Fibromyalgia, Chronic Fatigue Syndrome/Myalgic Encephalomyelitis
Fibromyalgia
Fibromyalgia/CFS/ME are complex medical conditions that can lead to significant levels of dysfunction and can be extremely difficult to manage.
Fibromyalgia is a common condition where people experience widespread generalised pain and tenderness throughout their bodies. Symptoms are often associated with significant fatigue, memory and concentration problems, sleep disturbance and brain fog. Symptoms are usually different for each individual, can be more pronounced in the context of psychosocial stressors, and can be extremely difficult to treat.
The gold standard treatments for Fibromyalgia are multidisciplinary management options that include a graded return to exercise, optimisation of physical activity and diet, sleep hygiene and psychological strategies. Medications used to treat fibromyalgia include antiinflammatories and paracetamol, antidepressants (such as SSRIs), neuropathic agents such as Amitriptyline or Lyrica, and opiate medications such as Endone or Oxycontin.
Traditional medications used for the treatment of Fibromyalgia can result in exacerbation of symptoms, such as neuropathic agents causing drowsiness and cognitive changes, or can be significant addictive, such as opiate medications like Endone.
Medicinal cannabis has gained increased traction for the management of Fibromyalgia and is often used both at day time and at night time. Medicinal cannabis is utilised mainly on an ‘as-needed’ basis, with people often needing it multiple times throughout the day.
The main benefits of medicinal cannabis for fibromyalgia are that it is not addictive like Opiates, so people can cease taking it whenever they like, it does not require titration up to higher doses, like Amitriptyline or Lyrica, and it does not lead to stomach upset, gastritis and peptic ulcers like regular anti-inflammatory use can. Many people have significantly improved sleep, function, pain and cognition with medicinal cannabis treatment of fibromyalgia.
Chronic Fatigue Syndrome/Myalgic Encephalomyelitis
CFS/ME is a debilitating complex illness that causes significant levels of dysfunction through overwhelming fatigue. CFS/ME symptoms often get worse after minimal exertion, whether physical of mental and is related to symptoms of poor concentration and memory, pain and dizziness. At least 1 in 4 people with CFS/ME have spent a large amount of time confined to bed.
There is no single identifiable cause of CFS/ME as yet, although post viral and immune system/inflammatory causes remain at the top of the list. The general consensus is that CFS/ME is likely from complex multifactorial causation.
There is no cure for CFS/ME, with most approaches aimed at symptomatic management and functional improvement. The multidisciplinary treatment gives the best outcomes, with a graded return to exercise, diet optimisation, sleep and psychological strategies. Medications include anti-inflammatories, antidepressants (such as SSRIs), and neuropathic agents such as Amitriptyline and Lyrica.
Medicinal cannabis is becoming an increasingly common treatment modality for people who have optimised other aspects of their life, such as exercise and diet, and is used during flares of CFS/ME symptoms. Medicinal cannabis likely helps multiple aspects of CFS/ME, including sleep, stress and anxiety, pain and appetite. Medicinal cannabis is used on an as-needed basis and should work immediately. Medicinal cannabis can also be immediately ceased if unwanted side effects are identified.
Cannabinoid Receptors
Cannabinoid receptors are located throughout the body, including the peripheral and central nervous systems, the immune system and various organs, they are also found in the pelvis, gut lining and endometrium.
Cannabinoid receptor activity can suppress the inflammatory response associated with chronic pain syndromes; it can also relieve complex and established chronic pain pathways. Cannabinoid receptors can also positively impact other symptoms, such as bowel dysfunction, sleep disturbance, anxiety and mood changes.
CBD (Medicinal Cannabis) vs THC (Illicit Cannabis)
One of the main differences between medicinal cannabis and illicit cannabis is that the dose of CBD and THC is controlled and administered to maximise symptom management while minimising perceptual or cognitive changes. Expert prescribers like our experienced doctors can help patients get the best effects with minimal disruption to their day and function.
To access a prescription, make an appointment through our Cannabis Clinic to see one of our Authorised Prescribing Doctors.