THC:CBD spray in the parent study showed that extended use (median 25 days, range 2–579 days) was generally well tolerated. Patients did not seek to increase their dose of THC:CBD spray (nabiximols) or other pain-relieving medication during extended use. The mean dose during the last 7 days of dosing (5.4 sprays/day) was lower than the mean dose (8.75 sprays/day) in the first weeks of the parent study. 84 In another placebo-controlled trial of THC:CBD oromucosal spray (nabiximols) in patients with opioid-refractory cancer pain (n = 360), the primary outcome (30% responder rate) after 5 weeks’ treatment was not met (p = 0.59), although patient-reported analgesia rates were significantly higher with active medication than placebo (p = 0.035). A dose-grading analysis indicated that analgesia rates were significantly higher with low-dose (1–4 sprays/day; p = 0.008) and medium-dose (6–10 sprays/day; p = 0.039) THC:CBD spray (nabiximols) than placebo. Adverse events compared unfavorably with placebo only in the high-dose group. 85

Treatment of Multiple Sclerosis Spasticity

Pain intensity measured on a 0–100 VAS (from 0 = no pain; to 100 = worst pain conceivable) improved by at least 50% in 67.5% of patients after 12 weeks’ treatment with THC:CBD oromucosal spray (nabiximols). Aggregated nine-factor symptom relief (ASR-9), a composite score that summarizes the outputs of nine pain evolution efficacy endpoints measured using validated instruments, was increased by 39% from baseline. Overall, 15.4% of patients (n = 123) showed at least 50% improvement in all nine factors, and 56.0% of patients (n = 488) showed at least 50% improvement in ≥ five ASR-9 factors. Other symptoms with relief rates ≥50% were stress (78.8%), depression (66.5%), anxiety (57.6%) and overall well-being (61.3%) ( Figure 2 ). Outcomes in terms of ≥50% improvement in pain intensity rates and mean ASR-9 symptom relief/improvement scores were significantly greater in the neuropathic pain subgroup (94.8% and 54.9%, respectively; n = 497) versus the mixed pain (24.9% and 18.2%; n = 249) or nociceptive pain (13.6% and 11.9%; n = 54) subgroups (p < 0.001 for all comparisons). Use of concomitant opioids, both as acute (rescue) or continuous pain treatment, was reduced. During the first 12 weeks of use of THC:CBD oromucosal spray (nabiximols), 18.1% of patients discontinued treatment due to inadequate efficacy (14.1%, n = 113) or treatment-emergent adverse events (TEAEs) (4%, n = 32). In all, 206 TEAEs were reported by 159 patients (19.9%), most commonly increased appetite (6.3%) or dysgeusia (2.9%) of mild intensity. This safety profile differs from that observed in other large-scale observational studies of THC:CBD oromucosal spray (nabiximols) in patients with MS spasticity in which the most common adverse events (at mean doses of 6–7 sprays/day) were dizziness, fatigue and drowsiness. 104 , 105

The main limitations of studies reviewed herein are the short duration (for a chronic condition), heterogenous patient populations and lack of active comparators. Although the data set for THC:CBD oromucosal spray (nabiximols) in chronic pain includes two extension studies, only limited numbers of patients received treatment long term.