When should higher-dose transdermal fentanyl be considered in patients with cancer pain associated with chronic pain syndrome (CPS), and what pain-reducing effect does tetrahydrocannabinol have on the brain?

Updated: Jan 14, 2020
  • Author: Manish K Singh, MD; Chief Editor: Stephen Kishner, MD, MHA  more...
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A 2011 study determined that predictive factors for switching to higher-dose transdermal fentanyl in patients with cancer pain who were previously taking either oral morphine or oxycodone were breast cancer, total protein value, alanine aminotransferase value, older age, and male sex. [41]

A small randomized, double-blind, placebo-controlled trial by Weizman et al on the use of tetrahydrocannabinol (THC, the psychoactive component of cannabis) in the treatment of chronic neuropathic pain suggested that the agent induces pain reduction by decreasing functional connectivity between the anterior cingulate cortex and the sensorimotor cortex. [42, 43]

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